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A proper treatment plan for acne includes an antibiotic in a large majority of patients by far.  This is why relying on an over-the-counter retail product approach is not a good treatment idea. Exceptions to the use of an antibiotic may include a very mild case, or the occasional random breakout involving  not more than a few lesions at most, seen by a person with his or her own treatment experience on what works to resolve the problem. An effective antibiotic would destroy multiplying bacteria in the setting of a clogged, or plugged-up pore, thereby eliminating the major acne cause.   



Oral antibiotics taken by mouth are the most commonly prescribed antibiotic type for acne.  But these can have their own issues: People may become worried about side effects, which may or may not be of real concern, and then there's always the question that comes up about how long, in months or years, to be on that oral antibiotic.  These issues are of much less concern if the antibiotic is applied topically, gently being rubbed into the skin. Up to now there have only been two antibiotics in this class: Erythromycin, which appeared on the dermatology scene in the early 1970s, and for which Dr. Fulton was a leading researcher, and clindamycin.  Topical erythromycin is starting to experience bacterial resistance, and there has long been interest in having another topical formulation and reducing dependence on the oral route of taking the medication. Oral minocycline is one of the most commonly prescribed antibiotics and has been a trusted staple, even with an occasional adverse effect, in acne treatment for decades.  However, a topical minocycline formulation has historically been difficult to achieve, even though it would be expected to offer optimum therapeutic benefit with fewer or no systemic adverse effects at all.

In October 2019, the FDA approved Amzeeq, a topical minocycline foam which is the first stable topical foam formulation of minocycline that has been shown to be an effective and well-tolerated treatment for acne.  Thus the foam vehicle as the form of topical minocycline is a true breakthrough in acne treatment. In its randomized-controlled studies, it was associated with a significantly greater reduction in both inflammatory and noninflammatory lesions, used once -daily, in comparison to other vehicles.  No serious treatment-related adverse or side effects have been reported in the data from some of the largest clinical trials for an acne medication to date.



Overall, this new topical minocycline foam delivery called Amzeeq represents a potentially  useful option as an important part of acne management. As a foam, it leaves no residue or dense feel on facial skin.  When applied in the morning, those wishing to apply sunscreen and/or make-up over the top of Amzeeq would find it easy to do so after the foam "melts" into the skin.  It would also be easier to apply to large body surface or hair-bearing areas such as the chest or back, than creams or ointments. In summary, Amzeeq provides a much-needed option in the treatment of moderate to severe acne.  It utilizes a proprietary Molecule Stabilizing Technology (MST) platform to effectively deliver minocycline in a foam-based vehicle. As a prescription medication, please call our office for a telephone- or office-based appointment  if you're interested in going on Amzeeq.   

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