The antibiotics used for acne are of two types: topical treatments (the type you apply to your skin) and oral treatments (the type you eat as a pill). The main topical antibiotics used are erythromycin and clindamycin. They are available in creams, lotions or gels, and need to be applied to all areas usually affected by acne.
Erythromycin and clindamycin are the antibiotics most commonly used and they can be combined with zinc, benzoyl peroxide or another treatment called a retinoid. Because antibiotics kill bacteria by using enzymes, bacteria can quickly adapt by evolving ways of blocking the enzymes and therefore becoming resistant to the antibiotics.
This resistance of bacteria is now a common problem in finding an effective antibiotic treatment. Combining the antibiotic with benzoyl peroxide works well here: the disinfectant mops up the resistant bacteria.
Even if you are not on a combined treatment, it can be worth using benzoyl peroxide for five days every four to six weeks or so to help prevent resistance developing and maximising the antibiotic’s effect. Even if your doctor doesn’t prescribe this, you can buy it over the counter and start it yourself; at your next visit mention that you’ve done this, or perhaps even discuss it with your doctor first.
Oral Antibiotics Used for Acne
Antibiotics used for acne are the most popular acne treatment that will kill the p. acnes bacteria found in many acne lesions. P. acnes lives in the skin where it metabolizes sebum (skin oil) to form inflammatory substances. Normal doses of antibiotics have been used for decades in the treatment of acne and they are known to be relatively safe and effective.
New data on smaller doses of antibiotics used for acne reveal that these doses may also be effective. These low doses avoid many of the common side effects seen with traditional acne treatments. The antibiotic with the longest history of acne treatment is tetracycline. It has been used for decades and remains popular among dermatologists to this day.
It may be used for months or years with minimal side effects. Lab tests should be performed on a regular basis when long-term antibiotic usage is prescribed by your dermatologist. In addition, pregnancy should be avoided when antibiotics (or most other medications) are prescribed (especially tetracycline and sulfa based products).
Oral antibiotics come in the same types as well. Your doctor or nurse will explain the dosages and whether you need to avoiding taking milk or food near to the time you take the tablets (this can block the absorption of some tablets).
As always, it is important to follow the instructions carefully to help stop the bacteria developing resistance to the antibiotic, and to be patient while waiting for the tablets to start working.
You can, of course, use topical treatment as well as taking an antibiotic tablet, but, if you have been prescribed an antibiotic to use on your skin, it should be the same type – for example, erythromycin tablet with erythromycin cream. This will help prevent the bacteria from becoming resistant to two different antibiotics at once.
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