Type 2 Minocycline-induced hyperpigmentation successfully treated with the novel 755 nm picosecond alexandrite laser - a case report

Laser Ther. 2017 Jun 30;26(2):137-144. doi: 10.5978/islsm.17-CR-03.


Background and aim: Minocycline therapy for acne vulgaris is associated with the occasional induction of various types of unsightly and often persistent hyperpigmentation, which is frequently resistant to hydroquinone treatment. Pigment-specific lasers have achieved some success with multiple treatment sessions. Recently, the picosecond domain 755 nm alexandrite laser (ps-Alex) has attracted attention in tattoo removal. The present study reports on the successful treatment, in a single ps-Alex session, of minocycline-associated pigmentation.

Subject and method: Subsequent to a course of minocycline, a 28-year-old Asian female developed persistent type 2 minocycline-related pigmentation on the bilateral lower extremities which was recalcitrant to hydroquinone treatment. The patient had a test treatment on a small area with a Q-switched ruby laser and the ps-Alex, following which the ps-Alex was selected for the actual treatment (spot size, 2 mm; fluence, 6.37 J/cm2; pulsewidth, 750 ps) on one leg first, followed later by the contralateral leg.

Results: Rapid clearance of the pigmentation was noted after a single ps-Alex session on both limbs without prolonged post-inflammatory hyperpigmentation (PIH). At one year post-treatment, clearance had been maintained.

Conclusions: Our results in this single case strongly suggest that the novel 755-nm ps-Alex laser is both safe and very effective for the treatment of type 2 minocycline-induced hyperpigmentation even in PIH-prone type IV Asian skin. Further trials with larger patient populations are warranted to confirm this optimistic result.

Keywords: Asian skin; Minocycline; picosecond alexandrite laser; postinflammatory hyperpigmentation; type 2 minocycline-induced pigmentation.

Publication types

  • Case Reports