We found no systematic reviews.

Tetracycline versus placebo

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.

Tetracycline plus topical treatments

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.

Tetracycline with other oral drugs

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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How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

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