What is the Best Antibiotic for Acne?

A look at taking antibiotics to fight acne

Antibiotics have been used in acne treatment for years; however, with increasing concern of developing antibiotic resistance, there is a trend to using shorter courses, usually three to six months of treatment. Applying antibiotics with topical benzoyl peroxide can reduce bacterial presence. Some doctors may advise that you take a probiotic when you are given oral antibiotics. This can be as simple as having a spoonful of yoghurt.

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What are the treatments available for Acne?

Using antibiotics on acne

The occasional pimple can be hidden. If utilized at all, over-the-counter cover-up creams and cosmetic products should be water-based. Even if the outbreaks cannot be completely removed, traditional treatment can provide relief.The best treatments hinder sebum production, stop bacterial growth, or encourage exfoliating of skin cells to unclog pores. Because many treatments can have side effects, any patient with acne should continue with caution when using a new treatment. People with any acne that reduces their self-esteem or makes them unhappy, those with acne that leaves scars or people with severe, persistent occurrences of acne, need the care of a dermatologist.

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Why use antibiotics?

Antibiotics work by handling the skin bacteria (P. acnes) that adds to acne. They also have an anti-inflammatory quality which can decrease the redness, inflammation, and pain of pimples.  Antibiotics are used for inflammatory acne – which are small, pink lumps and bumps, and pustules on the skin’s surface. In more severe cases the lumps are larger, deeper and may appear as nodules and cysts. Antibiotic gels and lotions are put on directly onto the skin and left on, not washed off. (for example Aczone, Clindatech, and Dalacin). Those gels and lotions currently used for the treatment of acne include the active components clindamycin or dapsone. You should apply these on a cool, dry face to lessen irritation. 

What forms of these antibiotics are available?

Using topical antibiotics evades some side effects that can occur with oral antibiotics; however, they may take a while longer to be effective. Larger acne areas like over the back may be hard to. There is also a blended product known as Duac gel that has both clindamycin and benzoyl peroxide.  Antibiotic tabs/capsules include doxycycline (e.g., Doxy, Vibratabs), minocycline (e.g., Minomycin, Akamin) and trimethoprim. Erythromycin can be used in younger patients and during pregnancy. Bactrim is a sulfa antibiotic and is used sometimes. Many various antibiotics are ready for use, and a doctor will recommend the most appropriate product for you. If one antibiotic doesn’t fix your acne, your doctor may adjust your dose or switch you to a different one to improve effectiveness. 

Prescription Treatments for Acne

Antibiotics may be applied topically or taken orally (systemic). They work by ridding the skin of acne-causing bacteria and decreasing inflammation. There are many topical products handy as creams, gels, solutions, pads, foams, and lotions. Topically applied antibiotics are limited in their capability to penetrate the epidermis and clear more deeply rooted acne, whereas systemic antibiotics move throughout the body and into the sebaceous glands. However, systemic antibiotics often induce more side effects than topical ones, but they can be used for more serious kinds of acne. Usually, topical antibiotics aren’t prescribed alone as an acne treatment, as they can heighten the risk for antibiotic resistance in epidermal bacteria. However, applying benzoyl peroxide with a topical antibiotic can reduce the chances of developing antibiotic resistance.Topical clindamycin and erythromycin are antibiotics with anti-inflammatory qualities and are effective against various bacteria. They should always be used together with benzoyl peroxide or a topical retinoid and put directly onto the skin. Oral erythromycin is also ready for use, but you can become resistant to its effects, decreasing its usefulness. Other oral anti-inflammatory antibiotics used regularly are doxycycline, minocycline, and tetracycline, all of which are considered effective in many instances of acne. Antibiotics do not fix the other causative reasons for acne and can take several weeks or months to clear acne up. They are often used in union with other drugs that “unclog” follicles. Many oral antibiotics should not be applied during pregnancy.

Warning About Acne Treatments
  • Oral antibiotics can cause sensitivity to sunlight and stomach upsets.
  • Taking oral antibiotics for more than a couple of weeks may leave women prone to yeast infections.

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How Can I Prevent Acne?

Because of acne’s link with fluctuating hormonal levels and possible genetic influences, many medical practitioners believe there isn’t a way to prevent it. The accepted norm is that neither good hygiene nor a healthy diet can stop acne outbreaks. Treatments can help manage it and reduce future breakouts. During adolescence, good skin care is recommended. The basics include a taking bath or shower daily and washing the face and hands with unscented or antibacterial soap. Other tips for stopping future outbreaks include:

  • Using non-comedogenic or sensitive skin products to decrease the chances of new lesions and lessen skin irritation.
  • Use a mild facial cleanser about twice a day.
  • Avoid cleansers or cleaning products that have scrubbing particles or have a rough texture. These products can irritate the skin and cause breakouts.
  • Apply a non-comedogenic moisturizer and sunscreen daily.
  • Wear makeup that is also non-comedogenic.
  • Resist picking, squeezing, or popping pimples. This can cause scarring and skin infections.

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How to use antibiotics for acne?

A doctor may prescribe an antibiotic gel, solution or lotion with directions on how often to apply it, which sections of the skin it should be applied, and for how long it should be used. Make sure you follow these instructions carefully. Other acne treatments (e.g., topical benzoyl peroxide or retinoids like Epiduo) are often prescribed with antibiotics to get the maximum benefit. In most cases, you should put on a thin layer once or twice a day to the whole affected area, not just the spots. This is because topically applied preparations work to lessen visible pimples but also help stop new ones. Applying them regularly over the entire area will lead to better management of acne. Oral antibiotics work quicker and tend to be more useful if large areas are involved, such as with acne on the face and body. Your doctor and pharmacist will inform you when it’s ideal to take tablets or capsules and whether or not they are to be taken with food. They can also give some practical tips on how to remember to take meds. Antibiotics usually show some signs of improvement in 6-12 weeks. Consult your doctor if your acne is not calming down within this timeframe. This may be an indication to change treatments.

Reducing the risks involved with antibiotic use

Over the years, these medicines have saved countless lives, but as with all medications, there can be side effects.

  • Doxycycline can enhance sensitivity to the sun, so it’s advised to take extra care to avoid sunburn:
  • Avoid being out in the sun when the UV alert level is above level 3. This is mostly in the middle of the day, especially in summer.
  • Check meteorology websites or download weather apps to have a daily alert sent to you and to keep track of the weather.
  • Stay in shaded areas whenever possible
  • Wear a hat and other physical protection like rash shirts while at the beach
  • Use non-comedogenic and/or non-acnegenic sunscreen regularly

Potential side effects of using antibiotics

  1. Nausea, diarrhea, and thrush may affect some people taking oral antibiotics. In some instances, the antibiotics used may cause headaches. If you suspect any medication you are under is causing headaches, especially if they occur in the morning, not easily relieved with paracetamol and/or linked with blurry vision or neck stiffness, you should discontinue using the medication and visit your doctor.
  2. Antibiotics can sometimes cause an allergic reaction. These reactions are more common with the use of minocycline, rare with doxycycline and uncommon with antibiotic gels, solution, and lotions. Persons with the warning signs or symptoms of an allergic reaction like an unexplained fever, sore throat, swollen neck glands, and rash should discontinue use of the medication and visit the doctor. Other symptoms include joint pain, headache and swelling, nausea, abdominal discomfort, diarrhea, and shortness of breath.
  3. Sometimes fever, rash, joint swelling and discomfort, skin ulcers and generally feeling unwell because of a minocycline allergy can occur several years after first beginning therapy. It must be noted that these are rare side effects.
  4. Uncommonly, topical antibiotic gels and lotions can cause skin irritation or allergic contact dermatitis. Using it with other acne treatments can increase inflammation, so it’s best to consult your doctor for advice on how to lessen irritation with these medications. Sometimes, a gradual application is recommended, and the treatment is used every second day or night until it can be tolerated daily.
  5. As with all antibiotics, there is a growing concern that if they are over-used or misused, certain strains of the acne bacteria will become resistant to them, making them ineffective. Taking the full dose of antibiotics as prescribed and using antibiotic creams and gels as instructed will reduce this risk.
  6. Combining antibiotic therapy with other acne treatments, e.g., benzoyl peroxide cream or wash also helps to defend against antibiotic resistance.
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