Dr. Thomas P. Habif, MD discusses Acne Treatment with Topical Antibiotics. See more at www.dermnet.com PLEASE RATE AND COMMENT!!! Pathogenesis of inflammation P. acnes is found in low numbers on normal skin and is probably not infectious. The bacteria may be the primary factor in the production of inflammatory acne. The mixture of abnormally desquamated cells and excessive amounts of sebum in the microcomedo provides a lipid rich environment for bacteria to thrive. They produce neutrophil chemotactic factors and stimulate neutrophils to release lysosomal enzymes. These proinflammatory mediators attack the microcomedo follicular wall and contribute to the formation of inflammatory lesions. Acne improves when the P. acnes numbers are reduced. P. acnes is sensitive to many antibiotics. The problem is to deliver antibiotics into the lipid-rich environment of the sebaceous follicles where the organism is proliferating. Topical and oral antibiotics are used alone or in combination with topical retinoids. Retinoids disrupt the microcomedo. Benzoyl peroxide Benzoyl peroxide is an effective non-specific antimicrobial agent. It penetrates sebum and suppresses the growth of P. acnes more effectively than topical clindamycin and erythromycin. It has only a weak effect on inflammation and little comedolytic activity. It does not stimulate bacterial resistance like erythromycin and clindamycin. Product formulations include gels, creams, lotions, cleansers and bar soaps. It is available

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