You shoud try some topical gels before you use antibiotics...
(adapalene gel, tretionin, ...)
Br J Dermatol 2002 Sep;147(3):523-7 Related Articles, Links
Topical adapalene gel 0.1% vs. isotretinoin gel 0.05% in the treatment of acne vulgaris: a randomized open-label clinical trial.
Ioannides D, Rigopoulos D, Katsambas A.
Department of Dermatology, Aristotle University School of Medicine, Thessaloniki, Greece.
[email protected]
BACKGROUND: Topical application of isotretinoin and adapalene has proved effective in treating acne vulgaris. Both drugs demonstrate therapeutic advantages and less irritancy over tretinoin, the most widely used treatment for acne. They both act as retinoid agonists, but differ in their affinity profile for nuclear and cytosolic retinoic acid receptors. OBJECTIVE: To compare the efficacy and tolerability of adapalene gel 0.1% and isotretinoin gel 0.05% in the treatment of acne vulgaris of the face, in a randomized open-label clinical trial. METHODS: Eighty patients were enrolled and were instructed to apply adapalene gel 0.1% or isotretinoin gel 0.05% once daily over a 12-week treatment period. Efficacy determination included noninflammatory and inflammatory lesion counts by the investigator and global evaluation of improvement. Cutaneous tolerance was assessed by determining erythema, scaling and burning with pruritus. RESULTS: Adapalene and isotretinoin gels were highly effective in treating facial acne. Adapalene gel produced greater reductions in noninflammatory and inflammatory lesion counts than did isotretinoin gel, but differences between treatments were not statistically significant. Adapalene gel was significantly better tolerated than isotretinoin gel during the whole treatment period. CONCLUSIONS: The two gels studied demonstrated comparable efficacy. When adapalene and isotretinoin were compared, significantly lower skin irritation was noted with adapalene, indicating that adapalene may begin a new era of treatment with low-irritant retinoids.
J Cutan Med Surg 2002 Oct 9; [epub ahead of print] Related Articles, Links
A Randomized, Double-Blind, Multicenter, Parallel Group Study to Compare Relative Efficacies of the Topical Gels 3% Erythromycin/5% Benzoyl Peroxide and 0.025% Tretinoin/Erythromycin 4% in the Treatment of Moderate Acne Vulgaris of the Face.
Gupta AK, Lynde CW, Kunynetz RA, Amin S, Choi K, Goldstein E.
Division of Dermatology, Department of Medicine, Sunnybrook and Women's College Health Science Center (Sunnybrook site) and the University of Toronto, Toronto, Ontario, Canada.
Background: Combination treatments for acne vulgaris, such as Benzamycin(R) (3% erythromycin/5% benzoyl peroxide) and Stievamycin(R) (0.025% tretinoin/erythromycin 4%), reduce bacterial growth, which contributes to the inflammatory lesions typical of adolescent acne, and also decrease the epidermal cell compaction which may form the characteristic noninflammatory comedone. Both agents contain erythromycin to reduce the growth of Propionibacterium acnes in skin. Benzoyl peroxide has antibiotic activity as well as anticomedogenic properties. Tretinoin may increase the turnover of epidermal cells and loosen the cells compacted to form comedones. A combination preparation containing the two antibiotics may reduce the development of resistance; the combination preparation containing tretinoin and erythromycin will have an antibiotic effect as well as acting on differentiation. Patients and Methods: This multicenter, randomized, double-blind, parallel group study compared the effectiveness of 3% erythromycin/5% benzoyl peroxide and 0.025% tretinoin/erythromycin 4%, each applied twice daily in patients with moderate acne vulgaris. Overall physician and patient ratings of severity of acne symptoms were performed at baseline and at weeks 2, 4, 8, and 12. Results: At baseline the two treatment groups had similar disease severity. The number of papules, pustules, and comedones was reduced in both treatment groups at week 12, and the reductions were not significantly different between the two comparators. Global physician rating of improvement was significantly higher in the 3% erythromycin/5% benzoyl peroxide group compared with the 0.025% tretinoin/erythromycin 4% group; however, there was no significant difference in global patient ratings between the two treatment groups. An aggregate score was produced, for both physician rating and patient rating, by adding up individual symptom severity ratings. Compared with 0.025% tretinoin/erythromycin 4%, 3% erythromycin/5% benzoyl peroxide provided significantly greater reduction in both physician- and patient-rated severity of acne symptoms; there was a significant difference between the two groups as early as week 2. The 3% erythromycin/5% benzoyl peroxide demonstrated significantly greater reduction of erythema and scaling, as evaluated by the study physician, compared with tretinoin 0.025%/erythromycin 4%. Patients judged 3% erythromycin/5% benzoyl peroxide to have a significantly greater effect on redness, dryness, oiliness, and burning. Conclusion: In moderate acne vulgaris, 3% erythromycin/5% benzoyl peroxide may provide a greater beneficial effect than 0.025% tretinoin/erythromycin 4%.
If you're not happy with results after 4 weeks you can add oral tetracycline antibiotic...
Doxycycline is slightly better than minocycline...
You can also use azithromycin if you don't tolerate the others well,
only 3 pills a week are needed.
Some people get good results with stuff you can get OTC like
vit B5 - 5g ED or more, ALA, etc...
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