Azithromycin for acne treatment regimen

Azithromycin is an antibacterial drug used to combat many microorganisms. It is often prescribed to people who suffer from acne-like rashes. With proper and regular use of the drug for a month, inflammation decreases by 20%, and after 8 weeks, acne completely disappears.

Efficacy of the drug

Azithromycin has bactericidal properties, due to which pathogenic microorganisms simply die under its influence. If the drug is used when a boil appears, then the focus of the inflammatory process stops producing pus, which is the main source for feeding microbes. Thanks to this, there is a noticeable improvement in the course of inflammation, and over time the problem goes away.

If Azithromycin is used in the case of a single pimple, then you may not expect a noticeable effect at all. Especially when the drug is used in isolation, and no other means of influencing the pimple are used.

In this case, the inflammatory process will disappear, due to which the redness and swelling will go away, but the secretion that has accumulated in the sebaceous gland will not go anywhere, and the excretory duct will also close the exit. As a result, the pimple will turn pale and decrease in size, but will not disappear.

Advantages and disadvantages of Azithromycin

Using an antibiotic is not the best or safest method for getting rid of acne. However, there are some circumstances when it is impossible to do without them.

Let's look at the benefits of Azithromycin in the fight against rashes:

1. compared to other drugs, treatment with Azithromycin takes much less time;
2. the drug is suitable for both internal and external use;
3. due to the fact that during therapy there is a cumulative effect, the therapeutic effect does not end within several days after the end of taking the drug;
4. During the period of therapeutic therapy, it is possible to simultaneously get rid of other diseases that are hidden in nature.

It is no secret that antibiotics have an adverse effect on the body. For acne-like rashes, they are prescribed only when absolutely necessary. The use of Azithromycin has the following negative aspects:

1. When used internally, Azithromycin produces excessive stress on the liver;
2. reduces the functioning of the immune system, causing the body to become more sensitive to the adverse effects of external factors;
3. to treatment with Azithromycin, the body is able to react with a strong allergic reaction;
4. When the course of treatment ends, a relapse may occur.

Method of application and masks based on Azithromycin

If you want to achieve maximum effect, you must strictly adhere to the prescribed treatment regimen and dosage. It is recommended to take one tablet 1 time per day, before meals or 2 hours after meals. To completely clear the skin of acne, the breaks between doses of the drug should be the same.

In addition to taking the drug orally, it can be used to prepare masks:

1. Take an Azithromycin tablet and crush it into a powder. Then a little water is added to the powder to obtain a paste. The resulting mixture is applied pointwise to problem areas every morning and evening.
2. Take one tablet of Azithromycin and Suprastin, crush them to a powdery state, and dilute with water to make a paste. The resulting product is applied to the affected areas, the skin is massaged for 2-3 minutes, after which the mask is washed off with warm water.
3. One Azithromycin tablet is crushed to a powdery state and mixed with Vishnevsky ointment and aloe gel. After this, the mixture is stirred well until it becomes homogeneous. The medicine is applied to problem areas, left for 10 minutes, and washed off with warm water and baby soap.

In this video, a specialist discusses the treatment of acne with antibiotics. How effective is it and what are the pros and cons of such treatment procedures.

Side effects

Any medicine can lead to side effects, Azithromycin is no exception. Let's consider the main ones:

1. When the medication is taken orally, it negatively affects not only pathogenic microorganisms, but also the beneficial intestinal microflora. As a result, a person may experience dysbiosis and other digestive disorders.
2. The use of this antibiotic can provoke disturbances in the functioning of the liver. The body does not remove toxic substances in the usual way, and glycogen begins to be produced less. As a result, a person experiences lethargy, irritability and increased appetite.
3. If the drug is used externally, redness, itching, peeling and swelling of the skin may occur. When taken internally, the occurrence of general allergic reactions is possible.

Contraindications

Before clearing your skin of acne with Azithromycin, you need to understand under what circumstances the drug is contraindicated:

1. hypersensitivity to the components of the drug;
2. serious liver diseases;
3. renal failure;
4. heart rhythm disturbances;
5. period of bearing a child;
6. breastfeeding the baby.

Under the above circumstances, in order to avoid serious complications, you need to choose another medicine to get rid of acne.

How to prolong the effect of pills

The main disadvantage of treating acne with Azithromycin is the high likelihood of relapse after the accumulated reserves of the substance in the tissues are exhausted. To avoid this and not repeat treatment therapy, at the end of the course you should adhere to some rules:

1. switch to a healthy diet, that is, consume as little fatty, sweet, fried and spicy foods as possible;
2. carry out hygiene procedures every morning and evening, and you also need to remember about regular peeling;
3. use exclusively high quality facial care products, or replace them with regular baby soap and natural oils;
4. refuse foundation so as not to block the access of oxygen to the pores;
5. If possible, do not touch your face with your hands during the day, so as not to cause an infection and not to provoke a new rash;
6. Do not squeeze pimples under any circumstances; if they bother you too much, it is better to consult a cosmetologist.

Azithromycin for acne is a popular antibacterial drug that is used to inhibit the activity of many microorganisms. The medicine is often prescribed to patients who have acne on their skin. If the treatment regimen is followed for a month, the inflammatory foci decrease and after eight weeks the acne disappears.

Antibiotic effectiveness

Azithromycin has a bacteriostatic effect, as a result of which pathogenic microorganisms stop multiplying and soon die. When the drug is used for furunculosis, the inflammation site stops secreting purulent contents, which is a nutrient for microbes. The intensity of the inflammation gradually fades and over time the boil disappears.

For single pimples, Azithromycin is ineffective . You may not see a noticeable result if other acne treatment methods are not used. The inflammatory process will fade away, swelling and redness will disappear, but the pathological fluid accumulated in the sebaceous gland will remain inside. As a result, the pimple will become less noticeable, but will not disappear.

Advantages and disadvantages of Azithromycin

An antibiotic cannot be considered the most suitable treatment for acne. But in some situations it is irreplaceable.

Among the advantages of Azithromycin are:

1. rapid achievement of visible results, unlike other drugs;
2. the drug is suitable for external and internal use;
3. the drug tends to accumulate in the structures of the body, so the therapeutic effect continues for several days after the last dose;
4. A correctly selected Azithromycin treatment regimen for acne can eliminate other diseases that have a latent course.

Any antibiotic has a negative impact on your overall health. Therefore, for dermatological rashes, Azithromycin is prescribed only when absolutely necessary.

The use of the drug is accompanied by some negative phenomena:

1. when taking Azithromycin internally, the liver experiences excessive stress;
2. the body's protective functions decrease, resulting in increased sensitivity to negative environmental influences;
3. when treated with Azithromycin, the patient may experience severe allergic manifestations;
4. after completion of the course of treatment, relapses may occur.

Treatment regimens and masks using Azithromycin

To achieve maximum results, you must carefully follow the prescribed treatment regimen and dosage.. Azithromycin against acne should be taken once a day, one tablet before meals or two hours after it.

To completely clear the skin of acne, it is recommended to take equal breaks between taking the medicine.

In addition to internal use, Azithromycin is used to prepare medicinal masks:

1. One tablet of the drug is ground into powder and a little water is added to make a paste. The finished mixture should be applied spotwise in the morning and evening to those places where there are pimples;
2. A tablet of Suprastin and Azithromycin is ground into powder and diluted with water to a paste. The resulting mass is applied to problem areas. Massage the skin for several minutes, then wash off the mask with warm water;
3. The Azithromycin tablet is ground, aloe gel and Vishnevsky ointment are added. The mixture is stirred well and applied to areas with rashes. Keep the mask on your face for 10 minutes. Then it is washed off with warm water and baby soap.

Side effects

Azithromycin for acne, as an antibiotic agent, can cause side effects. The drug itself is not toxic, but undesirable symptoms still occur.

When taken internally, the antibiotic negatively affects not only bacteria, but also beneficial intestinal microflora. As a result, the patient may develop dysbiosis or other digestive disorders.

Azithromycin use may contribute to liver dysfunction. The body begins to retain toxic substances, and the level of glycogen production decreases. The patient becomes lethargic, irritable, and begins to experience a constant feeling of hunger.

When using the drug externally, redness and swelling may appear on the skin. The skin begins to itch and peel. If ingested, general allergic symptoms may occur.

Contraindications

Before taking Azithromycin for acne on the face, you should carefully study the available contraindications. This will help avoid the development of unwanted symptoms.

The main precautions for taking Azithromycin are if the patient has:

1. hypersensitivity to the components of the drug;
2. severe liver pathologies;
3. Impaired heart function;
4. Kidney failure;
5. pregnancy;
6. lactation.

If a person has any contraindications to eliminate acne, you need to choose another medication. This way you can prevent the occurrence of serious complications.

Recommendations for preventing relapse

The main disadvantage of treating rashes with Azithromycin is the high risk of relapse after the drug is completely removed from the body. To prevent this and not return to treatment after completing the therapeutic course, you need to follow some rules.

Dermatologists recommend:

1. eat healthy food, reduce the amount of spicy, fatty, sweet and fried foods you consume;
2. Maintain skin hygiene twice a day and regularly cleanse it with scrubs;
3. use high-quality care products or use simple baby soap and natural oils;
4. do not apply foundation cosmetics to the skin, which restricts the access of oxygen to the pores;
5. try not to touch your face with your hands throughout the day. This way you can avoid infection and the appearance of new rashes;
6. Don't try to squeeze out a pimple! If the rash causes a lot of inconvenience, it is better to seek the services of a qualified cosmetologist.

Antibiotic Azithromycin for acne negatively affects the functioning of the liver, intestines and immune system, destroys beneficial microflora. However, the drug effectively fights acne, which is its main advantage. It is important to read the instructions and follow all recommendations for use and dosage.

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Information for specialists

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4. Modern approaches to the treatment of acne

The information is intended for healthcare professionals and cannot be used by other persons, including to replace consultation with a doctor and to make a decision on the use of these drugs!

Acne or acne disease (AC) is one of the most pressing problems of modern dermatology. The increased interest in this skin pathology is explained, according to Cunlife, a famous scientist who has been fruitfully working on the problem of acne for many years, by the fact that “all over the world there are not only more patients with acne, but an increase in the number of intractable forms.”

In his opinion, this may be due to the deterioration of the ecological situation on Earth, which leads to an increase in genetic disorders in the population, as well as an increase in resistance to drugs, primarily to antibiotics (3).

Acne – a genetically determined long-term polymorphic multifactorial disease of the skin, sebaceous glands and hair follicles. Acne is one of the most common skin diseases among young people, occurring in 85% of boys and girls aged 12 to 24 years, and in 10% it persists until the age period of 25 to 45 years. Most women experience spontaneous reversal of acne by the age of 25. Only 11% of acne occurs at the age of 25–35 years and in 5% at the age of 40 years and older. Recently, there has been a tendency towards an increase in the number of women whose acne debuts at the age of 25 years and older.

The complex influence of genetic factors remains the subject of study, but the genetically determined type of secretion of the sebaceous glands during puberty plays an important, if not the main, role.

According to K.N. Suvorova et al. (1), different expressivity and allelic variations of genes that determine the development of sebaceous glands, their functional ability and enzyme activity can play a large role in the development of ulcer and to a large extent determine the severity of clinical manifestations. There are reports of the presence of a nuclear R factor that determines genetic predisposition. These facts can probably explain the development of mild forms of PD in some people, and severe forms of UP in others. A history of acne in both parents creates a 50% chance of developing severe acne in an adolescent (1).

It is known that human skin, primarily its appendages (hair follicles, sebaceous and sweat glands), has steroid-sensitive receptors that perceive hormone-regulating influences on the development and secretory activity of these structures. During puberty, these interactions begin to actively manifest themselves. The main cutaneous targets for sex steroids are the epidermis, hair follicles, sebaceous glands, melanocytes and fibroblasts.

The German scientist S. Schmitz called the skin the largest endocrine gland in the human body. The skin takes an active part in the metabolism of steroid sex hormones, in particular in the extraglandular formation of androgens from precursor steroids, being at the same time the main target tissue for androgens.

The skin is a peripheral part of the metabolism of male sex hormones; their action is carried out through specific androgen receptors, which are found in various androgen-dependent structures of the skin. Stimulation of androgen receptors increases mitotic activity and differentiation of epidermal cells, increases the synthesis of intercellular lipids, stimulates hair growth and sebum secretion (3).

An important aspect is the participation in the development of inflammation by Propionibacterium acnes: they synthesize various chemoattractants that attract leukocytes to the site of inflammation, lipases and a number of enzymes that lead to damage to the follicle wall; produce vasoactive amines like histamine, which increase inflammation.

A generally accepted classification of UX has not yet been developed. There are a large number of classifications that are based either on the clinical manifestations of the disease or on an assessment of its severity.

The most convenient and often used in dermatological practice classification proposed by the American Academy of Dermatology. According to this classification, the following degrees of severity of PD are distinguished:

– 1st degree – characterized by the presence of comedones (closed and open) and up to 10 papules;

– 2nd degree – comedones, papules, up to 10 pustules;

– 3rd degree – comedones, papulopustular rash, up to 3 nodes;

– 4th degree – a pronounced inflammatory reaction in the deep layers of the dermis with the formation of multiple painful nodes and cysts.

Among the clinical manifestations of UB, the most common is the papulopustular form – 70–80% of cases. The comedonal form and the most severe manifestations of acne – acne conglobata – occur in 10-15% of patients.

There are several approaches to treating UP. Treatment tactics depend on the severity and prevalence of clinical symptoms. In addition, it is necessary to take into account age, gender, and the presence of concomitant pathologies. The treatment plan is based on an assessment of the severity of the clinical course.

For mild forms of urticaria, external therapy is sufficient. Moderate and severe urticaria require a combination of systemic and external therapy (2.5).

External therapy consists in prescribing shaken suspensions, including sulfur, resorcinol, salicylic acid; benzoyl peroxide gel. In modern external therapy, tretinoin, azeloic acid, and topical antibacterial agents are also used, among which the most popular are tetracyclines, erythromycin and clindamycin. They reduce the contamination of P. acnes on the surface of the skin and in the follicles. In addition, antibiotics have an anti-inflammatory effect, inhibiting leukocyte chemotaxis, and regulate the content of free fatty acids in surface fats.

Modern systemic therapy UB includes antibiotics, retinoids, antiandrogen replacement therapy and glucocorticosteroid drugs. Sufficiently long courses of these drugs have an anti-inflammatory effect, normalize keratinization in the follicles, and affect the composition of sebum.

Some treatment regimens for fulminant acne include salicylates, glucocorticosteroids, and dapsone.

Systemic medications for patients with acne, as indicated above, are prescribed for moderate and severe disease. Of the large list of antibacterial agents, only a few can be recommended for the treatment of acne. Considering the fact that antibiotics are prescribed for quite a long time for ulcerative ulcers, they should have low toxicity.

Penicillin was ineffective for urticaria, and sulfonamides were difficult to tolerate by patients. Antibacterial drugs with anti-inflammatory properties, such as tetracycline (and its derivatives - doxycycline, minocycline) and macrolides (erythromycin and azithromycin) are the drugs of choice for papullo-pustular acne.

The use of tetracycline in the treatment of acne is due to its ability to renew the content of free fatty acids in surface lipids. The dose of tetracycline was established through clinical experience, for other drugs the dose was selected in terms of tetracycline.

Without specific justification, some dermatologists consider antibiotic therapy for acne only as an antibacterial effect on the pathological process. In this regard, it is necessary to dwell on the various justified motivations for the use of both systemic and topical antibacterial agents for ulcerative disease. It should be noted that acne is not an infectious disease, but antibiotics are included in treatment regimens for this disease as an important element. First, P. acnes was sensitive to all antibiotics active against Gram-positive pathogens. Secondly, all effective drugs reduce the number of P. acnes by 90% or more, reducing the proportion of free fatty acids in surface lipids by 50%. Fatty acid levels can be reduced without any apparent effect on P. acnes. One of the proven mechanisms for inhibiting bacterial growth is a decrease in the concentration of fat-splitting lipases. Tetracyclines inhibit bacterial lipases more effectively than erythromycin, which leads to the expected therapeutic effect. Antibiotics, especially tetracycline, as well as sulfones provide a pharmacological effect that is not directly related to bacterial inhibition. They have a moderate anti-inflammatory effect, affecting neutrophil chemotaxis and macrophage functions. These drugs are also effective for rosacea, perioral dermatitis, and pityriasis lichenoides, which are not caused by bacteria.

Currently, only two groups of antibiotics are used in the treatment of acne: tetracyclines and macrolides. Comparative characterization is often based on measuring drug concentrations in the blood, but this is not sufficient. The level of an antibiotic in the blood does not provide information about its concentration in target tissues. Lipophilic tetracyclines, such as minocycline, penetrate better into lipid-rich sebaceous follicles and microcomedones. Doxycycline monohydrate has the same effectiveness as minocycline, but does not have side effects on the central nervous system.

Macrolides constitute a valuable alternative to tetracyclines (4). Their significant advantage is the possibility of administration during pregnancy and lactation. Of the modern macrolides, azithromycin, a broad-spectrum antibiotic of the azalide subgroup of the macrolide group, is of interest as a drug for the treatment of ulcers. Without creating high concentrations in the blood, azithromycin, due to its high lipophilicity, is well distributed in the body, penetrating into many organs, tissues and environments. Thanks to additional transport by neutrophils, it accumulates at the site of inflammation in very high concentrations (tens to hundreds of times higher than serum levels) and is retained for a long time, providing a post-antibiotic effect. Azithromycin is resistant to destruction in gastric juice.

Considering that in ulcers the use of antibiotics of only two groups (tetracyclines and macrolides) is justified, it can be argued that the prescription of tetracyclines is mainly aimed at changing the chemistry of sebum, while macrolides have a bactericidal effect against P. acnes and have anti-inflammatory and immunomodulatory effects.

In severe forms of ulcer, such as fulminant and conglobate, coccal flora is usually associated with immunosuppression, which makes the use of azithromycin justified. It is in severe forms of acne that this antibiotic should be included in the treatment regimen. A significant convincing argument in favor of azithromycin is the fact that there are no reports in the literature of P. acnes resistance to the drug.

Azithromycin is widely used in dermatological practice. Azikar " In the treatment of UB Azikar taken at a dose of 500 mg once a day for 3 days, then 500 mg once a week for 9 weeks.

For the treatment of UB we used Azikar in 45 patients with various forms of the pathological process. The patients were treated according to the scheme proposed above. Clinical effect was achieved in all (100%) patients. The treatment was well tolerated by all patients. No side effects were noted during therapy. Thus, we recommend Azikar in the treatment of UB as the drug of choice.

Of course, when treating UB with antibiotics, it is necessary to take into account possible adverse reactions. Sometimes when using antibacterial agents, nausea, vomiting, and gastrointestinal disorders may occur. Most often, such manifestations develop when the macrolides erythromycin and josamycin are prescribed, but these drugs are not used for moderate acne. Tetracyclines can cause reactions such as phototoxicity localized to the face, legs and feet, as well as phototoxic onycholysis. In some cases, severe blistering reactions may occur in fair-skinned individuals. Allergic reactions and fixed erythema are sometimes recorded. Occasionally, inhibition of gram-positive bacteria leads to a change in microflora towards gram-negative microorganisms, and gram-negative folliculitis can form. The possibility of developing candidal lesions, mainly in the form of candidal vaginitis, cannot be excluded. When using tetracycline and minocycline, pigmentation may develop. In addition to the skin, pigment inclusions were noted in the thyroid gland, bone marrow, and some visceral organs.

Antibacterial drugs for acne can, and sometimes need to be combined with courses of tretinoin, since their combination is more effective than either drug alone (3). Tretinoin affects vascularization, which increases the concentration of the antibiotic in tissues.

Systemic retinoids inhibit sebum secretion and promote epidermal cell differentiation. One of the representatives of retinoids is isotretinoin (Roaccutane). The drug reduces the activity of the sebaceous glands, reduces their size, the formation of sebum, inhibits the process of keratinization and thereby eliminates hyperkeratosis at the mouth of the sebaceous gland, preventing the formation of comedones, has a positive effect on the bacterial flora of sebum and reduces the colonization of P. acnes. The most serious side effects of roaccutane are embryotoxic and teratogenic.

Hormone replacement therapy sometimes has a positive effect in women for whom traditional acne treatment has been ineffective. Extremely rarely, in severe forms of acne, antiandrogens (cyprosterone acetate) and spironolactone (potassium-sparing diuretic) are prescribed.

At the beginning of treatment of fulminant acne or other severe forms of inflammatory acne, glucocorticosteroids are prescribed for approximately 1 month: 6-8 tablets per day in terms of prednisolone, followed by a consistent dose reduction.

Thus, establishing a diagnosis of severe forms of ulcer requires the mandatory inclusion of systemic drugs, primarily antibiotics, in the treatment plan. A skillful combination of pathogenetic drugs for external and systemic use can achieve a good clinical effect and improve the quality of life in most patients with various forms of acne.

Literature

1. Suvorova K.N., Kotova N.V.. Severe forms of acne. Intl. honey. magazine 2000; With. 732 – 26.

2. Collier A., ​​Freemann S., Dellavalle R. Acne vulgaris. In: Evidence-based dermatology, Blackwelle Publishing, 2008; 83 – 104.

3. Cunliffe WJ, Collnick HM. Acne. Diagnosis and management. – London, 2001. – 166 rub.

4. Kus S., Yucelten D., Aytug A.C. // Clin Exp Dermatol 2005; 30: 215 – 20.).

5. Noble W. // Semin. Dermatol. 1990. –Vol. 9; p. 586 – 90.