Doxycycline-Associated Hyperpigmentation: A Case Report and Literature Review

Drug-induced hyperpigmentation is an adverse cutaneous effect; it has been associated with several systemic medications. A healthy 40-year-old man developed facial and dorsal hand hyperpigmentation within two weeks of beginning doxycycline monohydrate 100 milligrams twice daily for acne. Skin pigmentation significantly diminished at a follow-up evaluation two months after discontinuing the medication. Doxycycline-associated skin hyperpigmentation, albeit uncommon, has been described in 18 patients in the literature, including our patient. The demographics included 13 males and five females ranging in age from 11 to 87 years; eight of the patients were less than 50 years old and ten of the patients were over 60 years old. Doxycycline-associated hyperpigmentation frequently occurs on the face and can occur at the site of a previous scar. In most cases, doxycycline was discontinued with the resolution of hyperpigmentation.