Topical Clindamycin acne treatment


This is a semi-synthetic antibiotic that have been derived from lincomycin. The oral version of clindamycin is clindamycin hydrochloride which does not penetrate well on the skin. Topical clindamycin is made up of clindamycin phosphate which has good penetration characteristic on human skin. Although topical clindamycin hydrochloride also works well on acne, the phosphate form is reported to perform better.

II. How does Topical Clindamycin works on acne?

Topical clindamycin causes inhibits protein synthesis on P. Acnes bacteria by binding to the subunit of the bacterial ribosome. This causes the bacteria to either die right away or it is inhibited to replicate. The reduction in the bacterial population also reduces the inflammation and infection caused by these bacteria. It is important to note that topical antibiotics do not decrease the quantity of oil that the oil glands pump out.

Advantages

Directly kills acne causing bacteria without the side effects of oral antibiotics which includes upset stomach, diarrhea and dizziness. Topical antibiotics are safer to use than oral or systemic antibiotics. If your acne is not very severe you should always use topical antibiotics as oral antibiotics have nasty side-effects when used for long periods of time.

Disadvantages

Antibiotic treatment is prone to what is known as bacterial resistance. Bacterial resistance is a condition where the acne causing bacteria is already immune to the germ killing power of the specific antibiotic used. The only solution to bacterial resistance is the use of another antibiotic or the use of products which does not induce bacterial resistance like benzoyl peroxide or azelaic acid.

Efficacy

The effectiveness of topical clindamycin and oral clindamycin is just the same as oral/systemic clindamycin, the only difference is that topical clindamycin is safer and has fewer side effects.

“Clindamycin appears to be superior in efficacy compared with erythromycin and tetracycline. However, the emergence and spread of resistance among propionibacteria to both erythromycin and clindamycin calls into question their long-term viability as topical anti-acne therapies”
( Source: Topical clindamycin in the management of acne vulgaris.Guay DR.University of Minnesota, College of Pharmacy, Department of Experimental and Clinical Pharmacology, Weaver-Densford Hall 7-148, 308 Harvard Street SE, Minneapolis, MN, 55455, USA. guayx001@umn.edu)

Sixty patients (aged 12-30 years) were enrolled in a 12-week, double-blind, randomized study to compare the efficacy of clindamycin phosphate 1% topical solution with oral tetracycline for the treatment of moderate acne. All patients experienced significant reductions in numbers of pustules, papules and inflamed nodules, and there were no significant differences between the two groups. Both treatment regimens were well tolerated, and no systemic side-effects were reported. Topical clindamycin phosphate 1% is considered a safe and effective alternative to oral tetracycline for the treatment of moderate acne vulgaris.
( Source: Topical clindamycin phosphate compared with oral tetracycline in the treatment of acne vulgaris.Katsambas A, Towarky AA, Stratigos J.)

III. Forms, Dosage and Administration

The solution form contains isopropyl alcohol 50% v/v, propylene glycol, and purified water. The gel form contains allantoin, carbomer 934P, methylparaben, polyethylene glycol 400, propylene glycol, sodium hydroxide, and purified water. The lotion form contains cetostearyl alcohol (2.5%); glycerin; glyceryl stearate SE (with potassium monostearate); isostearyl alcohol (2.5%); methylparaben (0.3%); sodium lauroyl sarcosinate; stearic acid; and purified water. This type of medication is designed for topical application only. Wash first affected area and then use a towel to dry it. Apply a thin layer on the affected area. Do not use more than what is necessary and avoid contact with the eyes and mucus membranes

IV. Precautions

Do not use topical corticosteroids at the same time with this product. Check if you have allergic reaction with this medication. Symptoms of allergic reaction include rashes, itching sensation and swelling.

V. Side Effects

This product may cause dryness, scaling and peeling of the skin.

Brand Names

Clinac® solution, Dalacin T® gel, lotion, solution, Topicil® solution & Duac® Once Daily gel

References

Resh William, Stoughton Richard. Topically applied antibiotics in acne vulgaris. Arch Dermatol 1976;112: 182-184.

Beck LE. Topical clindamycin therapy for acne vulgaris. Arch Dermatol [1]1981;117:482-485.

http://www.medscape.com/viewarticle/437515 Topical Clindamycin Plus Benzoyl Peroxide Fights Acne Laurie Barclay, MD ( last update 2002)

http://www.rxlist.com/cgi/generic/clindat.htm “CLEOCIN-T” ( last update 2007 )

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