Oral Antibiotics For Acne How Long

What Are Oral Antibiotics For Acne

Acne has a variety of causes, but bacteria on the skin is a common trigger for breakouts. Antibiotics for acne work to kill off the bad bacteria on your skin so that the good bacteria can restore balance, reduce inflammation, and diminish blemishes.

Topical acne treatments work for mild cases, but if you have severe, persistent skin problems, such as painful cystic acne, you may want to consider oral antibiotics instead.

Erythromycin is considered a mild oral antibiotic for acne, and its recommended for children and pregnant women. Those who want something stronger may want to consider tetracyclines, like doxycycline or minocycline .

Each of these treatments works to stop the growth of bacteria, making them effective for controlling breakouts.

However, you should only take them if you are willing to commit to the full treatment schedule. Stopping an antibiotic treatment early not only increases your chances of experiencing another acne outbreak, but it also puts you at risk of developing antibiotic resistance.

For this reason, oral antibiotics for acne should only be taken when needed, and you shouldnt expect to need them for more than a few weeks at a time.

In fact, you might want to pair your antibiotics with a benzoyl peroxide topical treatment to eradicate your acne faster and further reduce the risk of developing resistance.

Dosage Of Doxycycline For Acne

The dosage of doxycycline for acne varies by patient, but I typically recommend starting at a low dosage. Some doctors recommend 100mg a day or even twice a day, but I find that the side effects and impact on your microbiome are much more severe with this larger dose.

A doxycycline dosage of between 20-50 mg daily is a good place to start. Since this acne medication can wipe out your natural bacteria levels, continue to take a probiotic for acne to retain some of your bodys helpful microorganisms.

Antibiotics Make Your More Prone To Acne

Not only are antibiotics a short-term fix, but they can actually cause long-term harm to your skin. This happens because antibiotics kill the beneficial, or probiotic, bacteria from your gut.

The digestive system is colonized by billions and billions of bacteria. The number of bacteria in the gut is estimated to be 10 times larger than the number of cells in your body. These bacteria are often called as gut microflora or microbiota.

As humans we live in a mutually beneficial relationship with the bacteria in the gut. The so-called probiotic bacteria for example assist in digestion of food and creation of certain nutrients. And with every new study the importance of gut microflora in health is becoming more and more evident.

The biggest problem with oral antibiotics is that they cause long-term disturbances in gut microflora. Most antibiotics prescribed for acne are not precision weapons. They indiscriminately kill both harmful and probiotic bacteria.

Exactly what kind of damage they do to gut bacteria varies from person to person. Each of has unique bacterial makeup in the gut. And some strains of bacteria are more resistant to antibiotics than other strains. But whats clear is that most antibiotics cause at least some damage to the beneficial bacteria in the gut. And the damage is more likely to be extensive than minor because most probiotic bacteria cant resist antibiotics.

Long-term effect

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Thoughts On Acne Antibiotics Short Term Gain With Long Term Harm

We Need To Change How We Use Antibiotics

Thanks to using higher-than-needed doses of antibiotics and keeping patients on them for longer than recommended, the P. acne and other skin bacteria, like Staphlyococcus aureus have developed resistance to multiple topical and oral antibiotics used to treat this disease chronically. For instance, 20 or 30 years ago, the antibiotic erythromycin was used frequently to treat acne, but now both bacteria are uniformly resistant.

So far we have not seen too much resistance to the tetracycline class of antibiotics used today, but they too will be on their way out if we do not change our prescribing patterns.

This is frustrating because antibiotics dont need to kill bacteria to treat acne. Clearing P. acnes from the area can be helpful, but the bacteria is just one stimulus of inflammation, so removing it is an assist, not a win. And research has shown that the desired anti-inflammatory effects can be achieved at sub-antibacterial dosing. This means that the needed dose is so low that it cant kill good bacteria or challenge pathogenic bacteria to become resistant.

And antibiotics should never be prescribed on their own to treat acne. In fact, treatment guidelines always recommend that antibiotics be combined with a nonantibiotic topical treatment.

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How Are Doxycycline And Minocycline Used In Dermatology

Both doxycycline and minocycline are widely prescribed by dermatologists, most often for the treatment of AV, but are also used to treat other noninfectious inflammatory skin diseases such as rosacea, and a variety of cutaneous infections., Data from 2011 showed that dermatologists in the United States prescribed 8,153,961 antibiotic prescriptions of which doxycycline and minocycline comprised 38 and 30 percent, respectively. Based on this same database, 6,174,025 antibiotic prescriptions were written by US dermatologists for a tetracycline agent the distribution of prescriptions among the tetracyclines was doxycycline hyclate , immediate-release minocycline hydro-chloride , extended-release minocycline tablets , sub-antimicrobial dose doxycycline 40mg modified-release capsules , tetracycline hydrochloride , and doxycycline monohydrate . These data reflect the high level of dependence on the tetracycline class of antibiotics within dermatology, especially doxycycline and minocycline. ,,

When To See A Doctor For Oral Acne Medications

All oral acne medications require a prescription, which means you will need to make an appointment with the dermatologist. If your acne has not responded to topical or over-the-counter medications, you could be a good candidate for any of these treatments.

If you are unsure whether oral acne medications are right for you, visit Zel Skincare & Laser Specialists for a consultation. We can examine your skin and provide a personalized strategy for treating your acne. Maybe oral medications are right for you. Perhaps all you need is a topical acne treatment. Regardless, a dermatologist can be very useful in figuring out the path forward. Contact us today to schedule a consultation.

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Dont Wait To Treat Acne

You may think of acne as a teenage problem, but its not uncommon for acne to appear around age 9. The earlier it comes, the earlier it may go. However, those who start puberty later may have acne into their 20s.

Acne usually subsides on its own, but treatment is important if your child is bothered by his or her appearance, says Dr. Kassouf. Its also important if youre concerned about long-term effects. Severe acne can leave scars and cause skin discoloration.

Weeks Not Months Needed To Judge Response

Prior to initiating isotretinoin therapy, the majority of young adult patients with severe acne were associated with a much longer course of antibiotics than currently recommended, according to a small retrospective chart review in one New York City hospital.

Arielle R. Nagler, MD, of the New York University School of Medicine, and colleagues, found that almost two-thirds of young adult patients were treated with antibiotics for their acne for 6 months or more, with a third on antibiotics for a year or longer. Only 15.3% of patients were taking antibiotics for 3 months or less.

Action Points

• Note that this retrospective study of young adults with acne suggests that many are treated for longer than recommended with antibitoics, prior to escalation to isotretinoin therapy.
• Be aware that the study was conducted at a single institution — practices may differ in the broader population.

The results, published in The Journal of the American Academy of Dermatology, found that the average duration of antibiotic use was 11 months, or 331.3 days , with a median of 238 days. There was a difference in mean duration of antibiotic treatment from those who were treated only at the study site compared to those who had received antibiotics from multiple institutions , but those results barely approached significance .

Disclosures

In the past 12 months, Orlow served as a consultant for Demira, Galderma, GSK/Stiefel, and Provectus, and as an investigator for Amgen.

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How Long Should I Be On Oral Antibiotics

The usual minimum duration of therapy is 6 to 8 weeks. The maximum duration is usually approximately 12 to 18 weeks. If other therapies are not well tolerated, however, meaning that they are overly irritating to the skin or not effective, and if the oral antibiotic therapy was working well, your dermatologist may rarely opt to recommend that you continue the oral antibiotic indefinitely.

This is not an ideal option for most people. Periostat is the newer low-dose oral antibiotic that may be the exception to this general rule. Because the dose is so low, the idea is that it can and should be taken over a long period of time because the incidence of side effects is very low and resistance is not a problem.

After a successful course of antibiotics is completed, you should continue the topical regimen that your doctor prescribed to maintain clearance. Often prescription and OTC treatments can be used together and can complement each other very nicely, but you should let your doctor know about all the products that you are using on your skin.

Because there is no cure for acne and because so many factors cause the acne to recur, you may still need to retreat with oral antibiotics on occasion if you should have a flare of acne. In that case, your doctor will most likely recommend that you restart the last antibiotic that was effective and again complete a 12 to 18 week course. This pattern may need to be repeated on and off depending on how you do.

How Long Should You Take Antibiotics For Acne

While there is no hard limit on how long you can use antibiotics, their use should be limited to the shortest possible period to minimize the risk of developing bacterial resistance. Both topical and systemic antibiotics can cause resistance.

Antibiotics are typically prescribed for 34 months. Your dermatologist will then reevaluate whether you need to continue taking them. Some people with severe acne may need to use antibiotics for 6 months or longer.

It can take as little as 2 weeks after starting an antibiotic to see some improvements for others it can take up to 12 weeks.

You should not stop or change the dosage of antibiotics without first consulting your dermatologist. Using antibiotics incorrectly can contribute to the development of bacterial resistance.

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Doxycycline For Acne: How It Works Dosage Side Effects

Have you tried every cream, birth control, and urban legend for clear skin, all to no effect?

If other methods have failed, antibiotics such as doxycycline may help to clear up recurring acne vulgaris.

Doxycycline is an antibiotic used to treat inflammatory acne with pustules and red bumps after other treatments have failed. Unlike topical acne treatments, doxycycline is an oral medication taken in capsule or pill form.

Heres everything you need to know, from how doxycycline works to dosage to common side effects.

Is Doxycycline Right For You

Doxycycline for acne is an effective treatment with years of documented success stories. However, there are possible risks and side effects involved and its not the right fit for everyone.

Pregnant women, small children, and people on medications listed above should probably not take doxycycline. It also wont work for those with antibiotic resistance. This prescription is not a one size fits all, but its a great solution for a large number of acne patients.

In the end, your integrative dermatologist should be passionate about looking at the whole picture and getting you to your healthiest self. They should be able to give you the scoop on exactly what combination of medication is right for you in winning your war against acne.

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Oral Antibiotics To Treat Acne How It Works And When To Use This Treatment

In most cases, acne can clear up with little more than time and a quality topical ointment. Sometimes, though, youre left with a severe breakout that wont budge no matter how often you wash your face or use a topical treatment.

In these instances, it might be time to consider taking oral antibiotics for acne.

Below, well walk you through what to expect from this treatment regimen so you can determine whether oral antibiotics are right for you as an effective acne treatment.

When Should I Consider Taking Oral Antibiotics

Topical or systemic medications? The choice is made based on the presence, extent, and how severe the inflammatory lesions are. For best results, antimicrobial agents should be combined with topical retinoids and a topical BP product. This increases efficacy, shortens the treatment duration and helps prevent antibiotic resistance.

In the new age of acne treatment, combination therapy is generally the rule. This means that you should be on more than one type of medication at any given time. Because BP is so effective at minimizing resistance to P.acnes, it helps maintain the effectiveness of both oral and topical antibiotics and should be used along with them unless there is an allergy to BP. In those cases, BP is not an option, and other treatments are used.

The main indication for oral antibiotics is moderate to severe inflammatory acne. Tetracyclines are the most commonly used family of antibiotics along with a class of antibiotics known as macrolides, and a third class called sulfonamides.

Topical antibiotics and BP are indicated in people with mild to moderate inflammatory acne. It is highly recommended that topical treatments, such as with BP and azelaic acid or retinoids, be used in combination with oral antibiotics in order to speed the treatment results and to minimize the resistance of the bacteria to the antibiotic.

Oral Antibiotics Commonly Used for Acne

• Tetracyclines

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Doctors Turning To Antibiotic Alternatives To Treat Acne

Date:

Rutgers University

Summary:

Physicians are scaling back on prescribing antibiotics for long-term acne treatment in favor of a combinations of therapies, according to new researchers.

Physicians are scaling back on prescribing antibiotics for long-term acne treatment in favor of a combinations of therapies, according to Rutgers researchers.

The findings, published as Part I and Part II in the journal Dermatologic Clinics, surveyed studies on acute and long-term acne treatments over the past decade to identify trends.

“People are more conscious about the global health concern posed by the overuse of antibiotics and that acne is an inflammatory, not infectious, condition,” said Hilary Baldwin, clinical associate professor of dermatology at Rutgers Robert Wood Johnson Medical School. “Overuse of antibiotics also can promote the growth of resistant bacteria, which can make treating acne more challenging.”

Prolonged use of antibiotics can affect the microbiome in areas other than the skin, resulting in disease. The report noted that people who use topical and oral antibiotics were three times as likely to show an increase of bacteria in the back of their throat and tonsils compared with non-users. Long-term use of antibiotics in acne treatment also is associated with an increase in upper respiratory infections and skin bacteria and was shown to affect a user’s blood-sugar level.

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Do Antibiotics Really Work For Acne

Obviously antibiotics work short-term. Nobody doubts that. The real question is what happens after you finish the treatment. Acne forums are filled with posts complaining how acne came roaring back after the treatment stopped.

Anecdotal evidence is horribly unreliable, so I wanted to see what studies say on this. I looked for studies on recurrence or relapse rates after oral antibiotic therapy. Given how often they are used I was quite shocked that this was the best I could find:

In a study of women over the age of 25 with persistent AV , approximately 82 percent failed therapy with multiple courses of antibiotics and 32 percent had relapsed after treatment with one or more courses of oral isotretinoin.

Post-adolescent acne: a review of clinical features.

I couldnt find any studies on recurrence rates of acne after oral antibiotic therapy. Pretty much all studies just say that patients improved so and so many percentages after so and so many weeks. But nobody seems have bothered to follow up and see what happens after the antibiotic treatment. Because whats the point if acne comes back a few weeks later?

The one study that even touched this showed massive failure rate after multiple courses of antibiotics.

So if we ask do antibiotics really work for acne? I dont know about you, but my answer is flat no. Clear skin for a few weeks is nice, but I want a long-term solution. And that antibiotics aint.

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