Antibiotics are drugs that are used to treat diseases caused by various bacteria. So, it makes sense that they would work on acne – a skin problem caused by, among other things, bacteria called Propionibacterium acnes (P.acnes). And yet, we don't think of antibiotics as a typical acne treatment.
There's a lot of controversy surrounding this unorthodox treatment among doctors and dermatologists. Some dermatologists prescribe them as freely as giving out a piece of gum, and others use them as a last resort after other acne medications and treatments have failed. This makes us question whether antibiotics are worth the effort of using them.
So are antibiotics a safe and effective treatment option for moderate and severe acne? Let's find out.
How Do Antibiotics Work on Acne?
There's a reason why antibiotics are used more and more frequently to treat inflammatory acne. An overgrowth of P.acnes causes damage to the lining of the hair follicle. Because of this, all that nasty acne-causing stuff enters the skin and causes inflammation on acne-prone skin. This can result in mild, moderate, or even severe acne.
Antibiotics have the unique capacity to decrease bacteria in and around hair follicles, which can stop inflammatory acne. They can also reduce some of the chemicals made by white blood cells. You can get both topical and oral antibiotics to treat acne vulgaris.
However, it's worth mentioning that treatment depends on the type of acne you have. If you have hormonal acne, a hormonal treatment might work better.
Types of Antibiotics Used to Treat Acne
Here are the most common antibiotics used to treat acne.
Tetracycline
Tetracycline is, without a doubt, one of the most commonly prescribed antibiotics for acne. It's classified as a broad-spectrum antibiotic, and it works by stopping the protein synthesis of acne-causing bacteria. On top of that, it also stops the metabolism of bacteria, which lowers the chances of them spreading to other areas on the face.
The usual dosage is around 500 mg twice daily, taken on an empty stomach. Once a few months of treatment have passed, the dosage is either lowered to 250 mg twice a day or the treatment is stopped completely.
However, this oral antibiotic is not only used for acne. Tetracycline has been around for quite some time, and it's often used to treat and stop certain infections spreading, such as malaria and chlamydia.
There are a few things you should be aware of when combining other drugs with tetracycline. Firstly, be wary of ingredients or supplements containing magnesium, iron, aluminum, or zinc. There's usually an instruction manual that comes with the antibiotics. To get a more detailed description of which other oral medicine you should avoid while on them, read the information carefully.
Sometimes, the names of oral medicine will vary depending on where you're from. To be on the safe side, always consult that manual. The best thing you can do is talk to your dermatologist about the supplements or medication you're currently on. They'll advise you on whether you should stop using them.
Monocycline
Also known as minocin, this is the second most commonly prescribed antibiotic for treating acne. It belongs to the class of antibiotics called tetracyclines, and it's been used for treating severe and moderate acne for decades. Although it can work on several types of acne, it's mostly used to treat pustules and severe nodular acne. Your doctor will also prescribe minocycline if you haven't had a positive reaction to other types of antibiotics.
The dosage is typically around 50 to 100 mg a day, so quite lower than tetracycline. You can take it any time you want, and it doesn't have to be right after or during a meal. It can also treat pneumonia and urinary tract infections.
It's important to note that you shouldn't use minocycline if you're currently on Accutane. Combining the two might lead to many serious consequences.
Erythromycin
Erythromycin is another antibiotic that's often used as an acne treatment. The dosage of erythromycin is similar to that of tetracycline, 250 mg to 500 mg a day, depending on the severity of your condition. Unlike the others, you can take it along with your meals.
What's interesting to note is that it has some benefits which tetracycline lacks. Besides the ability to kill off acne-causing bacteria, erythromycin also contains some anti-inflammatory properties that speed up the treatment and increase its effectiveness.
Doxycycline
Often used as a final resort, this type of antibiotic is also found to be a great option for treating acne. If all else fails, your dermatologist will likely prescribe doxycycline to avoid further antibiotic resistance.
The dosage can vary from 50 mg to 100 mg a day - twice a day. Just like erythromycin, it should be taken with food to avoid side effects such as nausea. If your doctor puts you on doxycycline, pay special attention to the potential side effects because this type of antibiotic can increase your photosensitivity.
What Will Happen to your Acne Once You Stop Taking Antibiotics?
If you're considering using antibiotics as part of your acne treatment, you must've wondered what happens to your acne once you get off them. Is it a permanent solution that makes your acne disappear forever, or is it just a temporary mask for a bigger problem? Let's find out.
It's a truth universally acknowledged that anyone who's ever had to go on strong oral medication for acne eagerly awaits the day they'll have to stop taking them. But what if coming off this type of acne therapy leads to a relapse?
If you break out after going off antibiotics, it doesn't mean they didn't work. It just means you have a bigger problem that needs addressing. If you don't, the acne will return, regardless of your treatment.
Can You Get Antibiotic Resistance From Taking Antibiotics for Acne?
One of the biggest concerns for people who try oral antibacterial therapy is that they might develop a resistance to antibiotics, which will prohibit the continuation of the treatment or, worse, dissolve any results that might have occurred.
So what is antibiotic resistance, and who's more likely to get this peculiar condition?
Antibiotic resistance can affect anyone, regardless of age, background, and medical history. Unfortunately, it might be a bigger problem than we'd like to admit.
What are the results of antibiotic resistance, you might ask? On a global level, it makes certain infections, such as tuberculosis and pneumonia, harder to treat. This is because the antibiotics we've been using for decades are no longer as effective as they once were.
If you decide to try antibiotics, choosing the right doctor is important. A good dermatologist can make all the difference. Getting the correct dosage, type, and treatment plan is crucial to avoid complications. Never use antibiotics without getting a prescription for them. Ineffective treatments are one of the biggest threats to this ever-emerging problem.
So, how do you prevent resistance from occurring when taking them for your acne? You can follow a few rules to minimize the chances of developing antibiotic resistance.
- Always ensure they're prescribed by a professional. Don't insist on getting on them just for the sake of it. It's a serious treatment, and it should be approached that way.
- Check the inspiration date and follow the advice your doctor gives you closely.
- Don't stay on antibiotics longer than you have to. You can use probiotics while on them, so your digestion doesn't suffer.
Consult your doctor about any concerns you might have regarding this problem. With the right doctor and an effective treatment plan, you shouldn't worry too much about developing bacterial resistance to antibiotics. Antibiotics for acne are one of the most popular methods of dealing with pimples, so don't be discouraged.
Topical Antibiotics
You don't just have to consider oral antibiotic treatment options. Other than the pill form, you can get topical antibiotics. The most popular version is topical clindamycin and erythromycin, which, in addition to killing bacteria, have an anti-inflammatory effect.
Topical antibiotics usually come in the form of a toner, which you use right after you wash your face before applying a moisturizer for acne. Only put it on the affected area since it can dry out your face.
Topical antibiotics are often combined with topical benzoyl peroxide to help you avoid resistance. Benzoyl peroxide is popular for treating moderate to severe acne vulgaris.
Like with oral antibiotics, always check with your doctor before trying topical antibiotics.
How Long Does a Typical Antibiotic Treatment for Acne Last for?
Most of the time, patients are prescribed antibiotics to take anywhere from 12 to 18 weeks. How long you'll be on antibiotics depends on a couple of factors: your age, the severity of your acne, how well you respond to treatment, and more.
If you don't respond to the treatment after 18 weeks, your doctor will probably switch you to other acne treatments. It's best to avoid using antibiotics for a long period since you can develop bacterial resistance to them or experience digestion problems.
How Long Does it Take for Antibiotics to Clear Up Acne?
Unfortunately, antibiotics are not one of those treatments that give you results immediately. They usually take around six to eight weeks to work. After that, your condition should keep improving. This might be bad news for those who are impatient for a cure. But remember that those few weeks will pass regardless of whether or not you're on antibiotics. So, it's best to continue the treatment even when you don't see results immediately.
If there's no improvement, you might be resistant to antibiotics. But don't worry - your doctor might try other antibiotics from a different family than those you're currently on. Or they might put you on a completely different acne treatment, depending on the severity of your situation.
Remember, each acne type will need a different treatment regimen. That's why it's important to talk to your doctor if you're using topical or oral antibiotics and you haven't seen an improvement in six to eight weeks.
If you get frustrated and give up the treatment prematurely, you might regret it later. Be patient - it will be worth it in the end.
How Do You Go Off Antibiotics for Acne?
Let's talk about how most dermatologists go about stopping acne antibiotics.
After three months of treatment are over, you're usually advised to visit the dermatologist's office. If they decide that you've had at least a 90% improvement in acne lesions, they'll discontinue the antibiotic but tell you to use the same topical treatments as you did when you were on the antibiotic.
Once this initial check-up is over, you'll go to the dermatologist's office in a few weeks so that they see how well you're doing. Depending on the condition, they might put you on another topical treatment or tell you to continue with the old one.
Side Effects of Taking Antibiotics
There are a couple of side effects you might experience if you go on antibiotics. These side effects include:
- Diarrhea
- Nausea and vomiting
- Dryness in and around the mouth
- Sore throat or irritation
- Changes in the color of your urine
- General inflammation or itching
- Numbness in the skin
The abovementioned side effects are milder and more common. However, there are some more serious side effects that can happen, such as:
- Rash or allergic reactions
- Regular headaches
- Blurry vision
- Joint or muscle pain
- Pain or pressure around the chest
- Problems with breathing or swallowing
- Bloody stool
- Seizures
- Hives
- Yeast infections in women
All oral antibiotics can potentially lessen the effects of oral contraceptives or birth control pills, so talk to your doctor about this.
Regarding topical antibiotics, the side effects are not as serious. You might experience irritation, itching, or dryness in the area you're applying it to. If this happens too frequently, talk to your doctor about potentially switching to another form of topical therapy.
There is also a risk of developing contact dermatitis, which requires topical corticosteroids to improve.
If you experience any of these symptoms, call your doctor.
A Word of Caution
With all this information in mind, it's important to remember that acne medications aren't always the ultimate cure for acne. Sometimes, they will only control the symptoms or temporarily mask the acne. This is why relapses happen. If antibiotics don't work for you, other treatments such as Accutane, birth control pills, oral isotretinoin, topical retinoids, or spironolactone might. So don't despair!
The best thing you can do is be honest with your doctor so they can accurately diagnose you. That way, you can undergo the right treatment for your specific acne condition.
The treatment doesn't end once you stop taking antibiotics. One of the most common reasons for relapses is that patients get lazy with their skincare routine after coming off antibiotics. It's crucial to keep using the gels, face cleansers, topical antibiotics, Retin A creams, or benzoyl peroxide your doctor prescribed. Keep your face clean and clear of dead skin cells and debris. That way, you won't have to worry about dealing with acne lesions again.
Whether treating moderate to severe or even mild acne, speak to your dermatologist regularly about any concerns during treatment. Once it's finished, talk to them about a long-term plan to clear acne away for good. You can also find out how to improve the appearance of acne scars.
Bottom Line
Acne is a painful condition with skin redness, spots, and sometimes permanent scarring. Many things can worsen acne, from the weather and diet to ineffective skincare products.
Antibiotics can be beneficial for treating certain types of acne and painful breakouts. They kill the acne-causing bacteria named P. acnes, and they have an anti-inflammatory effect. The type of antibiotic you're prescribed, and the duration of the treatment will depend on your specific condition.
If antibiotics are unsuccessful, benzoyl peroxide, alpha hydroxy acids, topical retinoid options, and other excellent skincare options are available. The best thing you can do is keep a positive mindset, choose a skilled professional to guide you through the process, and be patient. The cure is out there somewhere!
References
Bacterial resistance to Antibiotics in acne vulgaris
This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances, and its goal is to offer a general view of the subject. In case you are suffering from a severe case of acne, you should consult with a dermatologist or a certified medical professional.
