Oral antibiotics for acne

Oral antibiotics are typically prescribed when topical treatments fail or for acne on larger areas of the body where applying topicals is impractical. They are also used for severe acne when Accutane (isotretinoin) isn’t an option.

How Do Oral Antibiotics Work on Acne?

Oral antibiotics help reduce acne in the short term by targeting bacteria and inflammation. However, they do not provide long-lasting results. To maintain improvements, oral antibiotics should be combined with an effective anti-acne skincare routine. After completing a typical 3-4 month course of antibiotics, it's crucial to continue using topical treatments to sustain results.

Common Antibiotics for Acne

Minocycline and Doxycycline are the most commonly prescribed oral antibiotics for acne today. They are more effective and have fewer side effects compared to older antibiotics like tetracycline.

Doxycycline:

• Brand names: Vibramycin, Doxy 100, Oracea, Monodox.
• Should be taken with a full glass of water, and patients should stay upright for at least 30 minutes to prevent esophageal irritation.
• Doses above 100mg/day may increase sun sensitivity.
• Main side effect: gastrointestinal distress.

Minocycline:

• Has a lower incidence of antibiotic resistance compared to doxycycline and can be taken with dairy.
• Offers anti-inflammatory benefits helpful for acne.
• Rare side effect: dizziness, particularly with the immediate-release formulation. Extended-release versions cause this less frequently.
• In rare cases, long-term use can lead to drug hypersensitivity and hyperpigmentation (brown spots on acne scars or lower legs).

Other Antibiotics for Acne

Other antibiotics are less commonly used for acne due to potential risks or lower effectiveness:

• Sulfamethoxazole-trimethoprim can cause severe side effects and is not recommended as a first-line treatment.
• Azithromycin is less effective as an anti-inflammatory than minocycline and should be reserved for more severe conditions than acne.

While oral antibiotics can be a helpful short-term solution for acne, they should be combined with topical treatments for long-term management. Minocycline and doxycycline are the most common options, with each having its own benefits and potential side effects. Always consult with a dermatologist for personalized treatment plans.

To learn more:

Should I treat my acne with Minocycline (Solodyn)?
Should I treat my acne with Doxycycline?
The risk of topical antibiotics in acne

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