Wednesday, February 8, 2023

Do Topical Antibiotics Work For Acne

Topical Antibiotics Aren’t Used As The Sole Acne Treatment

ACZONE DAPSONE GEL 5% FIRST IMPRESSIONS | Topical Antibiotic For Adult Acne

Topical antibiotics are not used on their own to treat acne, or at least they generally shouldn’t be.

Antibiotic-resistant bacteria are becoming more of a problem. Using topical antibiotics alone to treat acne can contribute to this problem, creating acne that just won’t respond to that type of antibiotic anymore.

Some healthcare providers believe that topical erythromycin isn’t as effective in treating acne as it used to be precisely because of this reason. Luckily, using another acne treatment along with your topical antibiotic can help prevent this problem from happening.

Besides, topical antibiotics alone simply aren’t the best way to treat acne. They work really slowly when compared to other topical acne treatments available. Who really wants to wait longer than they have to before seeing results?

Side Effects Of Oral Antibiotics

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

  • Nausea and/or vomiting
  • 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 , consult your doctor as soon as possible. In some cases, you may need to decrease the dose or stop the medication altogether.

To Use The Gel Follow These Steps:

  • Wash the affected area with warm water and gently pat dry with a clean towel.
  • Use you fingertips to spread a thin layer of gel evenly over the affected area. Avoid getting the gel in your eyes, nose, mouth, or other body openings. If you do get the gel in your eyes, wash with warm water.
  • Look in the mirror. If you see a white film on your skin, you have used too much medication.
  • Wash your hands.
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    Warning About Acne Treatments

    Patients taking acne drugs should be alert to possible side effects and interactions with other drugs and herbal remedies.

    The topical retinoids and benzoyl peroxide can leave skin reddened, dry, and sensitive to sunlight.

    Oral antibiotics may cause sensitivity to sunlight and stomach upset.

    Benzoyl peroxide may inhibit the effects of some topical retinoids, so never apply them at the same time of day.

    Taking oral antibiotics for more than a few weeks may leave women susceptible to yeast infections.

    Some over-the-counter acne products can cause rare but serious allergic reactions or severe irritation. Seek emergency medical attention if you have symptoms such as throat tightness, difficulty breathing, feeling faint, or swelling of the face or tongue. Also stop using the product if you develop hives or itching. Symptoms can appear anywhere from minutes to a day or longer after use.

    How Do Antibiotics Treat Acne

    Antibiotics For Acne

    A bacterium called Cutibacterium acnes plays a key role in the development of acne by releasing enzymes that break down surrounding oils and skin cells, and triggering inflammation.

    Antibiotics are medications that target bacteria some can directly kill bacteria and others work by preventing their growth and replication. In addition to fighting bacteria, many antibiotics have anti-inflammatory effects.

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    Appendix 2 Medline Search Strategy

    1. exp Acne Vulgaris/ 2. acne$.ti,ab. 3. 1 or 2 4. Dapsone/ 5. Erythromycin/ 6. exp AntiBacterial Agents/ 7. Tetracycline/ 8. .ti,ab. 9. or/48 10. .ti,ab. 11. Ointments/ or Gels/ 12. administration, topical/ or administration, cutaneous/ 13. .ti,ab. 14. or/1013 15. 9 and 14 16. topical antibiotic$.ti,ab. 17. Clindamycin/ 18. Metronidazole/ 19. .ti,ab. 20. aminoglycosides/ or gentamicins/ 21. Neomycin/ 22. .ti,ab. 23. Macrolides/ 24. Sulfacetamide/ 25. sulfonamide antibiotic$.ti,ab. 26. meclocycline$.ti,ab. 27. Lincoside$.ti,ab. 28. Quinolones/ 29. Quinolone$.ti,ab. 30. Chloramphenicol/ 31. Chloramphenicol.ti,ab. 32. Fusidic Acid/ 33. Fusidic acid$.ti,ab. 34. Nitromidazole.ti,ab. 35. Mupirocin/ 36. mupirocin$.ti,ab. 37. bactroban.ti,ab. 38. pseudomonic acid$.ti,ab. 39. Pleuromutilin.ti,ab. 40. retapamulin.ti,ab. 41. Polypetide$.ti,ab. 42. Bacitracin/ 43. bacitracin.ti,ab. 44. Polymyxins/ 45. polymyxin$.ti,ab. 46. or/1645 47. 15 or 46 48. randomized controlled 49. controlled clinical 50. randomized.ab. 51. placebo.ab. 52. clinical trials as 53. randomly.ab. 54. trial.ti. 55. 48 or 49 or 50 or 51 or 52 or 53 or 54 56. exp animals/ not 57. 55 not 56 58. 3 and 47 and 57

    The Future Of Acne Treatment

    A future direction in acne treatment development is utilizing agents that can kill P. acnes but that dont lead to microbial resistance.

    For instance, there are studies using synthetic antimicrobial peptides, tiny strings of amino acids that can physically destroy P. acnes. This remedy would likely be used in conjunction with other therapies that can treat other causes of acne.

    Even more promising is the use of nitric oxide, one of the most important and potent biological molecules, which can both kill P.acnes without the risk of it or any other bacteria developing resistance and inhibit multiple elements of inflammation involved in the formation of the vicious pimple. The limitation to date has been delivery, as nitric oxide is highly unstable.

    But nanotechnology might provide a way of delivering nitric oxide to treat acne. I, along with collaborators at the Albert Einstein College of Medicine and the University of California, Los Angeles, have shown that a nanoparticle capable of generating low levels of nitric oxide over time could hit all the key pathologic elements that lead to acne.

    In the meantime, if you are prescribed antibiotics for acne, ask your doctor how long you need to take them and if the dose is appropriate. And try to avoid popping those zits.

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    Side Effects Of Antibiotics

    Despite having proven benefits for acne, antibiotics do not always have the most promising results in other parts of the body.

    Over time, the following effects may be noticed from long-term use of oral antibiotics:

    • Nausea

    • Headaches

    • Abnormalities in heart function etc

    Certain antibiotics may also increase the risk of developing lupus, autoimmune hepatitis and, as we mentioned earlier, sensitivity to the sun.

    Topical antibiotics are typically safer, but have been known to lead to headaches, sunburn, hyperpigmentation, skin dryness, autoimmune hepatitis.

    In particular, a common adverse reaction to continued antibiotic use, is your body’s development of resistance to its effects.

    This resistance has, over the years, reduced the effectiveness of antibiotics like erythromycin for managing acne and other infections.

    Isotretinoin And Mood Changes

    Acne – Oral Antibiotics in Acne Treatment

    There have been reports of people experiencing mood changes while taking isotretinoin.

    There’s no evidence that these mood changes were the result of the medication.

    But as a precaution, contact your GP immediately if you:

    • feel depressed

    Several treatments for acne don’t involve medication.

    These include:

    • comedone extractor â a small pen-shaped instrument that can be used to clean out blackheads and whiteheads
    • chemical peels â where a chemical solution is applied to the face, causing the skin to peel off and new skin to replace it

    But these treatments may not work and can’t be routinely recommended.

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    Understanding Topical Antibiotics Adult Acne Creams:

    There are lots of solutions available for adult acne but adult acne vulgaris is the best medicine which you can give to your skin. This medication is only given when OTC medication does not work on adult acne. It can be in combination to other medicines as well as for separate treatment too. The solution helps you to overcome the problem of adult acne and give a clear skin.

    What Is Acne Anyway

    Acne is a chronic inflammatory skin condition, characterized by blackheads and whiteheads , pimples, and deeper lumps . They are caused when hair follicles are clogged with oil, bacteria and dead skins cells, and can occur on the face, neck, chest, back, shoulders and upper arms.

    While once thought to be a direct result of overactive sebaceous oil glands, now we know that inflammation is the driving force behind acne. In fact, this inflammation can be seen in the skin even before a pimple pops up. And clogged follicles can also stimulate more inflammation.

    The bacterium that lends its name to the condition Propionibacterium acnes, is just one of the factors that stimulates this acne-causing inflammation.

    Hereditary and genetic factors, hormones, emotional stress and even diet can also bring on the zits. For instance, foods with a high glycemic load such as white grains and sweets have been linked to acne, as they can increase oil production and skin cell turnover. This ultimately causes a backup in the pores and follicles on our skin creating a nice environment for the inflammation-inducing P. acnes to flourish.

    When that happens, these enzymes contribute to the formation of the big, angry, red, cystic acne lesion, and they can also contribute to the creation of pitted scars.

    This is why antibiotics are used to treat acne, but also rosacea, razor bumps and scarring hair loss, to name a few other dermatological conditions.

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    What Is Inflammatory Acne

    People with inflammatory acne have comedones, pimples, and pustules, and their skin can look red and irritated. They might also get painful cysts or nodules. Severe cystic breakouts might leave scars, which can look like light or dark marks, raised bumps, or craters in the skin.

    Adult female acne is a form of inflammatory acne that affects women over the age of 25. AFA breakouts occur along the beard area , and they can cause significant scarring in some women. Many women notice flare ups around the time of their periods, and in fact, hormones do play an important role in AFA.

    Antibiotic Resistance And Other Safety Issues

    Common Topical Antibiotics In Treating Acne

    You should not rely on antibiotics to control your acne long term. Taking antibiotics for too long can increase the risk of antibiotic resistance and other side effects.

    Infections caused by antibiotic-resistant bacteria can be dangerous and difficult to treat. The Centers for Disease Control and Prevention recommends limiting antibiotic use for acne to no longer than 3 months. There might be special cases in which antibiotics would be recommended for longer, but its especially important to see your provider for regular follow up care if this is you.

    After you stop taking antibiotics, your provider will likely recommend that you continue using a topical retinoid medication and benzoyl peroxide to keep your skin clear, even if you dont get anymore breakouts. If you stop using medications, its very likely your acne will come back.

    Due to safety concerns, providers are prescribing minocycline less often. Some possible side effects include liver problems, autoimmune issues, and pigmentation . Pigmentation can happen on the skin or inside the body and may be permanent.

    Doxycycline can cause stomach upset. It can also make your skin more sensitive to the sun.

    Women who are pregnant and children under 8 years old shouldnt take tetracyclines like minocycline or doxycycline. Oral erythromycin or azithromycin are better options. All antibiotics can cause diarrhea, nausea, and stomach upset.

    • Inflammatory bowel disease

    • Severe allergic reactions

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    How Do Antibiotics Work

    Antibiotics kill disease-causing bacteria. They are able to do this by preventing cell reproduction or by messing with cell function within bacteria.

    To manage acne, topical or oral antibiotics may be administered. Topical antibiotics are able to manage acne by reducing the population of p.acnes in the hair follicle.

    They are also recognized for their ability to prevent the formation of comedones, which come together when excess oil and dead skin cells block oil glands in the skin.

    Topical antibiotics also possess certain anti-inflammatory properties.

    Oral antibiotics work similarly to reduce the appearance of acne by decreasing the amount of acne-causing bacteria in the skin.

    Antibiotics are typically reserved for blemishes that put the vulgar in acne vulgaris. These include moderate to severe forms of this skin condition.

    Potential Side Effects Of Antibiotics

    Nausea, diarrhoea and thrush may affect a small number of people taking oral antibiotics.

    In some cases, antibiotics used to treat acne may cause headaches. If you think any medications are causing headaches, particularly if this happens in the morning, is not quickly relieved with paracetamol and/or associated with blurring of vision or neck stiffness, you should stop the medication and see your doctor.

    Antibiotics can sometimes cause allergic reactions. This is more common with minocycline, rare with doxycycline and uncommon with antibiotic gels and lotions.

    Anyone with warning signs or symptoms of allergic reactions, including an unexplained fever, sore throat, swollen neck glands or rash should stop the medication and visit the doctor.

    Other symptoms can include joint pain and swelling, nausea, abdominal discomfort, diarrhoea, headache and shortness of breath.

    Occasionally fever, rash, joint swelling and pain, skin ulcers and generally feeling unwell due to minocycline allergy can occur several years after first starting therapy. However, keep in mind these are rare side effects.

    As with all antibiotics, there is concern that if they are over-used or inappropriately used, strains of the acne bacteria will become resistant to antibiotics, making the medications ineffective.

    Taking antibiotics for the full course as prescribed and applying antibiotic creams and gels as directed will reduce this risk.

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    Selecting A Treatment Regimen

    The physician needs to consider a number of factors in choosing a treatment regimen for the patient with acne. These factors include cost , patient skin characteristics and types of lesions. An algorithm for the suggested management of acne is presented in Figure 5.

    Costs of Selected Topical Treatments for Acne


    Agent Cost and amount per container

    Benzoyl peroxide 5 percent/erythromycin 3 percent

    Cleocin T 1 percent solution

    *Cost estimated by the author based on product information for once-daily application to face for one month.

    Estimated cost to the pharmacist based on average wholesale prices in Red book. Montvale, N.J.: Medical Economics Data, 1999. Cost to the patient may be greater, depending on prescription filling fee.

    Costs of Selected Topical Treatments for Acne


    Agent Cost and amount per container

    Benzoyl peroxide 5 percent/erythromycin 3 percent

    Cleocin T 1 percent solution

    *Cost estimated by the author based on product information for once-daily application to face for one month.

    Estimated cost to the pharmacist based on average wholesale prices in Red book. Montvale, N.J.: Medical Economics Data, 1999. Cost to the patient may be greater, depending on prescription filling fee.

    Algorithm for the management of acne.

    Management of Acne

    FIGURE 5.

    Algorithm for the management of acne.

    The physician should not try to treat cystic acne topically but should use systemic antibiotics or isotretinoin .

    When To Use Topical Antibiotics


    Walk through the aisles of your local pharmacy, and you’ll notice an array of over-the-counter antibiotics in the form of creams, salves, and ointments . However, just because you can freely purchase these products and apply them ad libitum doesn’t mean that they work well. Furthermore, the improper use of topical antibiotics can pose a public health hazard in the form of increased antibiotic resistance. Overall, topical antibiotics have very few appropriate uses.

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    Topical Therapy For Acne

    JOHN J. RUSSELL, M.D., Abington Memorial Hospital, Abington, Pennsylvania

    Am Fam Physician. 2000 Jan 15 61:357-365.

    See related patient information handout on acne, written by the author of this article.

    Acne is a common problem in adolescents and young adults. The disorder is caused by abnormal desquamation of follicular epithelium that results in obstruction of the pilosebaceous canal. This obstruction leads to the formation of comedones, which can become inflamed because of overgrowth of Propionibacterium acnes. Topical retinoids such as tretinoin or adapalene are effective in many patients with comedonal acne. Patients with inflammatory lesions benefit from treatment with benzoyl peroxide, azelaic acid or topical antibiotics. Frequently, the use of comedonal and antibacterial agents is required.

    Acne and its associated problems with self-esteem and social inhibition represent a figurative rite of passage for as many as 80 percent of adolescents and young adults.1,2 Two thirds of affected teenagers wish that they could speak with their physician about acne, but only one third actually do.3 It is important for family physicians to be knowledgeable about the treatment of this common disorder.

    How Can Pandia Health Help

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    Oral Antibiotics In Acne

    The oral antibiotics most commonly prescribed in New Zealand for acne include:

    • Tetracyclines doxycycline , limecycline , minocycline . These are not suitable for children younger than 10 years old because they may stain teeth yellow
    • Cotrimoxazole Trisul®, Deprim®

    Side effects and risks of oral antibiotics

    • Allergy oral antibiotics can cause a variety of rashes in those susceptible. These can be mild or life-threateningly severe. Allergy to a tetracycline or to erythromycin is very uncommon, but more than 2% of those on trimethoprim or cotrimoxazole become allergic to it. Tell your doctor if you have ever reacted badly to an antibiotic.
    • may be a problem for those taking doxycycline. Taking the medicine after the evening meal reduces the risk of sunburn. Dress up and protect your skin from exposure to the sun.
    • Gastrointestinal disturbance affects about 5% of patients and includes nausea, colicky pain and diarrhoea.
    • Thrush affects 5% of treated women and most often affects the vagina. Thrush can also affect the oral mucosa or body folds , particularly in diabetics or in obesity. Thrush is less likely with erythromycin than with tetracycline.
    • Bacterial resistance may occur but is less common with the use of oral antibiotics than with topical antibiotics.
    • Acne antibiotics are unlikely to result in failure of the oral contraceptive pill but if you are concerned, add a barrier method and talk to your doctor about your risks.

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