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AcneTherapy Skips Antibiotics

Nonantibiotic based therapy may be helpful for acne maintenance, according to the results of 2 studies reported in the May issue of the Archives of Dermatology.

"Topical retinoids are a rational choice for maintenance therapy because of their activity on microcomedos (the precursor for all other acne lesions)," write James Leyden, MD, from the Skin Study Center in Broomall, PA.

Topical comedolytic agents, such as tretinoin, adapalene, azelic acid, and tazarotene, correct the follicular hyperkeratosis. In severe acne cases, where topical therapy may be inadequate, systemic therapy may be prescribed.

Isotretinoin is an oral medication that decreases oil production by shrinking the oil glands. Studies have shown that when isotretinoin is taken over a 20-week period, 80% of patients will have a complete resolution of their acne, in most cases, permanently.

"Yet this drug must be used with extreme care," warned dermatologist Stephen Mandy, MD, Clinical Professor of Dermatology, University of Miami.

"Since isotretinoin causes birth defects, women of child-bearing age must take the utmost precautions to prevent pregnancy during this therapy."

"In addition, there are other potential side effects which require routine monitoring by the patient's dermatologist during the treatment period."