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Treating Acne with Oral Antibiotics

An Overview of Oral Antibiotics Used to Treat Acne

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Updated April 19, 2014

You're probably fairly familiar with oral antibiotics. After all, who hasn't used them at some point, either for that dog bite you got last year or all those ear infections your child seems prone to get?

Oral antibiotics are arguably one of the greatest discoveries in medical history, helping fight infections that might otherwise become too much for our bodies to handle. You might be surprised to learn that oral antibiotics have also been used for many years to treat acne.

How Oral Antibiotics Work

Oral antibiotics work by reducing the amount of Propionibacteria acnes (P. acnes) found on the skin and in the follicle. P. acnes are the bacteria responsible for acne breakouts. Oral antibiotics can also diminish skin inflammation.

Usually, your doctor will prescribe a higher dosage at first, and move you to a lower dosage as acne improves. Oral antibiotics are used to treat moderate to severe acne, as well as milder but persistent cases.

Oral antibiotics prescribed as acne treatments include:

Generally, oral antibiotics are used in conjunction with topical acne treatments.

Possible Side Effects

All oral antibiotics can cause gastrointestinal upset (nausea, vomiting, diarrhea). Certain antibiotics may also trigger skin and tooth discoloration, and cause photosensitivity. For women, oral antibiotics can cause vaginal yeast infections.

Although many people believe oral antibiotics can lessen the effectiveness of
birth control pills, this is actually more fiction than fact. No studies have been done showing this to be the case.

Antibiotic Resistance

Another unfortunate result of antibiotic use is the development of antibiotic-resistant bacteria or "super bugs." While MRSA gets most of the attention, the bacteria that cause pimples can also become resistant to antibiotics.

Antibiotic-resistant P. acnes are becoming more common, making antibiotics lose their effectiveness in some cases. If you aren't getting noticeable results with one antibiotic, or the antibiotic you're currently using isn't as effective as it once was, your doctor may switch you to another.

Long-term use of oral antibiotics is more likely to create antibiotic-resistant bacteria. Because of this, some dermatologists are limiting the time patients take oral antibiotics or prescribing different acne treatment medications altogether.

Oral Antibiotic Treatment Tips

  • Use your entire prescription (no leaving tablets unused in the bottle!)
  • Some antibiotics you should take with food; others are best taken on an empty stomach. Make sure you know exactly how and when to take yours.
  • Don't go to bed immediately after taking your oral antibiotic. The pill may dissolve in your esophagus, causing painful burning.
  • Use sunscreen. This is a good skin care habit in any case, and there are plenty of noncomedogenic sunscreens, or even oil-free moisturizers with SPF, to choose from. Wear it daily.
  • Be patient. Oral antibiotics can take several months to really work.

Sources:

Acne Net. American Academy of Dermatology. "Prescription Medications for Treating Acne." http://www.skincarephysicians.com/acnenet/prescriptmeds.html. 2008. Accessed 15 May 2009.

Amerrican Family Physician. American Academy of Family Physicians. "Update on Oral Contraceptives." http://www.aafp.org/afp/991101ap/2073.html 01 Nov 1999. Accessed 25 May 2009.

Del Rosso JQ. "Selection of therapy for acne vulgaris: balancing concerns about antibiotic resistance." Cutis. 2008; 85(5):12-16.

Del Rosso JQ, Kim G. "Optimizing use of oral antibiotics in acne vulgaris." Dermatol Clin. 2009; 27(1):33-42.

DeRossi SS, Hersh EV. "Antibiotics and oral contraceptives." Dent Clin North Am. 2002 Oct;46(4):653-64.

NIAMS/National Institutes of Health. (2006). Questions and Answers About Acne [Brochure]. Bethesda, MD: U.S. Department of Health and Human Services.

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