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Lymecycline for acne - review
Drug reviews: use, side effects, effectiveness

Lymecycline for ACNE: Questions & Answers

Lymecycline is one of the most commonly used oral antibiotics in the treatment of acne. I previously reviewed the use of different antibiotics, including lymecycline for acne. In today’s post, I will focus solely on the use of lymecycline in the treatment of acne.

Summary of the post:

  • What is Lymecycline?
  • The legal classification of lymecycline
  • Why is lymecycline used in the treatment of acne?
  • How to get lymecycline for acne treatment
  • How to take lymecycline
  • Common side effects
  • Alternative options for acne treatment

What is Lymecycline?

Lymecycline is a drug, which belongs to a group of tetracycline antibiotics. In the UK, lymecycline is mainly used for the treatment of:

  • Acne
  • Other infections, for example, chlamydia, rickettsia and mycoplasma, caused by tetracycline sensitive organisms.

The legal classification of lymecycline

Lymecycline is a prescription-only medication, which means it needs to be prescribed by a doctor or another qualified prescriber for the supply to happen.

Lymecycline is usually prescribed as a generic drug – lymecycline 408mg capsules or occasionally as a branded medication called Tetralysal 300 mg capsules. Both drugs are the same medicines.

Lymecycline and branded Tetralysal for acne

How does lymecycline work for acne?

In acne, dead skin cells mixed with an oily substance produced by hair follicles called sebum. This process leads to the formation of a plug in the hair follicle, consequently blocking skin pores and forming blackheads or whiteheads. Bacteria present inside the blocked pores grow and contribute to symptoms of acne. Antibacterial drugs such as lymecycline kill bacteria and stop acne development

Oral antibiotics are effective in the treatment of moderate to severe acne (Strauss et al., 2007). Lymecycline or other antibiotics for acne are usually prescribed for a maximum of 3 months (NICE, 2020).

How to get lymecycline for acne treatment

Two main routes of getting lymecycline for acne (or other treatment) are:

  • Prescribing by NHS doctor (GP)
  • Use of private services (usually online)

Getting lymecycline for acne on NHS

The first option is the most common route of getting lymecycline for acne. However, oral antibiotics like lymecycline are not considered first-line treatment of acne.

Patients diagnosed with mild to moderate acne are usually prescribed a topical (applied to the skin) retinoid, for example, adapalene on its own or in combination with benzoyl peroxide. Alternatively, a topical antibiotic can also be prescribed.

It is recommended that topical antibiotics are prescribed in combination with benzoyl peroxide to minimise bacterial resistance, a process by which bacteria become resistant to the treatment with antibiotics.

Oral antibiotics, such as lymecycline, are recommended for the treatment of moderate acne when topical preparations failed to deliver satisfactory results. Oral antibiotics can be prescribed alongside topical drugs.

Optional treatment of acne at this stage is the use of oral contraceptive, like Dianette (Co-cyprindiol).   

How to get Lymecycline privately?

It is possible to buy lymecycline from registered pharmacies. The advantage of online services is the convenience of the service. You may get lymecycline for acne without going through other treatments in the first place, as long as the treatment is not contra-indicated.

Patients need to complete an online questionnaire (consultation), which is then reviewed by a doctor or another qualified prescriber, for example, a pharmacist. Once approved, medication is posted to the patient’s home.

The main disadvantage of online services to buy lymecycline for acne is the cost. Patients need to pay for the cost of medication supplied plus additional fees for the consultation and issue of private prescription. Usually, the overall price usually covers all those fees.

Any adolescent who is 18 years of age or younger and in full-time education would get a free supply of medication on the NHS.    

How to take lymecycline for acne

Children over 12 years of age may be given an adult dose of lymecycline.

  • The usual dose for the treatment of acne is one capsule daily.

Is lymecycline effective for acne?

Different studies have confirmed the effectiveness of lymecycline in the treatment of acne. For example, lymecycline’s efficacy and safety were investigated in a 12-week study of patients with moderate to moderately severe acne vulgaris (Bossuyt et al., 2003). The effectiveness of lymecycline was compared to another tetracycline, minocycline. Although licensed for acne, minocycline is rarely prescribed in the UK.

After 12 weeks, the reduction of inflammatory lesions (spots) was evaluated. The average reduction of inflammatory lesions for lymecycline was 63%, and the total lesion count decreased by 54%. Most patents (87%) tolerated treatment with lymecycline well.

Overall, lymecycline is considered an effective treatment of acne.  

Common side effects

As with all other drugs, side effects are grouped according to the frequency they may occur, for example, from rare to common or very common side effects. Common side effects associated with the use of lymecycline include (BNF, 2021):

  • Nausea
  • Abdominal pain
  • Diarrhoea
  • Headache
  • Skin reactions
  • Photosensitivity reactions (skin reaction to the sunlight)

There are many side effects with an unknown frequency which apply to the tetracycline group of antibiotics. These may occur when taking lymecycline, for example:

  • Difficulty in swallowing (dysphagia)
  • Inflammation of the oesophagus (oesophagitis)
  • Teeth discolouration
  • Candidiasis (oral or vaginal thrush)

Please refer to the product information leaflet for more details on side effects.

Alternative options for acne treatment

I mentioned in the post that oral antibiotics are not a first-line treatment in the management of acne. Topical preparations are considered to be the first-line treatment of acne. These usually include combination products of antibiotic with benzoyl peroxide, for example, Duac Once Daily gel.

Other drugs, which can be considered instead of lymecycline, are combined oral contraceptives, or example, Co-cyprindiol (Dianette®).

For severe acne, treatment with oral isotretinoin may be considered. Isotretinoin can only be prescribed after a referral to a specialist is made.

Over the counter products for the treatment of acne

It is also possible to purchase benzoyl peroxide over the counter without a prescription. Benzoyl peroxide is sold to treat acne from pharmacies as a branded product called Acnecide 5% gel.

Freederm gel for mild to moderate acne can also be considered since it is available over the counter without a prescription. Freederm gel contains Vitamin B complex (Nicotinamide) which reduces spot size, redness and inflammation. Freederm gel is available on Amazon.co.uk (link below).

[amazon box=”B07Y8R42VQ” image_alt=”Freederm gel for acne” image_tile=”Freederm gel for acne” link_title=”Buy Freederm gel for acne on Amazon.co.uk”]

References:

BNF (2021). Lymecycline. Available at: https://bnf.nice.org.uk/drug/lymecycline.html Accessed on 17/03/2021

Bossuyt L, Bosschaert J, Richert B, Cromphaut P, Mitchell T, Al Abadie M, Henry I, Bewley A, Poyner T, Mann N, Czernielewski J (2003). Lymecycline in the treatment of acne: an efficacious, safe and cost-effective alternative to minocycline. Eur J Dermatol. 2003 Mar-Apr;13(2):130-5. PMID: 12695127. Available at: https://pubmed.ncbi.nlm.nih.gov/12695127/ Accessed on 13/03/2021

NICE (2020). Acne vulgaris:Scenario: Management of acne vulgaris in primary care. Available at: https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/ Accessed on 17/03/2021

Strauss JS, Krowchuk DP, Leyden JJ, American Academy of Dermatology/American Academy of Dermatology Association, et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol. 2007;56(4):651–663 Available at: https://doi.org/10.1016/j.jaad.2006.08.048 Accessed on 30/05/2020

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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