Antibiotics - oral & topical
The simplest method of understanding how antibiotics work in association with acne, is to have a basic knowledge of the mechanisms involved. Acne usually starts around puberty and is the result of the hormonal changes that occur at that time. The production of the male hormone androgen (in both males and females) stimulates the tiny pilosebaceous units in the skin, to produce an excess of sebum and become blocked by an overgrowth of skin cells.
The pilosebaceous unit consists of, a hair, a hair follicle and a sebaceous gland. There are millions of them in the skin, predominantly on the face, back and chest - the areas affected by acne. Sebum is a greasy substance, produced by the sebaceous glands, which produces sebum, necessary to hydrate the skin. When the pilosebaceous unit starts to block, it becomes invaded by a germ called Proprionbacterium Acne's, more conveniently known as P Acne's.
The combination of blockage, excess sebum and infection by P Acne's, causes inflammation and the characteristic appearance of blackheads, red spots (papules) and pustules.
Normally mild to moderate acne can be treated by using over the counter treatments however in severe cases your doctor may recommend a prescription treatment. Prescription medicines tend to be more effective as they are stronger.
Antibiotics decrease the amount of bacteria in and around pores and also help reduce chemicals produced by white blood cells and the concentration of free fatty acids in the sebum which in turn reduces inflammation.
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There are two types of antibiotics available: oral and topical. Oral medications can be used in combination with topical medications however both can be used alone. It is thought that doctors prefer to treat the infection from within first: oral medications will not only treat the infection but they have anti-inflammatory qualities too. |
Oral antibiotics are normally only prescribed to adults.
The most frequently used antibiotics are:
- Erythronmycin
- Tetracycline
- Minocycline
- Doxycycline
- Clindamycin
Erythronmycin – has anti-inflammatory benefits which help reduce redness in lesions as well as killing bacteria.
Tetracycline – significantly helps reduce lesions.
Minocycline – is a form of tetracycline and is mainly used for pustular acne.
Doxycycline – is used for patients who do not benefit from erythronmycin or tetracycline whether that is because they don’t respond to it or they are unable to tolerate it.
Clindamycin – treats bacterial infections by killing the bacteria: Propionibacterium acnes (P Acnes). P Acnes feeds on sebum which produce fatty acids that can irritate the sebaceous glands making them inflamed which in turn causes sports. By controlling the bacteria the inflammation is kept under control which allows the skin to heal.
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Topical antibiotics are very similar to those available over the counter. The difference being that the creams, gels and lotions usually contain stronger doses of the active ingredients. Topical antibiotics can help reduce infection in or on the skin. Examples of these include medications which contain Benzoyl peroxide, salicylic acid or sulphur as the main active ingredient. |
When a stronger topical medication is required Retinoid A may be prescribed. An example of this is Tazorac, a cream containing Retinoid A in a stronger strength. The cream has a drying effect on the skin which helps clear up inflammation, redness, peeling and irritation. It is effective in the treatment of whiteheads and blackheads.
Other topical prescription medications include
- Azelaic acid – reduces the growth of the keratin surface skin cells that can block pores. Azelaic acid helps to unblock the pores which allow the sebum to escape which in turn reduces blackheads/whiteheads and spots. Azelaic acid also helps keep inflammation under control
- Adapalene – uses synthetic retinoids as the active ingredient. Adapalene prevents the formation of blackheads and or whiteheads and reduces inflammation. It effectively clears pimples and unblocks pores.
You should always seek advice from your doctor with regards to the most effective form of antibiotic treatment for your symptoms.
Information written by the talkhealth medical panel
Last Reviewed: 28 February 2011
Next Review Date: 28 February 2013
