Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 10/8/2021
Acne can be a menace to your skin, and while most people may see it as a result of oil or dryness that can be addressed cosmetically, it’s important to understand that acne is, at its core, often a bacterial issue.
That’s one of the main reasons you see serious acne treated with antibiotics on many occasions.
Antibiotics are often a last resort, because while they’re effective in treating infections, they can also bring some uncomfortable adverse effects to the table.
Tetracycline is one such antibiotic commonly prescribed for the treatment of mild and severe acne.
And even though antibiotics present a delicate struggle between being super effective while offering a somewhat steep side effect profile, many people find themselves in need of just that sort of firepower when everything else seems to fail.
If you’re reading this, it’s probably the case that you’ve put your skin through the metaphorical wringer, trying a dozen other treatments to get rid of those pimples and blemishes covering your face.
If you’re curious if tetracycline is a safe and effective option for treating your acne, the answer is yes — with a few caveats. To understand those caveats, we need to start with some basic information about what’s going on with your skin.
Put simply, acne, known clinically as acne vulgaris, is a bacterial infection. A little more specifically, it’s a bacterial infection as a result of four factors in your skin’s healthy function: oil production, dead cell disposal, inflammation and the bacteria itself.
For the worst inflammatory acne vulgaris, you need a treatment that has bacteria-fighting abilities and anti-inflammatory effects.
A pimple occurs when dead skin cells and natural oils (sebum) get stuck in your hair follicles, creating the perfect habitat for the Propionibacterium acnes, or P. acnes.
This is why acne vulgaris mostly happens on your face, back, chest or shoulders: it tends to happen on the parts of your body where there are more oil glands.
But dead skin cells and excess oil production can be caused by a lot of factors, from diet and water intake, to hormones, to stress or even the weather.
Because hormones can cause an imbalance, it tends to happen in adolescence. While some people grow out of it, it can persist.
Tetracycline is an oral antibiotic that’s frequently used to treat infections resulting from pneumonia, as well as eye and skin infections and occasionally for genital and urinary tract infections. It’s also sometimes used to treat diseases spread by ticks, lice and other insects.
And, as you probably suspect by now, it’s also used in the treatment of acne infections.
Typically, it’s taken orally several times a day. It’s a powerful antibiotic — oral tetracycline is used for serious food poisoning cases and even occasionally is employed in the treatment of bioterror attacks, specifically ones employing anthrax.
It’s part of a broad-spectrum antibiotic group that includes many other names, like demeclocycline, lymecycline, methacycline, chlortetracycline, oxytetracycline, minocycline, rolitetracycline and doxycycline. These are not prescribed as topical antibiotics.
Tetracycline and its derivatives work by inhibiting protein synthesis in bacteria, which inhibits growth and propagation of the cell, effectively stopping the spread of the infection.
Though powerful, they’re also considered generally inexpensive antibiotic therapy. Their biggest limitation is that they can cause bacterial resistance, which requires the development of further tetracycline strains that can remain effective.
As far as acne treatments go, tetracycline is popular.
In fact, it’s one of the most widely prescribed antibiotics for acne flare-ups, according to some research. It’s particularly effective against the P. acnes microorganism.
But not everyone agrees with that assessment.
One admittedly older study found evidence that tetracycline’s claim to acne fame may be due in part to a placebo effect.
That study further found that other options like retinoids and topical medications may be more effective, in a shorter time frame.
However, it’s also worth noting there were no other studies that we could find that corroborated this outlier.
Tetracycline is otherwise considered mostly safe and effective for acne treatment when taken as directed. That said, there are some side effects to be aware of.
There are some more common side effects experienced by tetracycline users that you should be most aware of.
For instance, according to one study, about seven percent of users experienced mild gastrointestinal adverse effects — things like stomach aches, bloating, nausea and abdominal pain were most common.
A smaller percentage of users experienced dizziness, headache and photosensitivity issues.
In rare cases, some users experienced complications due to hypersensitivity — if you experience these symptoms, it’s best for you to bring them to the attention of a healthcare professional immediately.
As you might suspect, this treatment is one of many under-researched options currently on the market. There are acne treatment options with more proven benefits.
Here are some simple strategies that can also benefit your skin.
Removing excess oil from your skin with blotting papers or astringents including witch hazel (or even using certain clay masks) can be an effective way to preserve and promote skin health.
But you don’t need a medicine cabinet full of products to deliver results.
One study limited to a dozen people between age 12 and 34 determined that just the trio of an over-the-counter cleanser, a toner and an acne treatment could deliver clearer skin in about six weeks.
A 2016 review pointed to several products that are considered effective: benzoyl peroxide, retinoids, certain antibiotics, and salicylic and alpha hydroxy acids were mentioned. They also noted corticosteroids, antiseptics, certain B vitamins and certain uses of hydrogen peroxide.
Preventing dry skin is absolutely crucial to acne management and prevention. Dead cells stick to your pores and can cause the right conditions for acne vulgaris. A moisturizer can help you manage this.
Aloe vera may get a lot of love in the magazines, but hyaluronic acid is your secret ingredient du jour for facial health — it has been shown to effectively promote the retention of moisture beneath your skin.
Washing your face is a great way to get rid of those dead cells we mentioned, but sometimes you need more potent weapons than water and a washcloth. Enter retinoids.
Retinoids (also known as retinol and retin-A) are synthetic vitamin A compounds that help get rid of lingering dead cells.
Prescription-strength retinoids like tretinoin are a great option if you need something stronger.
Also, retinoids have been shown in studies to improve collagen synthesis, which is great for skin health and anti-aging (just watch out for peeling, irritation for sensitive skin, and other side effects).
We may have spent a lot of words discussing tetracycline, but clindamycin combined with some easy to find over-the-counter acne products like benzoyl peroxide can help manage skin blemishes and reduce the frequency and severity of acne breakouts.
When used alongside tretinoin (with the guidance of a healthcare professional), it has been shown to be very effective for treating facial acne.
Even general issues of stress can cause problems with your skin, given enough space to grow out of control.
Health and wellness is good for the other parts of your body anyway, and skin problems now and down the road are just one of the preventable problems that better lifestyle choices can address.
Tetracycline and other antibiotics are one of many potential treatments for your acne. There are others, like retinoids and cleansing routines, that may provide effective relief for more mild or moderate acne types, but if you’re struggling with acne that won’t respond (like severe acne), tetracycline could help.
Whether you should try tetracycline for acne or not is a conversation you should have with a healthcare professional — someone who can assess your individual needs and concerns, and recommend the best treatment options to get you the blemish-free skin you want.
That conversation may also lead you to other causes of — or solutions to — your acne problems (including some of those we mentioned earlier).
No matter where you are in the process, learning more about what plagues your skin may help you find your solution faster.
Check out our acne guide to understand what’s going on on the surface of your skin at a deeper level.