OTC acne treatment as good as antibiotics

Results of a recent UK study in The Lancet highlight how over-the-counter (OTC) benzoyl peroxide lotion is as good as prescription antibiotics for the treatment of mild to moderate facial acne.

Antibiotic tablet treatment has been used extensively for common adolescent facial acne over the past 40 years. Despite concerns about increasing antibiotic resistance, 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.

Hywel Williams and colleagues from the Universities of Nottingham and Leeds (UK), compared five treatment options for acne in a randomized trial involving around 650 participants. Treatments being compared were the: oral antibiotics oxytetracycline or minocycline; topical antibiotic erythromycin; antimicrobial lotion benzoyl peroxide; or a combination of topical erythromycin and benzoyl peroxide.

Most improvement occurred in the first six weeks of treatment. Self-reported improvements after 18 weeks were similar in all five treatment groups.

Prof. 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.”

SOURCE: The Lancet, Volume 364, Number 9452 18 December 2004.