Antibiotics for Acne Treatment

More than two million people per year in the United States have acne severe enough to require treatment with antibiotics. With the population of the United States at slightly over three hundred million persons, this fact demonstrates that a large portion of the population suffers from, and receives antibotic treatment for, severe Acne.  The most common antibiotics prescribed are various forms of tetracycline, erythromycin and clindamycin.  Antibiotics can be very effective at attacking and controlling the bacteria in oil glands that cause Acne and the related inflammation (i.e., redness and swelling). Unfortunately, Antibiotics can cease to work over time and have certain side effects that cannot be ignored.

Individual courses of antibiotic therapy last from a minimum of 8 weeks for some patients to several years for others. Typical antibiotics used to treat severe acne include the following:

Erythromycin. Erythromycin has antibacterial and anti-inflammatory effects. Most of the side effects in patients treated with erythromycin are gastrointestinal symptoms.

Tetracycline and derivatives. Tetracycline is another highly effective Acne antibiotic. Tetracycline must be taken on an empty stomach. Because of the risk of tooth discoloration and inhibited skeletal growth, tetracycline should not be used in pregnant women or children younger than nine years. Moderate to severe phototoxicity (i.e., risk of sunburn) and gastrointestinal intolerance have been reported in patients treated with Tetracycline.

Two derivatives of tetracycline that are often used to treat acne are doxycycline and minocycline.   Doxycycline (e.g., Vibramycin, Doryx) is often effectively used to treat moderate to severe acne vulgaris. However, associated sensitivity to the sun (i.e., risk of sunburn) somewhat limits its usefulness. Minocycline (Minocin) is a potent acne medication, but treatment with this antibiotic generally is reserved for patients who do not respond to or cannot tolerate other treatment options. Rare but serious side effects are more common in patients taking minocycline than in patients treated with tetracycline or doxycycline.

Although Antibiotics have proven highly effective at controlling and causing the temporary remission of certain types of intermediate grade acne, in many cases, the body eventually develops a resistance to the treatment and in those cases, Antibiotics can cease to work.  In those cases, alternative or stronger treatment (Accutane, increased Antibiotic dosage, etc..) may be needed. Lastly, unless a person outgrows Acne, there is no end to the need to use Antibiotics (unlike Accutane which can lead to long term remission in certain cases). 

Recent research suggests that extended periods of antibiotic use for acne is associated with an increased risk of upper respiratory infections.  Further, prolonged use of antibiotics may cause an increase in the creation of antibiotic-resistant organisms.  Hence, patients should be careful before prolonged courses of antibiotics for Acne treatment.

One big advantage of antibiotics, however, over topical solutions is that they treat the entire skin surface. Topical solutions only affect the area to which they are applied. Further, with respect to external side effects, the drying, redness and peeling associated with most topical solutions are generally not present with antibiotics.



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