A Survey to Compare the Efficacy of Niosomal Erythromycin Alone versus Combination of Erythromycin and Zinc Acetate in the Treatment of Acne Vulgaris

Acne vulgaris is one of the most common inflammatory skin diseases. Topical antibiotics and retinoids are the first-line therapy in mild to moderate acne vulgaris. Due to increased resistance of Propionibacterium acnes (P. acnes) to topical antibiotics, searching for new formulations of drug release such as niosomes is considered in order to increase efficacy and decrease drug resistance. This study compared the efficacy of niosomal erythromycin4% versus combination of erythromycin 4% and zinc acetate 1.2% in the treatment of mild to moderate acne vulgaris. In this double-blind clinical trial, 70 patients with mild to moderate acne vulgaris of both genders aged between 12 to 30 years were included. The patients were evaluated by counting of the lesions and assessment of quality of life during the 2nd, 4th, 8th and 12th weeks. At the end of the study, 40% and 66.6% of the patients in the niosomal erythromycin group showed a reduction in the number of non-inflammatory and inflammatory lesions, respectively. The percentages for erythromycin and zinc acetate group were 46.6% and 63.3%. One hundred percent of excellent response (8 out of 30 patients) was observed in the niosomal group (P=0.002). A significant improvement in the quality of life was also observed in the niosomal group (P=0.001). Side effects were much less severe in the niosomal group than in the control group. The results showed that niosomal erythromycin has higher efficacy and less severe side effects in comparison with the combination of erythromycin and zinc acetate.