Benzoyl Peroxide

 Products Listed

1. Clearasil

2. Fostex

3. Oxy-10

Benzoyl Peroxide:

 Mechanism of Action

Lexi-Comp

Releases free-radical oxygen which oxidizes bacterial proteins in the sebaceous follicles decreasing the number of anaerobic bacteria and decreasing irritating-type free fatty acids

 (LEXI COMP)

Benzoyl Peroxide:

 Mechanism of Action

UIW-Slides

1. Keratolytic - converted to benzoic acid in the skin which loosens keratinized cells

2. Increased turnover rate of epithelial cells,which prevents closure of follicles

 3. Antibacterial activity against Propionbacterium acnes (P. acnes)

Can also be used to soften keratin, a major component of the skin.

 This serves to improve the skin's moisture binding capacity, which is beneficial in the treatment of dry skin.

Benzoyl Peroxide

 Side Effects

*(NO SYSTEMIC SIDE EFFECTS)*

1. Drying and peeling of the skin (main SE)

preventable by proper administration of

 Benzoyl Peroxide 

(slowly add BP to face NOT all at once)

 2. Burning, blistering, scaling, and edema

***Acne Antibiotics***

Drugs

1. tetracycline

2. minocycline

3. doxycycline

4. **clindamycin**:(Cleocin, Cleocin T.)

5. **erythromycin**

** MACROLIDES **

6. Trim/Sulf (Bactrim) or Metronidazole

***Azelic Acid is an Anti-MICROBIAL***

***Acne Antibiotics***

SE's: Tetracycline

1. GI: N/V/D

2. Pseudomembraneous colitis

 *(more likely with clindamycin)*

3. Bones and teeth are discolored

*(brown)*

4. Growth is impaired in the young

*(NOT recommended <16yo)*

5. Photosensitivity in fair skinned people

6. Increased incidence of superinfection

(A. children:thrush B. post-menopausal women:yeast infection)

 ***Little use of topical tetracycline:due to phosphorecence***

***Acne Antibiotics***

Contraindications: Tetracycline

Do NOT take with calcium containing products

***Acne Antibiotics***

Minocycline-(Minocin)

 & Doxycyline-(Vibramycin)

Pearls

MOA's: common to AA's

SE's: Ototoxicity and darkening of the skin and teeth

 > than tetracycline

1. May be more efficacious than tetracycline

 2. No drying of the skin if taken orally

 3. stonger due to increased lipid solubility compared with tetracycline

***Macrolide Antibiotics***

Drugs

Lexi-Comp list of Macrolide Antibiotics:

 1. Azithromycin

2. Clarithromycin

 3. Erythromycin

 4. Erythromycin and Sulfisoxazole

 5. Spiramycin

***Acne Antibiotics***

Clindamycin ORAL

 SE's

***Macrolide Antibiotics***

 1. Pseudomembraneous colitis

 (MORE LIKELY w/ clindamyacin vs. tetracycline)

 2. N/V/D

 3. Impaired liver function

 4. Neutropenia: the killing off of neutrophils-

 **rare**

 but very serious kills off all bacteria allowing C-diff to grow up allowing the proliferation of P.colitis which leads to severe diahrrea

***Acne Antibiotics***

Clindamycin TOPICAL SE's

***Macrolide Antibiotics***

Clindamycin TOPICAL SE's

 1. Dryness, scaliness or peeling of skin

 2. Contact dermatitis (excema)

***Acne Antibiotics***

Erythromycin

Products

***Macrolide Antibiotics***

Erythromycin: E-mycin, Ery-tab, A/T/S, Erycette, T-Stat, Ery-Sol, Benzamycin

***Acne Antibiotics***

 ORAL SE's unique to: Erythromycin

***Macrolide Antibiotics***

ORAL SE's unique to: Erythromycin

1. epigastric pain (heartburn)

***Acne Antibiotics***

TOPICAL SE's unique to: Erythromycin

***Macrolide Antibiotics***

TOPICAL SE's unique to: Erythromycin

1. Burning and drying especially when combined with BENZOYL PEROXIDE

***Acne Antibiotics***

 Erythromycin: Pearls

***MACROLIDE ANTIBIOTIC***

 1. Acne will often get worse before it gets better (after initiation of treatment)

2. Erythromycin and other macrolides can have many interactions with other medications due to CYP enzymes and residence time.