An occasional pimple is easy to deal with. You can also control minor acne breakouts with proper skin care and over-the-counter medications. However, when the breakouts get problematic, the doctors may prescribe antibiotics. Systemic antibiotics are often prescribed when topical treatments fail to provide any relief. In this article, we have discussed everything you need to know about using antibiotics for managing your acne.
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Antibiotics For Acne: Why Are They Used And How Do They Work?
Antibiotics are often used to treat acne. They are available in two forms:
- Topical Antibiotics: These are available in the form of creams, gels, toner-like solutions, acne pads, acne patches, and lotions. These are often used to treat mild acne.
- Oral Or Systemic Antibiotics: These are available in the form of tablets, capsules, and elixirs. Oral antibiotics are used when topical and other treatment methods fail to give any results. These are mostly used to treat moderate to severe acne and other forms of inflammatory acne.
Antibiotics are not available without a doctor’s prescription. Oral antibiotics are often prescribed along with topical treatments. Antibiotics are medicines that are used to fight bacterial infections. Hence, they are also known as antibacterials.
Antibiotics mainly work by reducing the number of acne-causing bacteria in and around the follicles, thereby reducing inflammation. However, topical antibiotics don’t kill or reduce the number of bacteria. They reduce inflammation (1). Hence, doctors often prescribe oral antibiotics (for their bactericidal effect) along with topical antibiotics.
Doctors do not recommend long-term usage of systemic antibiotics; they limit them to the shortest possible duration. Long-term use may make the bacteria antibiotic-resistant (1).
Certain antibiotics are often prescribed for acne. In the next section, we have discussed these (in both topical and oral forms).
Topical And Oral Antibiotics For Acne
Recommendations For Topical Antibiotics And Acne Medications
The American Academy of Dermatology recommends the following topical remedies for acne (2):
1. Retinoids And Other Similar Medications
Retinoids are widely used for acne management. They can be used as monotherapy or along with other oral or topical medication. These are used for treating inflammatory acne.
2. Benzoyl Peroxide
It is used for mild acne. Benzoyl peroxide can be used as monotherapy as well. It reduces the chances of developing antibiotic-resistant strains of bacteria. This is one reason it is often used in combination with other topical and systemic medicines or antibiotics.
3. Topical Antibiotics (Clindamycin and Erythromycin)
Clindamycin is prescribed as both an oral and a topical medication. Both these antibiotics are used for acne management. However, they are not prescribed as monotherapy as you might develop the antibiotic-resistant bacterial strains.
4. Acids (Salicylic And Azelaic Acids)
Salicylic acid helps to unclog skin pores (clogged skin pores are a major cause of acne) and also reduces inflammation. Azelaic acid helps to minimize pigmentation caused by inflammatory acne.
5. Resorcinol And Sulfur
These two topical medicines are often combined to treat acne. These are available as lotions and creams and can be purchased without a medical prescription.
6. Aluminum Chloride
Aluminum chloride has antibacterial effects. In a study, this topical acne medication showed improvement in acne lesions with minimal irritation (3).
Apart from these, birth control pills are often recommended for acne. These pills can only help treat acne caused by hormonal fluctuations.
Depending on your acne severity and skin type, the dermatologist will recommend the right medication for you.
Possible Side Effects Of Topical Medications
Topical antibiotics and acne medications may cause side effects that include:
- Skin peeling
- Burning sensation
- Stinging sensation
- Mild skin irritation and itching
Recommendations For Oral Or Systemic Antibiotics
The American Academy of Dermatology Association recommends the following oral antibiotics for acne management (2):
1. Tetracyclines (Minocycline And Doxycycline)
This is the most commonly prescribed antibiotic for acne management. Minocycline and Doxycycline are two tetracyclines that are used widely because they are more effective than other tetracyclines (4).
Caution: Pregnant women and children under nine years of age should not consume this medication.
2. Macrolides (Erythromycin and Azithromycin)
These are also used for acne management. However, these are not used frequently nowadays because of their decreased sensitivity to P.acnes bacteria (4). Erythromycin is often used separately to reduce bacterial growth and reduce inflammation.
Caution: Pregnant women should not take Erythromycin.
Clindamycin helps kill acne-causing bacteria and reduce inflammation. However, it should not be used for a prolonged period (or as a monotherapy) as it can cause the growth of antibiotic-resistant bacterial strains (4).
This is often used as a third-line antibiotic. Third-line treatment is used when the first-line (initial) and second-line (the subsequent) treatments fail to produce results. A study found significant improvement in acne lesions in patients who used this antibiotic for eight months (5).
5. Ampicillin Or Amoxicillin
These two medicines are used to reduce bacterial infection and the associated inflammation. These provide initial relief from the pain caused by severe acne.
Monotherapy with oral antibiotics is not recommended, and oral antibiotics must not be used for a longer duration (usually not more than three months).
Possible Side Effects Of Oral Antibiotics
These might cause:
- Allergic reactions: More than 2% of trimethoprim might cause allergic reactions in susceptible individuals.
- Photosensitivity: Doxycycline often increases your risk of UV damage.
- Gastrointestinal disturbance: Oral antibiotics may also cause nausea and diarrhea.
- Vaginal yeast infection: All antibiotics (especially tetracycline) may cause this in women.
Oral antibiotics may also reduce the effectiveness of birth control pills. If you are taking contraceptive pills, do not forget to inform your doctor.
Antibiotics alone cannot treat acne; because there are several factors that cause acne. These include:
- Excessive oil production
- Clogged pores
- Bacterial growth
Antibiotics only help kill or reduce bacterial growth. If you do not address other factors, it is impossible to treat and heal your condition. Hence, you need to focus on the other aspects of treatment, including the use of topical medications, and following a proper and gentle skin care regimen. Moreover, you have to be consistent with your treatment plan.
Antibiotics help in acne reduction, but you have to take them religiously and maintain the dosage recommended by your doctor. This will help in proper and fast healing. Also, if you are pregnant, consult your doctor before taking antibiotics.
We hope this article was informative. Let us know your thoughts/questions by leaving a comment in the box below.
- An overview of topical antibiotics for acne treatment, Dermatology, US National Library of Medicine, National Institutes of Health.
- Guidelines for care for the management of acne vulgaris, Journal of American Academy of Dermatology.
- Special topical approach to the treatment of acne. Suppression of sweating with aluminum chloride in an anhydrous formulation, Cutis, US National Library of Medicine, National Institutes of Health.
- Oral Antibiotic Therapy for Acne Vulgaris, The Journal of Clinical and Aesthetic Dermatology, US National Library of Medicine, National Institutes of Health.
- Oral trimethoprim as a third-line antibiotic in the management of acne vulgaris, Dermatology, US National Library of Medicine, National Institutes of Health.
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