Acne is a serious problem, but it can and should be dealt with. Modern medicine has a sufficient arsenal of means for a comprehensive, systemic elimination of both the result (acne of varying severity) and many causes and factors that provoke the course and development of the disease.
Undoubtedly, the first important step is to contact a specialist - try to avoid self-treatment of acne (pimples, acne), which may not only not bring the desired result, but also aggravate the situation. In particular, it is strongly recommended not to open, squeeze or otherwise remove pimples and pustules - this leads to the formation of significant scars and also contributes to the additional spread of infection. It is a professional dermatologist who will help you find the optimal way to combat acne and organize effective treatment.
It is necessary to take into account that in any case, treatment of acne and post-acne will require considerable patience and careful adherence to medical prescriptions over a long period (several months). In addition, you need to mentally prepare for certain difficulties - some stages of therapy may be accompanied by a slight deterioration in the condition of the skin.
Complex treatment of acne disease involves solving a number of diverse problems:
- Implementation of effective prevention designed to prevent the appearance of new manifestations of acne (comedones, papules, pustules, etc.); this is ensured through a set of measures for the general health of the patient’s body, as well as careful care of problem areas of the skin using special products, and compliance with general hygiene requirements.
- Elimination of existing formations; The removal of comedones is usually carried out in specialized beauty salons, where comedo extractors are used for these purposes, as well as a wide range of anti-acne procedures (photo-, light therapy).
- Reducing the level of sebum secretion from the corresponding glands of the skin; to ensure a clinically significant healing effect, it is necessary to reduce the level of secretion by at least 30%; For such adjustment, various medications are used that affect the patient’s hormonal levels (estrogens, antiandrogens).
- Localization and subsequent elimination of foci of skin inflammation; This stage involves the comprehensive use of antibacterial drugs for external and internal use.
- Minimizing the visibility of the results and consequences of acne, primarily scars; The main tool is cosmetic procedures such as cryotherapy, laser therapy, dermabrasion, etc.
As a rule, modern acne treatment, which provides an integrated approach to the problem, demonstrates the greatest effectiveness:
- combined use of drugs and medications that have a systemic effect on the body as a whole;
- the use of drugs that influence the maximum number of factors contributing to the development and aggravation of acne (including hypersecretion, keratinization of hair follicles, the course of inflammatory processes, etc.);
- identification and elimination of all factors that cause the occurrence and development of acne, complicate treatment and recovery, contribute to relapses, as well as the elimination of all associated pathologies (gynecological, endocrine, gastrointestinal, infectious, etc.).
How to treat mild acne
Quite often, mild acne can be treated with over-the-counter acne products. This category includes various lotions, gels, creams, which contain substances such as resorcinol, azelaic acid, benzoyl peroxide, sulfur, and salicylic acid.
They produce the following effect:
- benzoyl peroxide - destroys bacteria that provoke the formation of acne;
- azelaic acid - complex anti-inflammatory, antibacterial, keratolytic effect;
- salicylic acid, resorcinol, sulfur - elimination of comedones of any type (today the share of these substances in cosmetology is decreasing).
Such products are supposed to be applied daily to problem areas, immediately after hygienic cleansing of the skin. If irritation or dry skin occurs, the frequency of use of creams and gels is reduced (every 2-3 days).
The face should be cleansed twice a day using soap for problem skin or another gentle product. When using cosmetics, it is advisable to give preference to water-based products that do not clog skin pores.
If possible, it is worth using face masks to eliminate excess sebaceous secretions.
Despite the fact that mild cases can be easily treated on their own, it is recommended to consult a dermatologist on how to treat acne, especially if acne is noticeably progressing (increasing number of pimples, severe scarring, etc.).
Side effect:
The spectrum of adverse events associated with minocycline does not differ from other tetracyclines.
From the digestive system:
anorexia, nausea, vomiting, diarrhea, dyspepsia, stomatitis, glossitis, dysphagia, hypoplasia of dental enamel, enterocolitis, pseudomembranous colitis, pancreatitis, inflammatory lesions (including fungal) in the oral cavity and anogenital area, hyperbilirubinemia, cholestasis, increased content “liver” enzymes, liver failure, including terminal, hepatitis, including autoimmune.
From the genitourinary system:
vulvovaginal candidiasis, interstitial nephritis, dose-dependent increase in urea content in blood plasma.
From the skin:
alopecia, erythema nodosum, nail pigmentation, pruritus, toxic epidermal necrosis, vasculitis, maculopapular and erythematous rash, Stevens-Johnson syndrome, exfoliative dermatitis, balanitis.
From the respiratory tract:
shortness of breath, bronchospasm, exacerbation of asthma, pneumonia.
From the musculoskeletal system:
arthralgia, arthritis, limited mobility and swelling of joints, discoloration of bone tissue, muscle pain (myalgia).
Allergic reactions:
urticaria, angioedema, polyarthralgia, anaphylactic reactions (including shock), anaphylactoid purpura (Henoch-Schönlein purpura), pericarditis, exacerbations of systemic lupus, pulmonary infiltration accompanied by eosinophilia.
From the hematopoietic organs:
agranulocytosis, hemolytic anemia, thrombocytopenia, leukopenia, neutrocytopenia, pancytopenia, eosinopenia, eosinophilia.
From the central nervous system:
convulsions, dizziness, numbness (including limbs), lethargy, vertigo, increased intracranial pressure in adults, headaches.
From the senses:
tinnitus and hearing impairment.
From the side of metabolism:
thyroid gland: an isolated case of a malignant neoplasm, discoloration (according to the results of pathomorphological studies), dysfunction
.
Others:
Changes in the color of the oral cavity (tongue, gums, palate), changes in the color of tooth enamel, fever, color of secretions (for example, sweat).
How to treat moderate acne
Treatment of moderate acne involves the use of local preparations based on retinoids (gels, creams, etc. applied to the skin) in combination with systemic agents (capsules and tablets to influence pathogenic factors from the inside). If necessary (lack of desired effect), systemic antibiotics are prescribed in a limited volume; Women may be prescribed hormonal contraceptives.
Getting rid of moderate acne requires a relatively long course of medication - antibiotics are taken for a minimum of 6-8 weeks, and a maximum of 4-5 months. In addition, the doctor may prescribe a repeat course (the break between courses is 5-7 days).
If a significant number of pustules are observed, then topical antibacterial drugs are used as an additional measure; In this case, it is important to consider the compatibility of systemic and local medications.
The use of systemic antibiotic drugs may affect the skin's sensitivity to ultraviolet radiation, so it is better to avoid direct sunlight during the treatment period, especially in summer.
In addition, some antibiotics can provoke allergic reactions, thrush, and intestinal disorders.
For women, a combination course may be prescribed, including both systemic antibiotics and oral contraceptives.
If acne removal using all of the above measures was not effective or there was a need for accelerated treatment (the patient has acute psychological problems), then systemic retinoids, which are highly effective, but have certain limitations and side effects, can be used to a limited extent.
Consultation and observation by a dermatologist is mandatory. The doctor will not only help you decide how to treat acne and relieve inflammation, but will also determine whether the risk of recurrence can be completely eliminated.
How to treat severe acne
The fight against severe acne is based on courses of systemic antibacterial therapy using antibiotics, as well as external therapy with local drugs (retinoids).
In the presence of cystic formations, phlegmons and nodules, therapy can take a long time (the average course duration is from 4 to 9 months).
If such measures are not effective, your doctor may prescribe systemic isotretinoin-based retinoids. Their high effectiveness is due to their effect on the sebaceous glands - the production of sebum is suppressed, and with prolonged use of the drug the glands themselves become smaller. These changes are saved after the course, which allows you to consolidate the results obtained. In addition, isotretinoin demonstrates good antibacterial and anti-inflammatory effects.
This acne treatment shows high effectiveness; Before and after photos allow you to clearly evaluate the result.
Treatment of severe forms involves regular consultations with a doctor, as well as timely completion of all necessary tests.
In the treatment of moderate, moderate and severe forms of acne, antibiotics play the main role. Minocycline for acne stands out against the general background of other drugs of the tetracycline group, demonstrating the greatest effectiveness in the absence of significant disadvantages (increased photosensitivity, poor absorption from food).
Advantages of Minolexin in the treatment of moderate to severe forms of acne:
- Minolexin is well absorbed, actively penetrates fat follicles, intensively accumulates in the sebaceous glands, suppressing the growth of pathogenic microorganisms and providing an anti-inflammatory effect
- Minolexin effectively destroys many types of bacteria
- Minolexin is highly effective in lower doses and with shorter duration of treatment
- The result is visually noticeable already in the 6th week of taking Minoleksin
- Minolexin is easy to use and can be taken with meals
- Minolexin is widely and successfully used in Europe and the USA, now the drug is available on the Russian market
- Low resistance of pathogenic organisms to Minolexin - less than 5% (for other antibiotics, bacterial resistance to the drug can reach 62%)
Pharmacological properties
Pharmacodynamics
Semi-synthetic antibiotic from the tetracycline group. It has a bacteriostatic effect on cells of sensitive strains of microorganisms due to reversible inhibition of protein synthesis at the level of 30S ribosomal subunits. Has a wide spectrum of antibacterial activity.
Sensitivity of microorganisms:
Aerobic gram-positive:
Some of the microorganisms listed below have shown resistance to minocycline, so laboratory susceptibility testing is recommended before use. Antibiotics of the tetracycline group are not recommended for the treatment of streptococcal and staphylococcal infections unless sensitivity of microorganisms to minocycline is shown.
- Bacillus anthracis
- Listeria monocytogenes
- Staphylococcus aureus
- Streptococcus pneumoniae
Aerobic gram-negative:
- Bartonella bacilliformis
- Brucella species
- Calymmatobacterium granulomatis
- Campylobacter fetus
- Francisella tularensis
- Haemophilus ducreyi
- Vibrio cholerae
- Yersinia pestis
Minocycline susceptibility testing is strongly recommended for the following organisms:
- Acinetobacter species
- Enterobacter aerogenes
- Escherichia coli
- Haemophilus influenzae
- Klebsiella species
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Shigella species
Additionally:
- Actinomyces species
- Borrelia recurrentis
- Chlamydia psittaci
- Chlamydia trachomatis
- Clostridium species
- Entamoeba species
- Fusobacterium nucleatum subspecies fusiforme
- Mycobacterium marinum
- Mycoplasma pneumoniae
- Propionibacterium acnes
- Rickettsiae
- Treponema pallidum subspecies pallidum
- Treponema pallidum subspecies pertenue
- Ureaplasma urealyticum
Pharmacokinetics
Food intake does not have a significant effect on the extent of absorption of minocycline. Minocycline has a high degree of lipid solubility and low affinity for Ca2+ binding. It is quickly absorbed from the digestive tract in proportion to the dose taken. The maximum concentration of minocycline in blood plasma (Cmax) after oral administration of 200 mg is 3.5 mg/l and is reached (tmax) after 2-4 hours.
Binding to blood proteins is 75%; the effect of various diseases on this parameter has not been studied.
The volume of distribution is 0.7 l/kg. Minocycline penetrates well into organs and tissues: 30–45 minutes after oral administration it is found in therapeutic concentrations in the kidneys, spleen, eye tissues, pleural and ascitic fluids, synovial exudate, exudate of the maxillary and frontal sinuses, and in the fluid of the gingival grooves. Penetrates well into the cerebrospinal fluid (20 - 25% of the level determined in plasma). Passes through the placenta and enters breast milk.
With repeated administrations, the drug may accumulate. Accumulates in the reticuloendothelial system and bone tissue. In bones and teeth it forms insoluble complexes with Ca2+. Subject to enterohepatic recirculation, 30-60% of the dose taken is excreted with intestinal contents; 30% is excreted by the kidneys within 72 hours (of which 20–30% is unchanged), in severe chronic renal failure – only 1–5%. The half-life (T1/2) of minocycline is approximately 16 hours.
Publications:
- E.S. Snarskaya, M.E. Minakova, E.V. Kuznetsova. Russian Journal of Skin and Venereal Diseases. Minolexin and its place in the standards of treatment of acne vulgaris, No. 3, 2014.
- S.A. Masyukova, I.V. Ilyina, E.G. Sanakoeva, E.V. Gorbakova et al. Minocycline in the treatment of acne and rosacea. Abstracts of the XXXII scientific-practical conference Rakhmanov readings. Dermatology in Russia. 2015; 4 (S1): 82. Pp. 27
- T.A. Belousova, M.V. Goryachkina. Antibiotics in the treatment of acne: the problem of rational choice. EFFECTIVE PHARMACOTHERAPY. Dermatovenereology and dermatocosmetology” No. 1 (4), 2014.
- A.V. Samtsov. Minocycline in systemic acne therapy. Bulletin of dermatology and venereology. 2020; 96(1):67–71.
- E.S. Snarskaya. Antibacterial therapy for acne vulgaris. Bulletin of dermatology and venereology. 2019;95(5):58–67.
- L.S. Kruglova, N.V. Gryazeva. Experience with the use of minocycline in a daily dosage of 50 mg and topical therapy in patients with acne vulgaris. PHARMATEKA, 2022, VOLUME 27 No. 8.
Composition per capsule:
Active substance:
minocycline hydrochloride dihydrate (in terms of minocycline) 50.0 mg or 100.0 mg.
Excipients:
microcrystalline cellulose (73.5 mg/147.0 mg), povidone K-17 (8.75 mg/17.5 mg), potato starch (7.0 mg/14.0 mg), magnesium stearate (1.75 mg/3.5 mg), lactose monohydrate (up to the weight of the capsule contents 175.0 mg/350.0 mg).
Hard gelatin capsules:
for 50 mg:
water (13-16%), quinoline yellow dye (0.5833-0.75%), sunset yellow dye (E110) (0.0025-0.0059%), titanium dioxide (0.9740-2.0 %), gelatin (up to 100%).
for 100 mg:
water (13-16%), titanium dioxide (2.0-2.1118%), gelatin (up to 100%).
