The effect of oral doxycycline and topical 5% benzoyl peroxide on quality of life in patients with mild to moderate acne vulgaris
Keywords:
Acne, quality of life, doxycycline, benzoyl peroxide, dermatology life quality indexAbstract
Objective The purpose of the study was to determine the impact of mild to moderate acne vulgaris on quality of life (QoL) and to assess the effect of oral doxycycline and topical 5% benzoyl peroxide treatment on QoL. Patients and methods One hundred patients, of either sex, suffering from mild to moderate acne vulgaris, were asked to fill the Dermatology Life Quality Index (DLQI) pro forma (Urdu and English version) independently before starting the treatment. The total score ranged from 0-30. The higher the score, the greater was the impact on QoL. All the patients were subjected to oral doxycycline 100 mg daily and were asked to apply 5% benzoyl peroxide once daily. Patients used these medicines for a period of three months, after which they were again asked to fill the DLQI pro forma. The data were analyzed after compiling the results. Results The results of 100 patients, who completed the study, were compiled. The mean age of patients was 20.45±3.27 years. Among 20 male patients, 8 suffered from grade 1 and 12 from grade 2 acne. Among 80 female patients, 9 suffered from grade 1 and 71 from grade 2 (p=0.012), showing a significant association between grading of acne with respect to gender of the patient. The disease was notably severe among females. Duration and progression of disease showed no significant effect on QoL. Before treatment, the mean DLQI score for females was 14.05±6.32 with minimum score of 1 and maximum score of 25. The mean score for male patients was 12.63±6.46 with minimum score of 1 and maximum of 26, showing that QoL is worse among females as compared to males. The mean pretreatment score was 12.92± 6.43. The score dropped to 5.34±3.14 (p=0.000) after treatment showing that there is a significant improvement in quality of life of these patients. Conclusion The study shows that mild to moderate acne vulgaris has a very large effect on the quality of life of our patients with significant psychosocial limitations. The combination treatment of oral doxycycline and topical 5% benzoyl peroxide significantly improves the quality of life in acne patients.References
Iftikhar U, Aman S, Nadeem M, Kazmi AH. A comparison of efficacy and safety of topical 0.1% adapalene and 4% benzoyl peroxide in the treatment of mild to moderate acne vulgaris. J Pak Assoc Dermatol. 2009;19:141-5.
Ahmed S, Aman S, Nadeem M, Kazmi AH. Efficacy and safety of oral azithromycin in the treatment of mild to moderate acne vulgaris. Ann King Edward Med Univers. 2011;17:437-41.
Doward LC, McKenna SP. Evolution of quality of life assessment. In: Rajagopalan R, Sheretz EF, Anderson TR, eds. Care Management of Skin Diseases. New York: Marcell-Dekker; 1998. p.9-94.
Noor SM, Khurshid K, Mahmood T, Haroon TS. Quality of life in vitiligo patients. J Pak Assoc Dermatol. 2004;14:55-8.
Finlay AY, Khan GK. Dermatology life quality index (DLQI). A simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19: 210-6.
Adalatkhah H, Sadeghi-bazargani H, Amini-sani N, Zeynizadeh S. Melasma and its association with different types of nevi in women: a case-control study. BMC Dermatol. 2008;8:3.
Kokandi A. Evaluation of acne quality of life and clinical severity in acne female adults. Dermatol Res Prac. 2010;2010. pii: 410809. doi: 10.1155/2010/410809. 410809
Zip C. The impact of Acne on Quality of Life. Skin Therpy Lett. 2007;12:7-9.
Ilgen E, Derya A. There is no correlation between acne severity and AQOLS/DLQI scores. Int J Dermatol. 2005;32:705-10.
Mork C, Wahl A, Moum T. The Norwegian version of the dermatology life quality of life index: a study of validity and reliability in psoriatics. Acta Derm Venereol 2002;82:347-51.
Rubinow DR, Peck GL, Squillace KM, Gantt GG. Reduced anxiety and depression in cystic acne and patients after successful treatment with oral isotretinoin. J Am Acad Dermatol. 1987;17:25-32.
Hafez AK, Mahran AM, Hofny ER et al. The impact of acne vulgaris on the quality of life and psychologic status inpatients from upper Egypt. Int J Dermatol. 2009;48:280-5.
Takahashi N, Suzukamo Y, Nakamura M et al. Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne. Health Qual Life Outcomes. 2006;4:46-52.
Salek MS, Khan GK, Finlay AY. Questionnaire techniques in assessing acne handicap: reliability and validity study. Qual Life Res. 1996;5;131-8
Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134;454-8.
Cunliffe WJ, Meynadier J, Alirezai M et al. Is combined oral and topical therapy better than oral therapy alone in patients with moderate to moderately severe acne vulgaris? A comparison of the efficacy and safety of lymecycline plus adapalene gel 0.1% versus lymecycline plus gel vehicle. J Am Acad Dermatol. 2003;49:18-26.
Mallon E, Newton JN, Klassen A et al. The quality of life in acne: A comparison with general medical conditions using generic questionnaire. Br J Dermatol. 1999;140:672-6.
Akman A, Durusoy C, Senturk M. Treatment of acne with intermittent and conventional isotretinoin: a randomized, controlled multicenter study. Arch Dermatol Res. 2007;299:467-73.
Gupta MA, Gupta AK, SchorkNJ et al. Psychiatric aspects of the treatment of mild to moderate facial acne. Int J Dermatol. 1990;29:719-21.
Kulthanan K. Jiamton S, Kittisarpong R. Dermatology Life Quality Index in Thai patients with Acne. Siriraj Med J. 2007;51:3-7.
Akyazi H, Baltachi D, Alpay K, Hocaoglu C. Quality of life in acne vulgaris before and after treatment. Dicle Med J. 2011;38:282-8.
Newton JN, Mallon E, Klassen A et al. The effectiveness of acne treatment and assessment by patients of the outcome of therapy. Br J Dermatol. 1997;137:563-7.
