J Clin Aesthet Dermatol. 2024;17(12):13.
Minocycline: A Patient Perspective
Dear Editor:
Since its release nearly 50 years ago, minocycline has risen in popularity to the extent of becoming a prominent tool in a dermatologist’s prescribing arsenal.1 However, as more data accumulates on this drug, clinicians should consider an often overlooked source of information: social media. Social media is often the first place many patients go to report their side effects or drug experiences, particularly on Reddit.com via “subreddits.”.2 Subreddits are discussion boards within Reddit.com dedicated to a specific topic.2
Given minocycline’s widespread usage, it is vital to examine how this drug is perceived on social media in order to understand the public’s perspective and identify any potential side effects that might be overlooked. Gaining insights from social media analytics can enhance the patient-provider relationship by allowing providers to empathize more deeply with patients and better understand their perspectives.
In our search of popular subreddits, including the “acne” subreddit and “_skincare_addiction”_ subreddit, we found numerous posts with concerning titles, such as, “Minocycline ruined my life…” and “Minocycline Dangers: This happened to my friend and acne is the least of their worries.” Numerous posts highlighted the association of minocycline with depersonalization/derealization disorder and the development of somatic symptom disorder. Interestingly, despite the existence of only one reported case study3 of this side effect, many Reddit posts and comments discuss it extensively. Additionally, we found many posts from users expressing fear of starting minocycline due to side effects they discovered, ironically, on Reddit itself. While there were also numerous posts from users who reported success with minocycline, some were hesitant to continue long-term because of warnings they found on Reddit. One user even mentioned that their doctor had approved the long-term use of minocycline, yet they sought confirmation from the subreddit community due to the widespread negative opinions.
These posts highlight a significant gap in the patient-provider relationship, especially concerning minocycline. Providers can use these insights to offer better anticipatory guidance, particularly regarding minocycline-associated mental health effects and expectations of long-term use. Dermatologists should be aware of the polarized depiction of minocycline on social media. Potential solutions to mitigate this polarization may include multidisciplinary collaboration, online patient portals, improved and more accessible education resources, and even artificial intelligence.2 Further research into minocycline’s association with mental health may be warranted, though current research suggests that minocycline does not improve depression symptoms when added to existing regimens.4
With regard,
Kripa Ahuja, MS, and Peter Lio, MD
Keywords. Minocycline, patient-provider relationship, social media, public perspective
Affiliations. Ms. Ahuja is with the Eastern Virginia Medical School in Norfolk, Virginia. Dr. Lio is with the Department of Dermatology at Northwestern University in Chicago, Illinois.
Funding. No funding was provided for this article.
Disclosures. Dr. Lio reports being on the speaker’s bureau for AbbVie, Arcutis, Eli Lilly, Galderma, Hyphens Pharma, Incyte, La Roche-Posay/L’Oreal, Pfizer, Pierre-Fabre Dermatologie, Regeneron/Sanofi Genzyme, Verrica; reports consulting/advisory boards for Alphyn Biologics (stock options), AbbVie, Almirall, Amyris, Arcutis, ASLAN, Bristol-Myers Squibb, Burt’s Bees, Castle Biosciences, Codex Labs (stock options), Concerto Biosci (stock options), Dermavant, Eli Lilly, Galderma, Janssen, LEO Pharma, Lipidor, L’Oreal, Merck, Micreos, MyOR Diagnostics, Regeneron/Sanofi Genzyme, Sibel Health, Skinfix, Suneco Technologies (stock options), Theraplex, UCB, Unilever, Verdant Scientific (stock options), Verrica, Yobee Care (stock options). In addition, Dr. Lio has a patent pending for a Theraplex product with royalties paid and is a Board member and Scientific Advisory Committee Member emeritus of the National Eczema Association.
References
- Baldwin HE, Ward DB. Fifty years of minocycline and its evolution: a dermatological perspective. J Drugs Dermatol. 2021;20(10):1031–1036.
- Ahuja K, DeSena G, Lio P. Analysis of reddit reveals jak inhibitor questions among atopic dermatitis patients. J Drugs Dermatol. 2024;23(4):e121–e123.
- Shamout Y, Sigal A, Litvinov IV. Minocycline-induced transient depersonalization: a case report. SAGE Open Med Case Rep. 2019;7:2050313X1882382.
- Hellmann-Regen J, Clemens V, Grözinger M, et al. Effect of minocycline on depressive symptoms in patients with treatment-resistant depression: a randomized clinical trial. JAMA Netw Open. 2022;5(9):e2230367.