Minocycline-induced scleral pigmentation

Ophthalmology. 1997 Jun;104(6):936-8. doi: 10.1016/s0161-6420(97)30204-8.


Purpose: Minocycline is a commonly used drug in the management of acne and rosacea. Four individual cases of oral minocycline-induced scleral pigmentation are reported in the dermatologic literature. This is the first report in the ophthalmic literature and will add three new cases of probable minocycline-induced scleral pigmentation.

Materials and methods: Data on minocycline from the spontaneous reporting systems of the National Registry of Drug-Induced Ocular Side Effects, Food and Drug Administration, World Health Organization, and Lederle Laboratories were reviewed as to minocycline-related scleral pigmentation. Photographs, published cases, discussions with the examining ophthalmologists, and the personal observation of one patient (case 1) are the basis of the authors' conclusions.

Results: Seven cases of probable oral minocycline-induced scleral pigmentation are presented. These changes may or may not be associated with minocycline-induced pigmentary changes in other tissues, such as the skin, teeth, fingernails, bone, thyroid, or mucosa. The characteristic scleral pattern is a blue-gray 3- to 5-mm band starting at the limbus, which usually is enhanced in the palpebral aperture, possible due to the photosensitizing properties of the drug.

Conclusions: Oral minocycline can cause scleral pigmentation. This pigmentation may resolve within years, or it may be permanent.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minocycline / adverse effects*
  • Mouth Mucosa / drug effects
  • Mouth Mucosa / pathology
  • Pigmentation Disorders / chemically induced*
  • Pigmentation Disorders / pathology
  • Scleral Diseases / chemically induced*
  • Scleral Diseases / pathology
  • Skin / drug effects
  • Skin / pathology
  • Tooth / drug effects
  • Tooth / pathology


  • Anti-Bacterial Agents
  • Minocycline