Oral Antibiotics for Acne

Acne is caused by many different factors and ranges from mild to severe. Whiteheads and blackheads caused by clogged pores are generally mild, while bacteria-infected pimples can be painful, inflamed and turn into much more severe cases of acne. When exploring different acne treatment options, your doctor or dermatologist may prescribe you oral antibiotics to help supplement topical creams and lotions. 

Oral antibiotics for acne are by prescription only in Australia, so it’s important to understand how they work and how to best take them for your particular needs.

How do antibiotics work for treating acne?

When pores and hair follicles get blocked, they are clogged with sebum (oil), dead skin cells and bacteria. Noninflammatory acne like whiteheads and blackheads turn into inflammatory acne like papules, pustules, nodes and cysts when the bacteria causes the blemishes to become red, inflamed and potentially infected. 

Antibiotics work on inflammatory acne by controlling the skin bacteria (P. acnes) that contributes to acne. In addition to fighting bacteria, antibiotics also have an anti-inflammatory property that can help reduce redness, swelling and pain.

What types of antibiotics can be used for acne?

There are both oral and topical antibiotics that are prescribed for acne treatment. Topical antibiotics for acne, like clindamycin, commonly come as a lotion or a solution to be applied over the entire affected area. These can be effective, but may take longer to work than oral antibiotics. 

Oral antibiotics are tablets or capsules that you take by mouth. They are often prescribed alongside a topical retinoid cream or another acne treatment to produce the best results. Always take your medication exactly as prescribed and talk to your doctor about your results and any side effects you notice.

Types of oral antibiotics for acne

There are several different types of oral antibiotics that can be prescribed to treat acne, including doxycycline, erythromycin and minocycline. Like all antibiotics, each of these can be prescribed to treat a variety of bacterial infections ranging from STIs to chest infections to acne. 

When oral antibiotics are prescribed for acne, they work by controlling the skin bacteria (P. acnes) that contributes to breakouts and blemishes. They also have an anti-inflammatory effect which can help reduce redness, swelling and inflammation.

Doxycycline

Doxycycline, available under brand names like Doxsig in Australia, belongs to a class of medications called tetracycline antibiotics. When doxycycline is used for acne, it often comes in 50 mg to 100 mg tablets to be taken once or twice daily. Always take your medication exactly as prescribed.

While most people tolerate doxycycline well, there are some common side effects to be aware of such as nausea, vomiting, diarrhea and inflammation of your esophagus that may feel like heartburn. One particularly important side effect to be conscious of is sun sensitivity; always wear sunscreen to protect your skin, especially on the acne-affected areas.

Minocycline

Minocycline, available under brand names like Minomycin in Australia, is also a tetracycline antibiotic. When minocycline is used for acne, it often comes in 50 mg tablets. Always take your medication exactly as prescribed.

Similar to doxycycline, minocycline has a few common side effects that are generally quite mild, including nausea, diarrhea and dry mouth. If you experience anything serious, contact your doctor. 

Erythromycin

Erythromycin, available under brand names like E-mycin in Australia, belongs to a class of medications called macrolide antibiotics. When erythromycin is used for acne, it often comes in 250 mg or 400 mg tablets or capsules. Always take your medication exactly as prescribed.

Common side effects of erythromycin include nausea, upset stomach, diarrhea and vaginal thrush. Taking erythromycin with food may help with any upset stomach symptoms you experience. Talk to your doctor about any serious side effects you notice.

How long do oral antibiotics take to work?

Oral antibiotics can take about six to eight weeks before seeing results. It’s important to follow your acne treatment plan exactly as your doctor or dermatologist has prescribed. Oral antibiotics are often prescribed alongside a topical retinoid that helps with skin cell turnover. 

While it’s common for topical retinoids to make your acne worse before it gets better, the oral antibiotics won’t have this issue; they will fight pimple-causing bacteria over time to help manage acne breakouts. It’s common for oral antibiotics to be prescribed for up to six months or longer.

How do oral antibiotics compare to other acne treatments?

Oral antibiotics are an effective way of managing moderate to severe acne both when prescribed alone and alongside a topical retinoid. They may work faster and better than topical options if there are large areas of your body that are affected by acne. Some people with inflammatory acne may prefer to only take oral antibiotics instead of using a topical. 

Are oral antibiotics safe?

Yes, oral antibiotics are safe to take to treat acne. However, antibiotics in general should be taken for the shortest amount of time possible in order to prevent bacterial resistance to the drugs. Severe side effects from antibiotics are uncommon. While tetracyclines like doxycycline and minocycline are not recommended for pregnant women, erythromycin could be considered for pregnant women to use to treat severe acne if the benefits outweigh the risks of treatment. Talk to your doctor if you are planning pregnancy or pregnant. 

Acne affects us at all ages, and it can be tough on our self-esteem. There are many clinically proven treatments for acne available and commonly recommended by dermatologists. If over-the-counter options aren’t working for you, you can be prescribed a personalised acne treatment plan online via Rosemary. Start your online visit today.

References:

∙ Acne.org (May 2020) - Acne Best Practice Management
∙ Journal of Clinical and Aesthetic Dermatology (May 2015)  -
Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation
∙ Journal of Clinical and Aesthetic Dermatology (February 2011) -
Oral Antibiotic Therapy for Acne Vulgaris
∙ American Family Physician (May 2004) -
Diagnosis and Treatment of Acne

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