Compare · Medications

Minocycline vs Soolantra

Minocycline: An oral antibiotic for moderate to severe inflamed acne. It works about as well as doxycycline, but carries a few rarer risks, so it is usually the second choice. Soolantra: A once-daily cream for the bumps and pustules of rosacea. It calms inflammation and reduces the mites that live in facial follicles, but it does not treat flushing or fixed redness.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
16:9 hero for Minocycline. Never cropped: the tone strip and the corner logo depend on the full frame.Soolantra — Header Image
Which one?At a glanceWhat it treatsDiagramsHow you take itResultsSide effectsSafetyCostWhen you stopQuestions

Which one is right for you?

Choose Minocycline if…

Choose as a second-choice acne antibiotic when doxycycline doesn't suit — it works about as well, with a few rarer risks.

  • Doxycycline caused sun sensitivity or stomach upset
  • Inflamed acne needing tablets
  • A short 3–4 month course

Choose Soolantra if…

Choose for rosacea bumps and pustules as a once-daily cream that often clears them — it doesn't treat flushing or fixed redness.

  • Rosacea bumps and pimples
  • You want once-daily use
  • You'll give it 12–16 weeks
Often combined

Can you take them together?

Used together for moderate to severe rosacea bumps. Soolantra often continues after minocycline stops.

At a glance

● Minocycline
● Soolantra
Type
Tetracycline antibiotic
Topical antiparasitic and anti-inflammatory (ivermectin 1%)
What it does
Kills acne bacteria and calms inflammation
Calms inflammation and reduces Demodex mites
Best for
Moderate to severe inflamed acne
Rosacea bumps and pustules
Prescription
Yes
Yes
Form
Tablet or capsule
Cream
How often
Once or twice daily
Once daily
Course length
3–4 months
Ongoing
Time to results
4–8 weeks
4–16 weeks
Main side effect
Dizziness; rare skin discoloration
Mild burning or dryness
Blood tests
Not routinely
None
Pregnancy
Avoid
Check with your clinician
Cost
Low; generic available
Moderate; generic available

What it treats

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level
Minocycline
Soolantra
Strong evidenceMost established uses
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Reduces inflamed breakouts.
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Reduces bumps and pimples.
Moderate evidenceSome supportive research
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Reduces bumps.
—
Limited evidenceEarly or small studies
An inflamed lump in the armpit on fair skin. The skin over it is swollen, shiny and red, with a pair of small blackhead-like openings in the skin beside it.

Hidradenitis Suppurativa

Can calm mild flares.
—
Little evidence
dark keratin plugs in dilated pores on the nose and adjacent left cheek, with the face turned to the person’s right on light skin.

Blackheads

Doesn't unclog pores.
The finger webs and wrist on fair light skin, with small red bumps, several thin gray burrow lines a few millimetres long, and scratch marks across the area.

Scabies

Scabies needs permethrin or ivermectin tablets.
Not effective
—
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Not an acne treatment.
Post-Inflammatory Redness.

Post-Inflammatory Redness

Doesn't fade redness alone.
Can make it worse
Shoulders and upper back on fair skin, covered in a sheet of many small pink-red bumps, all of them the same size and packed close together.

Fungal Acne

Antibiotics can let yeast overgrow.
—
How it works

Minocycline

Minocycline. Helps reduce acne bacteria and inflamed spots. 1. Slows acne bacteria: Blocks the 30S ribosome that bacteria use to make proteins. 2. Calms inflammatory responses: Can also reduce some inflammation-related activity. 3. Reduces inflamed spots: Red bumps and pimples can gradually improve.
Open full-size diagram
Diagram explanation and sources

Slows acne bacteria: Blocks the 30S ribosome that bacteria use to make proteins. Calms inflammatory responses: Can also reduce some inflammation-related activity. Reduces inflamed spots: Red bumps and pimples can gradually improve.

Bacterial protein-synthesis inhibition is established. The complete acne mechanism and the contribution of individual antibacterial and anti-inflammatory effects are not fully defined. This does not imply direct exfoliation, oil-gland shrinkage, or treatment of resistant bacteria.

Source 1 · Source 2

Soolantra

Soolantra. Ivermectin helps settle rosacea bumps and pimples. 1. Reduces Demodex mites: Kills mites that may contribute to rosacea inflammation. 2. May calm immune signals: Anti-inflammatory effects may also help skin settle. 3. Reduces bumps and pimples: Inflammatory rosacea lesions gradually improve.
Open full-size diagram
Diagram explanation and sources

Reduces Demodex mites: Kills mites that may contribute to rosacea inflammation. May calm immune signals: Anti-inflammatory effects may also help skin settle. Reduces bumps and pimples: Inflammatory rosacea lesions gradually improve.

The label states that the rosacea mechanism is unknown. Anti-parasitic and anti-inflammatory actions are supported by a small in-vivo pilot; clinical efficacy has randomized-trial support. Demodex is not the sole cause of rosacea.

Source 1 · Source 2 · Source 3

How you take it

Treatment plan

Dose is set by what you tolerate more than body weight. Dizziness is the usual limit, not the stomach. Liver problems can lower it.

Starting dose: Commonly 50 mg to 100 mg once or twice a day. Some doctors start low for a week to see how you feel.

Going up: After a week or two if it is tolerated and acne has not begun to respond.

Usual dose: Around 100 mg once or twice daily. The extended-release form is about 1 mg per kilogram of body weight, once daily.

Total course: About three to four months. Guidelines advise reassessing at three months and stopping once the topical can hold the result. Long uninterrupted use is what raises the pigment risk.

When to Apply: Once a day, usually at night, on clean dry skin. A pea-sized amount for the whole face, spread thinly rather than dabbed on bumps. Keep it off the eyes, lips and inside of the nose. Moisturizer and sunscreen go on top once it has dried.

How to Start: Once daily from day one. No build-up schedule, and twice a day speeds nothing up.

If It Irritates: Mild burning, stinging or dryness early on is common; moisturizer before or after usually settles it. A flare of bumps in the first two to four weeks happens and passes. It does not mean the cream is wrong.

If It's Not Working: Give it twelve weeks before judging, up to sixteen for the full effect. There is one strength, so the next step is adding something else, often azelaic acid or an oral antibiotic, not more cream.

When to take it

With a full glass of water. Food is fine and usually reduces nausea. Stay upright for at least 30 minutes afterwards, and not right before bed — a tablet that lodges in the food pipe can burn the lining.

If it makes you unsteady, taking it at night helps, since you sleep through the peak. Ask your doctor before changing the timing.

Space antacids, iron and calcium supplements by about two hours. They bind the drug and less gets in.

Not covered in this guide yet
If you miss a dose

Take it when you remember, unless the next dose is close. Never take two at once — a doubled dose mostly produces nausea and dizziness.

Not covered in this guide yet
Monitoring

No routine blood tests for a standard three to four month course in a healthy person. Monitoring is clinical: a review at about three months, and a look at skin, gums and old scars for a gray or blue tinge.

Blood tests are ordered if something appears. Joint pain, fever or unusual tiredness prompts testing for a lupus-like reaction; a rash with fever and swollen glands, for a hypersensitivity reaction that can involve the liver. Both are rare, likelier with long use, and usually settle once the drug stops.

This is not a drug to stay on for years. Two things build up: antibiotic resistance, and pigment that is dose and duration related and can be slow to fade or permanent. Guidelines say oral antibiotic courses for acne should be as short as possible, with a topical retinoid alongside to take over.

No blood tests or laboratory monitoring. Very little is absorbed through intact skin, far below the amounts involved with the tablets.

Monitoring is a conversation at around twelve weeks: have the bumps reduced, is the cream comfortable, is anything separate needed for redness. People stay on it for years without a dose change, because nothing accumulates.

Irritation after months of comfortable use usually points to a change in the routine or a second problem such as contact dermatitis, worth reviewing rather than pushing through.

When you’ll see results

Approximate windows, not promises.

● Minocycline
● Soolantra
First dose

First doseTaking it: One tablet with plenty of water, sitting upright. Nausea or dizziness show up in the first few days if they happen.

Weeks 1 to 2

Weeks 1 to 2Settling in: Little change in the skin yet.

Weeks 1 to 2Adjusting: Mild burning, dryness or itching. Some get a short flare as mite numbers drop. Little visible change yet.

Weeks 2 to 6

Weeks 2 to 6Working: Red, sore papules and pustules become fewer and less painful. This is what minocycline is aimed at.

Weeks 8 to 12

Weeks 8 to 12Judge it here: Most of what an antibiotic will give has arrived. Dark marks fade as fewer new spots form, over months, faster with sun protection.

First few minutes

First few minutesApplying it: A pea-sized amount once a day, thinly over the whole face.

Weeks 2 to 4

Weeks 2 to 4First change: Fewer new pustules, which clear before the firm red bumps. The face looks calmer before the count is obviously lower.

Weeks 4 to 12

Weeks 4 to 12Working: Steady reduction in bumps and pustules. Most of the gain happens here, and background pink fades as the inflammation settles.

Weeks 12 to 16

Weeks 12 to 16Judge it here: The point the trials measured, where most people were rated clear or almost clear.

Side effects

Sorted by what to do about them.

Minocycline

Soolantra

Common
Common
  • Dizziness or lightheadedness
  • Stomach upset
Common
  • Mild burning or stinging
  • Dry skin
Tell your doctor
Tell your doctor
  • Blue-gray skin or gum discoloration
  • Joint pain or a new rash
Tell your doctor
  • Rosacea worsening
Stop and get care
Stop and get care
  • Severe headache with vision changes
  • Fever, rash and swollen glands together
Stop and get care
  • Swelling or trouble breathing

Safety and who should avoid it

Pregnancy
Avoid
Ask the doctor managing your pregnancy.
Use care
Ask the doctor managing your pregnancy.
Breastfeeding
Use care
Discuss with your clinician.
Use care
Discuss with your clinician.
Children
Not under 8
Stains developing teeth.
Not used
Adults only.
Monitoring
None routine
Review at 12 weeks.
None
Judge at 12–16 weeks.
Key interactions
Check
Isotretinoin; antacids, iron, calcium.
None known
—
Other cautions
Avoid
Tetracycline allergy; lupus history.
Use care
Keep out of eyes.

Cost and getting it

Getting it and cost

Generic immediate-release minocycline is inexpensive and widely stocked, usually in the same price range as generic doxycycline, and both are covered by most plans.

The extended-release brands cost far more, and prior authorization is common. You would be paying for comfort rather than clearing: the slower release was meant to reduce dizziness, not clear acne better.

If cost is the problem, say so before you leave. Doxycycline, minocycline and plain tetracycline are all generic, so the choice can follow what your plan covers.

Sold as Soolantra, with generic ivermectin 1% cream now available in some markets. Price varies widely between pharmacies and plans, and many plans want metronidazole or azelaic acid tried first.

A tube lasts a while, since a pea-sized amount covers the whole face once a day. If cost is the barrier, price generic ivermectin cream, a pharmacy discount card, or generic metronidazole or azelaic acid.

When you stop

Comes back?
Acne returns unless a retinoid and benzoyl peroxide are in place.
Bumps can return months after stopping.
Taper needed?
No.
No.
After the last dose
Blue-gray discoloration, if it happened, fades slowly.
Restarting usually works.

Common questions

Minocycline:How long will I be on it?

Usually three to four months. If a year has passed and you are still refilling, the plan needs revisiting.

Minocycline:Is minocycline stronger than doxycycline?

No. Comparisons have not shown it clears acne better. An alternative, not an upgrade, with a few risks doxycycline does not have.

Minocycline:What is the blue-gray staining, and will it happen to me?

Minocycline can leave a slate or blue-gray color in skin, old scars, gums, nails and sometimes the whites of the eyes. It is uncommon, linked to long use and high total doses, and can be slow to fade or permanent.

Minocycline:Why does it make me dizzy?

More of the drug reaches the inner ear and brain than with doxycycline. It appears in the first few days, is dose-related, and settles after stopping.

Minocycline:Can I drink alcohol?

Occasional drinking is fine. Heavy drinking clears the drug faster, which can make it work less well.

Minocycline:Do I really need a cream as well?

Yes. The antibiotic lowers inflammation while you take it but does nothing about the clog that starts a spot. The retinoid, usually with benzoyl peroxide, holds the result afterwards and limits resistance.

Soolantra:Does it get rid of the redness in my face?

Not the kind most people mean. It reduces redness from inflamed bumps, so the face looks calmer. It does not stop flushing or remove visible vessels; those need brimonidine or oxymetazoline, or laser and light.

Soolantra:Why did my rosacea get worse in the first two weeks?

A short early flare is common, probably because dying mites release material the immune system reacts to. It settles within a few weeks.

Soolantra:Is this the same as taking ivermectin tablets?

Same drug, completely different medicine. The cream goes on the face, almost none enters the bloodstream, and it treats skin only.

Soolantra:How long will I need to use it?

Rosacea is managed, not cured, so most people use it long term. Bumps return within a few months of stopping.

Soolantra:Can I use it alongside other rosacea treatments?

Yes, and combinations are common: a redness treatment in the morning and ivermectin at night, or ivermectin with oral doxycycline.

Soolantra:Do I need to change my pillowcases because of the mites?

No. These mites live in the follicles of nearly every adult face. They are not caught from bedding, pets or people, and cleaning does not change their numbers.

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