Acne, hair loss, eosinophilia while taking Minocycline
November 13, 2010 | 25,00 EUR | answered by Dr. med. Olaf Stephan
I am male and 28 years old, I have been dealing with acne for a long time. Three months ago, I was prescribed Skid (Minocycline) for the first time (2x50mg/day). Since I often had stomach/intestinal problems, a blood test was done during the Minocycline intake and it revealed eosinophilia with significantly elevated levels, everything else was okay. After consulting with my dermatologist, he said the eosinophilia is not related to the intake of Minocycline. He had never seen this before. Additionally, I am currently experiencing severe hair loss. According to a hair specialist, it is androgenetic alopecia. I am now also taking Propecia (1mg daily). I am still taking the Minocycline. Recently, another blood test was done. The eosinophilia is decreasing, despite taking Minocycline. I can't shake the feeling that the eosinophilia, Minocycline, and hair loss are related. Could the hair loss also be caused by the Minocycline? Can you share any experiences? What could/should I do?
Dear inquirer,
it is somewhat difficult to answer your question, as ultimately I cannot provide a secure diagnosis. I have also read the article you sent me from the medical journal. In general, the most common causes of blood eosinophilia (= increase in eosinophilic white blood cells) are allergies and parasitic diseases (such as intestinal tapeworm or similar), these two disease entities should be ruled out first, for which questions need to be clarified such as: are allergies known to you or do you have corresponding symptoms like skin redness, itching, asthma, rhinitis, conjunctivitis, food intolerances or contact allergies, also in the presence of an allergy regularly elevated IgE levels can be found in the blood (this can be quickly determined by a blood test), furthermore, the stool can be examined multiple times to search for intestinal parasites. Medication side effects can sometimes be difficult to prove, but overall they are quite rare and more common in long-term therapy (as in your case), however, the symptoms are often unspecific and also occur in many other "internal" diseases. The best and simplest way to trace a medication side effect is to first discontinue the drug and monitor whether the observed changes regress in a certain period of time. Since taking Minocycline is not necessarily vital for you, I would recommend taking a break, if the eosinophilia then regresses in the next few weeks, the connection with the antibiotic appears very likely, although it is also possible that you are allergic to Minocycline (as mentioned, IgE would have to be elevated as well). Furthermore, I advise you to have the liver and kidney values determined by your treating physician, as these two organs (due to their central role in metabolism) are often also affected by most medication side effects. Eosinophilic lung infiltrates are very rare overall, can also occur as a distinct group of diseases (not just as a side effect) and are often initially asymptomatic, the eosinophils in the blood can, but do not have to be elevated. A simple chest X-ray would initially lead to diagnostic clarification here. These side effects of Minocycline are known, described multiple times, and can occur in rare individual cases. I would not attribute the hair loss to the medication, perhaps you have suffered from it before taking Minocycline? Otherwise, the above mentioned applies here as well, if there is a connection with the medication, a clear improvement should occur after discontinuation. I hope that I could initially help you further, with kind regards, O. Stephan.
