Oral Antibiotics for Acne

What is Oral Antibiotics for Acne?

Antibiotics used to be a common treatment for acne, and while there is still a role for antibiotics in certain acne cases, its use has largely been superseded by other topical treatments, Isotretinoin medication and other light-based treatments such as lasers.

Some common antibiotics used to treat acne include: Doxycycline, Minocycline, Tetracycline and Erythromycin.

At SL Aesthetic Clinic, we offer Doxycycline as an antibiotic to treat acne in suitable patients. While Minocycline is a comparatively more effective antibiotic for the treatment of acne, its potential side effects are more serious than Doxycycline.

How Do Antibiotics Work to Improve Acne?

Antibiotics have two main beneficial effects on acne:

  1. They reduce the number of acne-causing bacteria called Proprionibacter acnes on the skin surface and in the follicles.
  2. They exert an anti-inflammatory action.

How Effective are Antibiotics?

The effectiveness of oral antibiotics are limited in treating acne. Several clinical studies show that oral antibiotics may reduce symptoms by approximately 50%, but are not more effective than other acne medications.

When Is Antibiotics Useful for Acne Treatment?

Generally, we prescribe antibiotics for acne in 2 situations:

  1. Mild pubertal acne for children above the age of 12, who may outgrow their acne and just need a little help in the interim to control their acne better.
  2. If a heavy bacterial load on the skin is suspected, evidenced by substantial inflammation and/or pus formation.


How Long is a Course of Antibiotic Treatment?

Antibiotics are usually prescribed for 1 – 3 months. Antibiotics do take a few weeks to work and usually not continued for more than 3 months to reduce the risk of developing antibiotic resistance.

What are the Problems with using Oral Antibiotics for Acne?

  • Success rate is not the best: often, antibiotics fail to work and even if they do, they do not produce impressive results. This is why we also prefer a combination of treatments for a more holistic effect.
  • Temporary benefit: even when they do work, the benefits can be temporary since antibiotics should not be prescribed for more than 3 months.
  • Side effects: Different antibiotics have a different list of potential side effects which may range from just an irritation to life threatening reactions.
  • Antibiotic resistance: prolonged treatment with antibiotics can lead to antibiotic resistance, which is becoming a universal problem, leading to infections which become more and more difficult to treat.

What are the common side effects of Doxycycline?

  • The most common side effect is gastrointestinal upset such as nausea, bloatedness and diarrhoea. This can be reduced by taking the medication with a glass of water after meals.
  • Sensitivity to sunlight resulting in itch, redness and being prone to sunburns.
  • Itching of the genital areas or a sore mouth/tongue. This may indicate a yeast infection which will require treatment.
  • Stop the medication if you develop a rash when you first start taking Doxycycline.

What Precautions Should I Take with Antibiotics for Acne?

  • For women who are pregnant, planning for pregnancy or breastfeeding, do inform your doctor as these antibiotics may affect the bones and teeth development of your baby.
  • Antibiotics should not be taken in children less than 12 years old as it can cause discolouration of teeth and affect bone growth.
  • Antibiotics may affect the effectiveness of oral contraceptive pills taken concurrently and increase your chance of unwanted pregnancy.
  • Inform your doctor if you are taking over-the-counter medicines, vitamins, minerals and herbal products.

What other acne treatments are there?

Acne has many causes and underlying reasons, which means a whole arsenal of solutions are ready to tackle these causes. These include photodynamic therapies, chemical peels, acne injections, and isotretinoin medication.

[27 May 2019] Written by Dr. Charlene Goh

Dr. Charlene Goh – The Fashionista
MBChB, Scotland; Dip Practical Dermatology, Wales

Having obtained her medical degree in Scotland, Dr Charlene Goh returned home to Singapore, where she practised in several major hospitals and in various departments. But her education did not stop there.

From a young age, Charlene has had a strong interest in skincare and beauty trends. Urged by Dr Kelvin Chua to pursue her passion, Charlene went away to study Practical Dermatology at Cardiff University in Wales.

Not one to rest on her laurels, she returned home and picked up certifications from various aesthetic organisations.

Now armed with the proper certifications and experience, Charlene is adept at a wide range of minimally invasive aesthetic procedures such as laser treatments, dermal fillers, botulinum toxin injections, etc.

A firm believer in presenting one’s best self, Charlene hopes to help others achieve confidence through a holistic approach; a wholesome combination of a healthy lifestyle and diet, complemented by clinically proven aesthetic treatments.

Charlene is a self-confessed beauty junkie and fashionista, and will happily discuss the latest trends with friends and patients.

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