Q: Is minocycline safer than isotroin in the treatment of acne? Is there no medicine for acne, which does not have severe side effects. Can clarithromycin or azithromycin be used as an alternative treatment for acne? Does minocycline give rise to vision or liver problems?

A:The drug treatment of acne depends on the clinical status i.e. mild, moderate or severe. In mild cases one should use (a) Topical (skin) creams such as benzoyl peroxide preparations, azelaic acid. (b) Topical antibiotic creams/ointments such as erythromycin, clindamycin or tetracycline. (c) Topical retinoid and related preparations such as tretinoin, isotretinoin, adapelene creams These products can be used alone or in combination. In moderate acne the following medicines are useful - tetracyclines (including minocycline), erythromycin, trimethoprim - plus a topical (skin) preparation. In severe cases and if there is nodulocystic acne with scarring, then treatment with oral isotretinoin may be required. However it should be under the strict supervision of a competent dermatologist.