Antibiotic resistance in acne.
Teens have enough to worry about, lets make acne not one of them!
In the most recent guidelines for acne treatment, according to the American Academy of Dermatology, the co-administration of benzyl peroxide (BP), alongside topical and oral antibiotics is recommended. Benzyl peroxide is comedolytic and kills Propionibacterium acnes by generating free radicals.The guidelines include recommendations of the avoidance of antibiotic monotherapy.
Here are the highlights from the study:
- For mild-to-moderate acne, first-line treatment is with BP, topical retinoids, or combination therapy, which may incorporate a topical antibiotic (BP + antibiotic, BP + retinoid, BP + antibiotic + retinoid). Topical antibiotic monotherapy is not recommended. In patients who benefit from topical antibiotic treatment, available fixed-combination antibiotic/BP formulations simplify the regimen and potentially improve patient adherence.
- For moderate-to-severe acne, first-line treatment is with oral antibiotics combined with BP and a topical retinoid. Oral antibiotic monotherapy is not recommended. Topical antibiotics may also be included in the regimen, provided BP is used concomitantly.
- The first-line oral antibiotics are doxycycline and minocycline, which exert anti-inflammatory as well as antimicrobial effects.
- Because of associated resistance, systemic erythromycin should be avoided, except in patients unable to tolerate tetracycline therapy (eg, pregnant women and children aged <8 years); trimethoprim-sulfamethoxazole may also be considered.
- Duration of therapy should preferably be limited to 3 to 4 months. To facilitate this, BP and topical retinoids should be continued as maintenance therapy after discontinuation of systemic antibiotic treatment.
For cystic and regular acne in tweens and teens, I recommend DFH's Acnutrol. It comes in oral caps and a topical gel to apply directly on the lesions . Two caps a day and cystic acne is significantly reduced in less than two weeks. Acne is a reflection of altered gut flora from a poor diet. The outside of your skin is just a mirror of inflammatory events in the gastrointestinal tract. I encourage our tweens and teens to reduce their intake of processed foods, trans-fats, uncultured dairy products like cheese and milk, fried foods, soda, sugar, corn and gluten. I design daily menus using fruits and vegetables that they like. Fruits can be added to healthy protein smoothies and vegetables can be cooked at low temps in the toaster oven to make kale, carrot, zucchini or fennel chips that are delicious with a sprinkle of sea salt. Your favorite fruits and vegetables can always be juiced for a power boost after school and before sports activities. If you have questions, call us and we'll help create individualized strategies.