Topical Antibiotics for Acne Vulgaris

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Abstract
Thirty years ago, oral antibiotics were introduced for acne vulgaris. One can only wonder why it has taken 30 years to get around to seriously using them topically in the management of acne. Topical preparations that contain tetracycline hydrochloride and erythromycin have been available by prescription for more than 15 years; however, to my knowledge, these have never really been used or seriously studied in the management of acne vulgaris. The first experimental antibiotic preparations to have been found useful in the topical management of acne vulgaris were erythromycin and tetracycline, which were in vehicles that were unrelated to those previously available.1-4 It has been known for many years that topical tetracycline hydrochloride and germicidal agents will decrease the free fatty acids on the skin surface, as well as the number of Corynebacterium acnes that can be scraped off the surface.5-8 However, germicidal agents that have been widely