Efficacy of Topical Sodium Sulfacetamide in the Treatment of Mild and Moderate Acne Vulgaris: A Randomized, Comparative Study

Background and Design: Clindamycin and erythromycin are the most widely used topical antibiotics in the treatment of mild to moderate acne vulgaris. The combination of topical antibiotics with benzoyl peroxide increases the efficacy of the treatment and reduces antibiotic resistance of Propionibacterium acnes. Sodium sulfacetamide is a sulfonamide antibiotic. Although it has been known for many years, it is not widely used in acne treatment. However, it has recently acquired currency again. In this study, we aimed to assess the efficacy of sodium sulfacetamide in the treatment of mild to moderate acne vulgaris and to compare with the other widely used topical antibiotics. Material and Method: In our comparative study, 60 patients with acne vulgaris were randomly assigned into 3 groups, wherein the 1st, 2nd, and 3rd groups were applied sodium sulfacetamide 10% lotion, clindamycin 1% lotion, and erythromycin 2% gel, respectively, twice daily for 12 weeks. Each group consisted of 20 subjects. The treatment was combined with benzoyl peroxide in all groups. The patients were assessed for noninflammatory (open and closed comedones) and inflammatory (papules and pustules) lesion counts at 4, 8, and 12 weeks and, adverse events were recorded. Results: There was no significant difference between the groups for age, sex and acne duration (p>0.05). Statistically significant decrease was obtained with all 3 treatment regimens at the end of the study (p<0.05). No significant difference was detected between the 3 groups regarding noninflammatory and total lesion counts at 4, 8, and 12 weeks, however, clindamycin was superior to other treatments at the 8th week regarding inflammatory lesion counts (p<0.05). There was no statistically significant difference in adverse effect rates between the three groups (p>0.05). Conclusion: In this study, topical sodium sulfacetamide was found to be as effective and safe as erythromycin and clindamycin when combined with benzoyl peroxide in the treatment of mild to moderate acne vulgaris. These results should be supported by studies with larger cohorts. (Turkderm 2012; 46: 33-8)