Physicians are scaling back on prescribing antibiotics for long-term acne treatment in favor of combinations of therapies, according to research published in Dermatologic Clinics, which surveyed studies on acute and long-term acne treatments over the past decade to identify trends. “People are more conscious about the global health concern posed by the overuse of antibiotics and that acne is an inflammatory, not infectious, condition,” says Hilary Baldwin, MD, clinical associate professor of dermatology at Rutgers Robert Wood Johnson Medical School. “Overuse of antibiotics also can promote the growth of resistant bacteria, which can make treating acne more challenging.”
Among the antibiotic alternatives, researchers found that there’s been renewed interest in benzoyl peroxide, which is often is used in combination with topical retinoids. Oral spironolactone also appears to be especially effective in women, and various hormonal therapies that target androgens have been shown to be safe and effective. The researchers report that laser and light therapies and regulating diet show promise, as well. They do add that antibiotics remain highly effective for moderate to severe cases of inflammatory acne and are approved by the FDA as a supplement to other treatments. “Numerous studies have shown that these combinations are fast, effective and help reduce the development of resistant strains of bacteria that cause acne, but the Centers for Disease Control and Prevention recommend that antibiotics be used for a maximum of six months,” notes Dr. Baldwin.