Antibiotics for acne

Author: Updated and reviewed by Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand; Vanessa Ngan, Staff Writer; Clare Morrison, Copy Editor, April 2014.

Antibiotics are commonly used to treat acne. They are available as topical preparations for mild acne, and as tablets, capsules and elixirs for oral use in moderate and severe acne.

A doctor's prescription is required to obtain antibiotics. The antibiotics listed on this page were available in New Zealand in April 2014. Other antibiotics or brand names are available on prescription in other countries.

Mechanism of action of antibiotics in acne

Antibiotics have two main effects in acne:

Topical antibiotics in acne

Topical antibiotics require a prescription in New Zealand.

Side effects and risks of topical antibiotics

Oral antibiotics in acne

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

Side effects and risks of oral antibiotics (see also, DermNet's page on tetracycline)

Controversies in use of antibiotics for acne

Antibiotics are moderately effective for acne and are frequently used for acne treatment. They are often prescribed for months or years, because acne is a chronic skin condition. However, many physicians are concerned about the use of antibiotics for acne, mainly because of reports of increasing rates of bacterial resistance to antibiotics.

Bacterial resistance and serious infections including cellulitis, pneumonia, tuberculosis and diarrhoeal illnesses are a global threat. New, more expensive antibiotics are often less well tolerated than older agents and are unavailable in many countries. Very few new antibiotics are being discovered or brought to market.

Note:

If you are prescribed antibiotics for acne, discuss these concerns with your doctor. Make sure your acne treatment is reviewed regularly. It's best to limit a course of antibiotics to 3 months, if possible. Apply topical benzoyl peroxide and/or a topical retinoid to areas affected by acne while on antibiotics and after they have been stopped. Find out if other, non-antibiotic treatment might be suitable for you.

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