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For additional information see NHS - Lymecycline.

How does lymecycline work?

Lymecycline improves acne symptoms by reducing the number of surface skin bacteria (cutibacterium acnes). The bacteria cause infection and inflammation of blocked skin pores, which leads to acne spots and pustules. Skin gels or creams (Differin, Epiduo) to reduce pore blocking should be continued alongside taking lymecycline capsules.

It can take up to 8 weeks of treatment before acne improves.

Who is lymecycline for?

Lymecycline can be used by most people over 12 years old to treat moderate acne with blackheads, whiteheads, inflammation, infection, pustules, and cysts.

Who should not take lymecycline?

Lymecycline should not normally be taken with other antibiotics or whilst using topical acne treatments containing antibiotics, e.g. Zineryt and Duac.

Not suitable for children under 12 years, and only available from Dr Fox to over 18s.

Pregnant and breastfeeding women should NOT take lymecycline.

It is also not suitable for people with a medical history of liver or kidney disease, systemic lupus erythematosus, or myasthenia gravis.

Do not take lymecycline if also taking Roaccutane (isotretinoin) or lithium.

Do not take lymecycline if there is known sensitivity to any tetracycline antibiotic.

How to take

Take one lymecycline capsule a day with a glass of water or other drink, usually in the morning. It should not be taken within 2 hours of some medicines, particularly quinapril (for high blood pressure), indigestion tablets, or tablets containing calcium, aluminium, magnesium, zinc, or iron. See the manufacturer's Lymecycline patient information leaflet for further details about other interacting medicines.

The course of treatment is 3 months, or up to 6 months if acne has not completely cleared, followed by a 3 month break. If acne is not improving after 8 weeks consult your GP or dermatologist.

Lymecycline side effects and cautions

As with any medicine lymecycline can cause side effects, although these rarely require the capsules to be stopped.

Heartburn and indigestion can occur especially if taken at night. Some women have a flare up of thrush. Other common side effects can include nausea, abdominal pain, diarrhoea, and headache. Further information on possible side effects is in the manufacturer's patient information leaflet.

Lymecycline, like other tetracyclines, can increase sensitivity to sunshine and UV light and increases the incidence of sunburn. Avoid direct sunlight and use high SPF sun cream.

Alternative acne treatments

Dr Fox suggests a stepwise treatment plan for acne. Lymecycline should be used at step 4, usually after trying direct skin treatments in the form of gels and creams (topical treatments).

Topical peeling and anti-inflammatory preparations should be continued whilst lymecycline is being taken, e.g benzoyl peroxide, Differin, or Epiduo. These work differently from antibiotics and combined therapy is more effective and reduces the development of antibiotic resistance.

Antibiotics by mouth, such as lymecycline, may be more effective than topical antibiotic acne treatments although where topical treatments are effective, switching to oral antibiotics should not be necessary.

Other oral antibiotics are sometimes used to treat acne, including clarithromycin, erythromycin, and trimethoprim. Minocycline (another tetracycline type antibiotic) was used in the past but can cause liver damage so is now rarely prescribed.

The combined contraceptive pill can be an effective treatment for acne in women.

If acne is severe, scarring, or causing significant distress, a dermatologist may consider prescribing Roaccutane (isotretinoin) capsule treatment.

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