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doxycycline
acne
What Is Acne?
P acnes will multiply rapidly in clogged
hair follicles where sebum is
trapped
Comedo (plural: comedones): An acne
lesion
Benzoyl peroxide, with its broad-spectrum antimicrobial activity, is
among the most widely used topical agents in the treatment of
inflammatory acne vulgaris Benzoyl peroxide is marketed either alone or
in combination with other topical antibiotics; namely, erythromycin and
clindamycin The combination products confer specific advantages over
benzoyl peroxide alone, particularly in decreasing the in vivo
follicular counts of Propionibacterium acnes, the anaerobic bacterium
implicated in the pathogenesis of acne In addition, the topical
treatment of inflammatory acne has been complicated by the development
of P acnes resistance to topical erythromycin and clindamycin
Combination products containing benzoyl peroxide and the topical
antibiotics have been shown to both: (i) prevent the development of
antibiotic resistance in acne patients; and (ii) confer significant
clinical improvement to patients who have already developed antibiotic
resistance
Retinoids
play a vital role in the treatment of acne because they act on the
primary lesion, the microcomedo They are synthetic derivatives of
vitamin A (retinol), and are selected for their effectiveness Several
compounds are used for acne, either in topical or systemic formWe
describe and compare the different topical retinoids, tretinoin
(all-trans-retinoic acid), isotretinoin (13-cis-retinoic acid),
adapalene (derived from naphthoic acid), and tazarotene (acetylenic
retinoid) They act mainly as comedolytics, but anti-inflammatory
actions have also been discovered recently
Photodynamic therapy
(PDT) with use of topical 5-aminolevulinic acid (ALA, Levulan
Kerastick, Dusa Pharmaceuticals, Inc, Wilmington, MA) photosensitizing
agent is a new modality for the treatment of acne Eighteen patients
(aged 15 to 63) with moderate to severe inflammatory acne received
ALA-PDT ALA remained in contact with skin for 15 to 30 minutes before
exposure to blue light (ClearLight [Lumenis] or BLU-U [Dusa
Pharmaceuticals, Inc]) or the Aurora DSR (Syneron Medical Ltd), which
uses Electro-Optical Synergy (ELOS), a unique combination of optical
and radiofrequency (RF) energy Patients received two to four ALA-PDT
treatments over four to eight weeks or two cycles of ALA-PDT (weeks 2,
4) preceded by salicylic acid peel (weeks 1, 3) over four weeks The
average follow-up time was four months On a scale of 00 to 40, the
average acne grade improvement was 175
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