Antibiotics for Acne: Do They Work?

Green tea, apple cider vinegar, tea tree oil and toothpaste (which fyi — doesn’t work) are just some of the treatment methods that have been popularly adopted for managing acne. 

However, while these home remedies for acne show promise in handling acne, another treatment method may also be found in the home, a little closer to the medicine cabinet — antibiotics.

Antibiotics have been used for decades to manage conditions like urinary tract infections and strep throat. 

However, they’ve also been adopted as a popular way to manage acne in certain individuals. 

The real question, however, is: do they really get the job done?

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 (acne-causing bacteria) 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.

Antibiotics Commonly Used for Acne

With oral and topical options available, antibiotics may be found in tablets, solutions, lotions, gels and even saturated pad form. 

Oral Antibiotics For Acne 

Tetracycline

Tetracyclines are perhaps the most popularly prescribed antibiotics for treating acne. This medication is available in 500mg doses taken twice daily, or a 250mg dosage administered four times a day.

If you're on tetracyclines to manage acne, you might want to steer clear of certain foods as they can reduce its absorption by the body. 

These include meals high in calcium, magnesium, iron, zinc, or sodium bicarbonate. This also applies to antacids high in aluminium.

And while tetracycline may be great for managing acne, it may not be the best option if you're on birth control, as it can tamper with their effectiveness. 

You can, however, eat your pill and have it where barrier protection is recommended while using the pill. 

Doxycycline

This is another effective antibiotic for managing infections. It belongs to the tetracycline family, but is more easily absorbed than the regular form of the drug.

It's also a convenient option when you're not looking to limit your diet too much when managing your acne. 

Doxycycline is less affected by food when it comes to absorption by the body. That said, you may want to pay attention to food containing iron, calcium, magnesium and aluminium, as they can affect how well your body soaks up this drug. 

And speaking of looking out, you may want to take extra care to apply sunscreen when using this medication, as it has been known to cause sensitivity to the sun and increase the chances of getting sunburnt.

Doxycycline is available in a maximum dose of 300mg/day. For mild cases of inflammation, it may be taken at 40mg daily.

Minocycline

Minocycline is also an oral antibiotic popularly recommended to manage acne. It has properties that make it more easily absorbed by the body, which can help to minimize the effects food can have on how the body takes it in.

These properties also boost its access to the sebaceous glands. This helps minocycline fight off acne causing bacteria and other acne-causing substances a lot more easily. 

Unlike antibiotics like doxycycline which can cause annoying sunburns in certain doses, minocycline has very little effects after sun exposure — a welcome feature when considering the effects of acne scarring. 

It also requires a single daily dose to be effective against acne.

Macrolides

Macrolides tick all the boxes when it comes to antibiotic effects on acne. They're well absorbed and penetrate easily into the skin.

But one advantage sets them apart from other forms of this medication — their safety for use during pregnancy. 

Topical Antibiotics For Acne

Clindamycin

Available as a foam, gel, solution, lotion or swab, clindamycin is one of the better-known forms of topical antibiotics.

In foam and gel form, you'll probably be required to apply it just once a day. Other forms will require twice daily usage.

Like other antibiotics for acne, it is very effective in slowing or stopping the growth of bacteria that can cause acne.

Erythromycin

Like clindamycin, erythromycin is available in various topical forms. 

At the height of its effectiveness, it was largely recommended for treating inflammatory acne and was found to be less effective for non-inflammatory lesions. 

However, overtime, acne bacteria got a little too used to this medication and developed a strong resistance towards it, especially in cases where it was used alone, and it is no longer a popular solo recommendation when managing acne. 

It is now rarely used for managing acne.

Because topical antibiotics are prone to bacterial resistance, they are commonly combined with other treatments like benzoyl peroxide which help to prevent or reduce resistance, as well as topical retinoids. 

These retinoids help to reduce exposure to antibiotics and by extension the chances of developing a resistance to them.

How Effective Are Antibiotics for Acne?

There’s a reason the major tetracyclines — tetracycline, doxycycline and minocycline — are so popular for managing acne: they get the job done. 

Approved by the FDA for treating different infections, doxycycline and minocycline are more popular for managing acne, while limited studies have been carried out on the effects of tetracyclines and macrolides in treating acne.

In identical studies carried over 12 weeks, the effects of minocycline on moderate to severe acne were tested on 924 patients who were 12 years and older were given 1mg/kg per day for the duration of the research.

At the end of the study, patients recorded significant improvements to their acne, and minocycline was found safe for use.

Likewise, in a compilation of six studies where doxycycline was pitted against another antibiotic ( azithromycin), the tetracycline was found to be just as effective in reducing cases of moderate to severe acne.

When a study combined topical clindamycin with benzoyl peroxide to test its effectiveness against azelaic acid (another popular treatment for managing acne) the combination was found to be more effective in treating mild to moderate cases of acne.

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

• Vomiting

• Diarrhea

• 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.

Other Treatments for Acne

If you'd rather skip past diarrhea and other possible side effects of using antibiotics to manage acne, the following treatment methods are trusted alternatives to reduce the appearance of more different forms of acne:

• Benzoyl peroxide

• Retinoids like isotretinoin

• Birth control pills

However, if you’d like treatment specially made to care for your acne, our Acne Cream contains prescription-strength retinoids, as well as topical antibiotics to help with treating whiteheads, blackheads and other serious forms of acne.

Do Antibiotics for Acne Really Work?

In oral or topical form, antibiotics have enjoyed long-standing use for managing acne, especially where other acne treatments have been unsuccessful.

However, because of the tendency to build a resistance towards their effects, as well as a number of side-effects, their use should be restricted to recommendations given by trusted healthcare professionals.