Facial acne is common among adolescents and antibiotic tablet treatments have been used extensively over the past 40 years. Concerns exist about increasing antibiotic resistance, and few studies have compared the efficacy and cost-effectiveness of different treatment options for acne - including the comparison of tablet antibiotics and antibiotic lotions with the antimicrobial treatment benzoyl peroxide.
The latest edition of the Lancet reveals how Hywel Williams and colleagues from the Universities of Nottingham and Leeds, UK, compared five treatment options for acne in a randomised trial involving around 650 participants. The treatments being compared were: the oral antibiotics oxytetracycline or minocycline, the topical antibiotic erythromycin, the antimicrobial lotion benzoyl peroxide, or a combination of topical erythromycin and benzoyl peroxide.
The tests showed that most improvement occurred in the first 6 weeks of treatment. Self-reported improvements after 18 weeks were similar in all 5 treatment groups.
Professor Williams commented: "Differences in cost-effectiveness between regimens were large; the cheapest treatment (benzoyl peroxide) was 12 times more cost-effective than minocycline. We found that clinical efficacy of oral tetracyclines is compromised by pre-existing propionibacterial resistance. By contrast, topical regimens that included erythromycin and benzoyl peroxide were unaffected by resistance but were not superior to benzoyl peroxide alone."
Professor Tony Avery, head of primary care at The Medical School, Queen's Medical Centre, Nottingham, said that the findings were encouraging, but added a cautionary note that users of topical OTC treatments should be aware that these kind of treatments can cause the skin to dry out and become scaly. He added that individuals using topical acne creams should apply some sort of moisturiser in conjunction with the treatment.
Matthew Patey, director of the British Skin Foundation, said that the findings were interesting, adding his belief that the findings were encouraging to sufferers of mild to moderate acne. However, he also said that if symptoms continued while using OTC treatments people should consult a doctor.