The use of hormone therapy and antibacterial drugs in the treatment of acne

− the basis for the treatment of acne in patients with moderate to severe forms. The most commonly used antibiotics in the treatment of acne are tetracyclines. Drugs with a higher degree of lipophilicity (doxycycline 50-100 mg / day, minocycline at a dose of 1 mg / kg of body weight per day) − more effective than tetracycline. Follow us on

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− a new antibiotic of the tetracycline group, which can be used in adults and children over 9 years of age in the treatment of moderate to severe non-nodular acne. Compared to other antibiotics of the tetracycline group, sarecycline exhibits a narrow spectrum of antibacterial activity, including against gram-negative intestinal bacteria. The drug also has an anti-inflammatory effect. In clinical trials, sarecycline has been shown to be effective in treating acne within the first 3 weeks of use.

A study evaluating the efficacy of doxycycline in the treatment of acne at a dose of 40 mg (subantimicrobial dose) and 100 mg compared with placebo showed a positive result in both cases.

Modern approaches to acne treatment

Side effects of antibacterial acne medications Oral use of these antibiotics can lead to the development of vaginal candidiasis. The use of doxycycline is associated with the development of photosensitivity, while minocycline is associated with pigmentation of the skin, mucous membranes and teeth.

The risk of antibiotic resistance in the skin microflora against the background of systemic antibiotic therapy in the treatment of acne is currently being studied and is a controversial issue. A study by Miller et al demonstrated an increase in skin contamination with coagulase-negative staphylococci not only in acne patients who had been treated with antibiotics for a long time, but also in those close to them.

Investigation of the role of the leading causes of acne in the development of the disease At the same time, a study by Fanelli et al found that Staphylococcus aureus remains sensitive to tetracycline even after long-term use in the treatment of acne. Studying the

is important because tetracycline antibiotics are today the drugs that are used against MRSA (Methicillin-resistant Staphylococcus aureus). Drugs such as trimethoprim (alone or in combination with sulfamethoxazole) and azithromycin may also be effective in treating acne.

The use of topical antibacterials should be reduced or discontinued as soon as the skin condition improves. If there is no clinical improvement within 6-8 weeks of acne treatment, the use of topical antibiotics in the future is not advisable.

Topical retinoids should be used until the skin is completely clear of acne.

The duration of systemic antibiotic therapy for acne is usually 3-4 months.

Antibacterial therapy for acne: to be or not to be

Hormonal preparations for the treatment of acne The use of

in the treatment of acne results in a reduction in sebum production. In addition, by suppressing the production of gonadotropin, estrogen reduces the production of androgens in the ovaries. The use of combined oral contraceptives (COCs) also leads to an increase in the synthesis of SHBG (Sex hormone-binding globulin) in the liver, which reduces the level of circulating free testosterone.

In the treatment of acne,

at a dose of 25-200 mg once a day for 3-6 months, which has antiandrogenic properties, can be used. Side effects associated with the use of spironolactone include dizziness, breast tenderness, and dysmenorrhea. The development of dysmenorrhea can be prevented by the simultaneous use of spironolactone with oral contraceptives. In two studies, spironolactone was associated with reduced acne and minimal side effects.

Acne: a serious condition with serious causes A large retrospective US study in healthy women aged 18-45 showed that there is no need to monitor serum potassium levels in this group while taking spironolactone. The use of spironolactone should be avoided during pregnancy, as there is a risk of feminization of the male fetus. Spironolactone is not recommended for use in men due to the risk of gynecomastia. It is promising to conduct large randomized trials aimed at determining the effectiveness of spironolactone monotherapy in the treatment of acne.

Retinoids: a revolutionary tool for fighting acne and photoaging

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