Patients with moderate or severe acne vulgaris, or an inadequate response to topical treatments, are often treated with oral antibacterials, in particular, tetracyclines. Minocycline is one of the most commonly prescribed tetracyclines in acne, the predominant use for this drug. In 2005, around 2.5 million prescriptions for oral tetracyclines were dispensed in England at a cost to the NHS of over pound 21 million, and minocycline accounted for 40% of this expenditure. The drug is often recommended with claims that it is more effective, less likely to cause bacterial resistance, and easier to take than other tetracyclines. Here we consider the use of minocycline for acne.