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Oral Antibiotics for Acne: What You Need to Know

If you’ve ever experienced acne, your first thought was probably how to get rid of it — fast. Maybe you’ve tried over-the-counter acne washes, treatments, and creams; but if you’ve never seen a doctor about it, you might not have considered getting prescribed oral antibiotics for chest, back, and/or really severe acne. 

What is an oral acne treatment?

Oral acne treatment can be an antibiotic pill that is taken once or twice a day and prescribed by a doctor. Because this method is very strong, it is usually saved for patients with moderate to severe acne. Noticeable effects from this treatment may take anywhere from 2 weeks to 2 months. Oral acne treatment can also be isotretinoin (Accutane) which is a very strong version of the topical tretinoin.

The above situation is totally normal, albeit maybe a bit scary. So let’s discuss everything you need to know about oral antibiotics.

How Do Oral Antibiotics Work to Treat Acne?

Before learning about the different types of oral antibiotics that are used to treat acne, it’s important to understand what an antibiotic does. “Anti” means ‘against’ and “Biotic” roughly translates to ‘life’. Therefore, antibiotics are “anti-life.” But that doesn’t mean it’s going to hurt you – the ‘life’ in this case is the bacteria that contributes to your acne. In short, antibiotics stop the growth of bacteria to help treat acne.

Oral antibiotics are prescribed by physicians and should be used as directed. There are many oral antibiotics used for acne, including, but not limited to Doxycycline, Erythromycin, Tetracycline, Minocycline, Trimethoprim/Sulfamethoxazole (TMP-SMX), and Azithromycin.

Please note that oral antibiotics do not cure acne. While antibiotics reduce inflammation caused by bacteria and kill bacteria, they may not prevent acne from returning. Furthermore, following additional healthy skin practices (i.e. managing stress, washing no more than twice a day, avoiding hair grease, etc) and/or using topical acne treatments like benzoyl peroxide and/or Tretinoin may be necessary to maintain acne-free skin.

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Side effects of oral antibiotics

SSide effects from oral antibiotics are uncommon but may occur in some individuals. While the most frequently reported symptoms come from the digestive system, the following are also possible: 

  • Nausea and/or vomiting
  • Diarrhea
  • Bloating and indigestion
  • Loss of appetite
  • A raised, itchy skin rash
  • Coughing and/or wheezing
  • Tightness of the throat

If you are taking oral antibiotics and notice any of the above side effects (or others), consult your doctor as soon as possible. In some cases, you may need to decrease the dose or stop the medication. If you are having wheezing or tightness of the throat, stop the medication, call 911, and/or go to the emergency room.

Controversies over the use of antibiotics

It’s important to remember that oral antibiotics should be used as directed and may only be necessary as a last resort. If an individual takes antibiotics too often, the bacteria on your skin and in your body may develop antibiotic resistance, in which case antibiotics may not be effective in the future for acne but also for blood/urine infections, you may get in the future. For this reason, physicians typically prescribe oral antibiotics for a short period of time (3-6 months maximum).

Bacterial resistance to antibiotics

Antibiotic resistance occurs when bacteria are still able to grow despite the presence of antibiotics. Using an antibiotic for a prolonged period of time increases the chances of this happening because bacteria can mutate and develop the ability to live despite the antibiotic.

TIf this happens, then there will be no effect from the antibiotics on your acne = it would be a waste of money to use antibiotics if your skin bacteria is resistant to the antibiotics. Also, there is the risk that you need antibiotics for future blood and/or urine infections when you get older and the antibiotics won’t work because you created resistant bacteria.

Thankfully, there are many ways to decrease the risk of antibiotic resistance. First, you can simply not use oral antibiotics as an acne treatment. Instead, you can try other treatment options to see which works best.

Second, our expert Pandia Health doctors recommend you ALWAYS use benzoyl peroxide in addition to the antibiotics. This double-kills the bacteria, decreasing the risk of antibiotic resistance. Additionally, make sure you only take the medication as prescribed (for the limited time by the doctor). This will prevent overuse, in turn, reducing the likelihood that bacteria will become resistant.

Alternatives to Antibiotics for Acne Treatment

If you cannot take oral antibiotics for acne or you’re interested in alternative treatments, talk to your physician about your options.
Some alternatives to oral antibiotics include:

Topical treatments

If an individual cannot take antibiotics due to former allergic reactions, their doctor may recommend an over-the-counter topical treatment such as benzoyl peroxide. This helps treat acne by killing bacteria on the skin and preventing pores from getting clogged.

Topical treatments, like tretinoin cream, are often used as a first-line defense against acne and can be an effective alternative to oral antibiotics. They work by making the pores smaller, making the skin cells less sticky, and making the pores make less oil. Topical retinoids can also be used in combination with other treatments to achieve clearer, healthier skin.

Birth control pills

Much like spironolactone, some birth control pills contain hormones that can help regulate the levels of androgens in the body, minimizing acne. These pills are typically prescribed to women who have acne that is related to hormonal fluctuations.

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Anti-Hormonal treatment

When it comes to hormonal acne treatment, androgens – a type of hormone – can contribute to the development of acne by increasing sebum (oil) production in the skin. Fortunately, hormonal treatments like spironolactone can help reduce acne by regulating androgen levels in the body. By working with a healthcare provider to explore hormonal acne treatment options, you can better manage your acne and achieve clearer, healthier-looking skin.

Oral isotretinoin

Isotretinoin (also known by the brand name Accutane®) is a medication that’s prescribed for severe acne if at least 3 different other treatments used at the same time have proven unsuccessful. However, due to isotretinoin’s high risk of birth defects, it requires that if you have uterus, you must be on 2 forms of birth control and that you and the dermatologist have to sign lots of paperwork. Generally, only dermatologists prescribe isotretinoin. Isotretinoin should not be taken by pregnant women.

Treat Your Acne With Pandia Health’s doctors

Oral antibiotics are a powerful tool to treat moderate to severe acne. They target the bacteria that cause inflammation, reducing redness and swelling. However, antibiotics should be used with caution and under the guidance of a doctor to avoid antibiotic resistance and side effects. Working with a doctor to develop a personalized acne treatment plan is crucial for safe and effective use.

Speak to an expert doctor at Pandia Health today and get antibiotics for acne online with free delivery. #SkipTheTrip to the pharmacy and enjoy #PandiaPeaceOfMind.

Pandia Health is dedicated to providing accurate, reliable health knowledge. Check us out on Instagram, TikTok, YouTube, and our other social channels for more information about acne treatments, women’s health, and lifestyle habits.

Disclaimer: The above information is for informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment. 

Frequently Asked Questions

How long do antibiotics take to work for acne?

Oral antibiotics for acne can take anywhere from 2 weeks to 2 months to see results.

Will acne come back after antibiotics?

Antibiotics are not a permanent solution to fending off acne. Antibiotics will often help clear up your current breakout and kill the bacteria that’s causing it, but most people will need to consistently treat their skin and take preventative measures to limit future breakouts.

Which antibiotics are good for acne?

Both topical and oral antibiotics are effective at helping to treat acne. Antibiotics should never be used alone to treat acne but always with benzoyl peroxide and ideally tretinoin.

Topical antibiotic treatment is more suited for individuals who have mild acne. Topical antibiotics for acne typically come in the form of a cream or gel or lotion and can be used directly on the skin. On the other hand, oral antibiotics may be necessary when acne is more severe. These are swallowed and should only be taken as prescribed by a doctor, usually once or twice a day for 3 months or 6 months maximum.

Generally, doxycycline, tetracycline, TMP-SMZ, Azithromycin and sometimes minocycline are used to treat acne.

Are oral antibiotics effective at treating acne?

In most cases, oral antibiotics are very effective in treating acne. However oral antibiotics must be used with benzoyl peroxide (to prevent antibiotic resistance), ideally are also used with tretinoin (to treat acne in general), and are only used for 3-6 months maximum.

What is the best pill for acne?

The most common antibiotic pills prescribed for acne are doxycycline, tetracycline, minocycline, and erythromycin. Birth control pills may also help improve hormonal acne in people with uteri. Failing all other acne treatments, Isotretinoin (Accutane, Absorica) is a very strong acne treatment that comes as a pill.

Is benzoyl peroxide good for acne?

Benzoyl peroxide is the most effective acne-fighting ingredient that an individual can acquire without a prescription (the American Academy of Pediatrics even said so!). It removes excess oil and skin cells, keeping the pores unclogged (a.k.a clearer skin). But if that doesn’t work, get a prescription from a doctor for tretinoin. Anything a doctor prescribes beats anything you can get over the counter.

Can birth control pills help improve your skin?

Yes, birth control can help treat hormonal acne in women. Acne is caused by an excess production of sebum (oil), which is triggered by androgen hormones. Birth control containing estrogen and progesterone lowers the amount of androgens in the body, which helps reduce acne . The expert doctors at Pandia Health know which birth control pills are better than others for acne.

Do oral antibiotics treat severe acne?

Yes, oral antibiotics are effective at treating severe acne. Oral antibiotics are used for treating moderately severe acne after other methods (i.e. topical creams, topical antibiotics) have failed. Oral antibiotics are never used alone and usually are prescribed with tretinoin and benzoyl peroxide.

What is the best oral antibiotic for acne?

The best oral antibiotic for acne largely depends on the person. The doctor might start by prescribing doxycycline.

Do oral antibiotics increase your skin’s sun sensitivity?

Yes, oral antibiotics increase your skin’s sensitivity to the sun. Increased skin sensitivity to the sun is called photosensitivity. This sometimes occurs when a drug causes your skin to be more sensitive to the UV light emitted from the sun.

This typically appears on the skin as a bad sunburn and/or rash.

Thankfully, this can be largely prevented with the conscious use of hats, shade, and sunscreen when you go outside.

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