Antibiotics work by cleansing the skin of acne-causing bacteria and reducing inflammation.
Antibiotics can be used on the skin (topically) or taken orally (systemically). There are several topical products available in creams, gels, solutions, sanitary napkins, foams, and lotions. Topical antibiotics are limited in their ability to penetrate the skin and clear deeper acne, while systemic antibiotics circulate throughout the body and enter the sebaceous glands. However, systemic antibiotics often cause more side effects than topical, but they can be used for more severe types of acne. Usually, topical antibiotics are not self-recommended as an acne treatment, because they can increase the risk of antibiotic resistance in skin bacteria. However, using benzoyl peroxide with topical antibiotics can reduce the possibility of developing antibiotic resistance.
Antibiotics do not address other causes of acne and may take weeks or months to clean. Antibiotics are often used in combination with other drugs that “clog” the follicles. Many oral antibiotics for acne should not be used during pregnancy.
Clindamycin and topical erythromycin are antibiotics which are also anti-inflammatory drugs and are effective against a number of bacteria. They must always be combined with benzoyl peroxide or topical retinoids and applied directly to the skin. Oral erythromycin is also available, but you may become resistant to its effects, limiting its usefulness.
Other commonly used oral anti-inflammatory antibiotics are doxycycline, minocycline, and tetracycline, all of which are quite effective in many cases of acne.
Retinoids or vitamin A derivatives
This drug is available as a topical or oral medication. Topical retinoids clear moderate to severe acne by influencing the way the skin grows and decays. Retinoids can be used in combination with other acne products, such as benzoyl peroxide and oral antibiotics. Topical retinoids do not have severe side effects of oral retinoids; Retinoids are not recommended for pregnant or breastfeeding women. Side effects of topical retinoids include redness, dryness, and itchy skin.
For severe cystic acne, isotretinoin is the most effective therapy. This drug is the only medication that intervenes in all causes of acne.
Talk to your doctor about the potential risks of this drug. Even often it can eliminate severe acne that has not responded to other treatments. However, these products can have side effects. This can cause severe birth defects and must NEVER be taken by a woman who is pregnant or who does not use contraception. In addition, it should not be taken by women who are breastfeeding. Some studies show its use has been associated with an increased risk of depression, suicide and inflammatory bowel disease.
Other side effects are dry skin and lips, muscle and joint pain, headaches, increased levels of triglycerides (a type of cholesterol), and, rarely, temporary hair loss. For most people who use this drug, side effects can be tolerated and not a reason to stop therapy before the zits disappear.
Another topical is azelaic acid, which comes in a gel or cream and has antibacterial and anti-inflammatory properties. This is more commonly used for other types of conditions called rosacea, but may help mild acne.
Dapsson. Dapsone is an antibacterial and anti-inflammatory topical gel.
Oral contraception. Birth control pills contain female hormones that work by counteracting the effects of male hormones (such as testosterone) on zits. Its use is limited to female patients. The maximum benefit of oral contraception in zits occurs in three to four months. Side effects include nausea, weight gain, spots, breast pain, and blood clots.
Spironolactone. Spironolactone is an oral drug that can block the action of body hormones in the skin’s oil glands. This drug is not FDA approved for acne, but is very helpful for women who have acne that worsens around the time of menstruation and menopause.
Another common remedy that your doctor may try is triamcinolone, a type of corticosteroid solution that is injected directly into acne nodules.