We found no systematic reviews.
We found no placebo-controlled RCTs of tetracycline. One series involved 29 patients with perioral dermatitis, observed for 3 years.6 The criteria for inclusion were a diagnosis of perioral dermatitis, based on a clinical appearance of papular erythema involving most of the area bordered by the nasolabial folds and the sides of the chin, and rash of a duration of 3 months or more. Patients were instructed to apply topical 0-5% or 0-25% ichthyol in water, or 0-5% or 1% sulphur in calamine lotion at night, alternating with 1% hydrocortisone cream by day. If no favourable response was seen after 1 or 2 weeks, oral tetracycline was prescribed at a dosage of 250 mg three times daily for 1 week and twice daily thereafter. Four patients responded to topical therapy alone and did not need oral tetracycline. Patients treated with tetracycline usually improved within 10-14 days, and were treated for 2-3 months (mean). They relapsed when treatment was stopped. The tendency to relapse diminished with longer periods of treatment.
We found no placebo-controlled RCTs of tetracycline plus topical treatments. One trial followed 95 patients with perioral dermatitis for a period of 42 months.7 Fifty-six patients were treated with oral tetracycline, 250 mg four times daily, together with a topical sulfacetamide-sulphur-hydrocortisone lotion. The other 25 patients received sodium sulfacetamide-sulfur-hydrocortisone lotion alone. Of the 56 patients
What are the effects of oral antibiotics?
treated with oral tetracycline plus sodium sulfacetamide-sulphur-hydrocortisone lotion, 48 (86%) had complete clearing, with a mean treatment duration of 1 month. Fourteen patients (56%) treated with topical sulfacetamide-sulphur-hydrocortisone lotion only had clearing, with a mean treatment duration of 1 month.
In a small subsidiary study, 37 patients received tetracycline 1 g daily, and nine patients received erythromycin 1 g daily.6 Clearing did not occur in 10 patients, even after 10 weeks of treatment, while patients who did achieve complete clearing needed a mean treatment duration of 4-6 weeks.
In one 6-year case series, 39 patients were treated with either tetracycline or erythromycin, 250 mg twice daily, and with 1% hydrocortisone cream or 0-05% desonide cream, topically twice daily.8 The mean duration of treatment was 3 months. Twenty-nine (74%) of 39 patients cleared after 2-3 months of therapy and stayed clear. Nine (23%) cleared but relapsed after treatment stopped. One patient did not achieve remission with therapy.
In a separate study, 43 patients previously given potent local steroids were treated with oral tetracycline, 250 mg either once or twice daily, combined with either 1% hydrocortisone ointment or Alphaderm ointment.9 All patients had improved after 3 months' treatment, and most improved as early as 6 weeks.
Nine patients with a 3-year history of perioral dermatitis received oral tetracycline or doxycycline for 2-3 months.10 Patients with severe disease were treated concurrently with prednisolone, 5-15mg/day for 2-3 weeks. Topical therapy included precipitated sulphur lotion and methylprednisolone acetate ointment. Seven of nine patients were reported cured after 2 months, the other two patients had symptomatic relief.
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.