T. Barrett, S. de Zwaan
Background: Minocycline is an effective and commonly used antibiotic in the treatment of rosacea, acne and other inﬂammatory disorders. However, occasionally its use is limited by the development of hyperpigmentation, with three different subtypes of pigmentation described. Both QSwitched Nd:YAG and Picosecond Lasers have previously been used for the treatment of minocycline-induced hyperpigmentation, however there is a paucity of studies. We compare the use of Q-Switched Nd:YAG laser (using 1064 nm and 532 nm) and picosecond alexandrite laser (755 nm) in a patient with severe type III minocycline-induced hyperpigmentation over a ten month period, with the purpose of evaluating the efﬁcacy of both treatment modalities.
Case: An 81 year old female patient, was referred for management of severe Type III minocycline hyperpigmentation, following a ﬁve year period of low dose minocycline (50 mg daily) for the management of rosacea, with a total cumulative dose of >100 g. Over a ten month period, the patient was treated with Q-Switched Nd:YAG, laser followed by picosecond alexandrite laser, with her response photographed during her treatment.
Discussion: We observed some response to ﬁve treatments with Q-Switched Nd:YAG, but a near-complete resolution in the patient’s abnormal pigmentation following treatment with four treatments with picosecond alexandrite laser.