Oral Acne Therapy - An Introduction

Oral antibiotics are used in the management of moderate to severe acne. As the topical antibiotics, oral antibiotics work on acne by virtue of their antibacterial and antiinflammatory effects.

 

Compared with topical therapy, oral therapy has a more rapid onset of action and works faster to improve your acne. Commonly, though, multiple medications are combined for the most effective treatment of acne. So in most cases, patients use more than one medication at any given time. By using drugs that have different means and modes of activity — for example, by taking oral antibiotics and applying a topical treatment — you attack your acne on several fronts. In designing your treatment regimen, your doctor can choose combinations of different classes of drugs that work on different targets, based on the severity of your acne and the possible side effects of the medication.

 

Being prescribed oral medications is not a message that you should stop applying topical medications! Make sure you go over your full medication regimen with your doctor before you leave her office. If you have questions later after you leave, call back to clarify.

 

Your doctor may decide to add oral antibiotic therapy to your topical therapy because the topical medications are

 

 

Or:

 

Whenever oral drugs are taken, the potential dangers — including side effects, drug allergy, drug resistance, drug intolerance, drug interactions, and fetal exposure in women who are or may become pregnant — must be carefully considered.

 

A risk-benefit assessment is particularly important whenever a benign (non-life-threatening) condition such as acne is being treated. That means that you should ask your doctor about the advantages of taking an oral medication versus the disadvantages (such as possible scarring) of not taking it. Ask about the possible side effects — the risks — and what positive things you might expect — the benefits — if you take the drug.

 

Antibiotics, both topical and oral, have been central to the treatment of acne for many years. However, public health concerns about their widespread use has increased in recent years due to a number of issues:

 

Bacterial resistance: Resistance means that a medicine no longer works, or becomes less effective, because the bacteria change (mutate) and no longer respond to the drug that is trying to kill or suppress them. No matter how many new antibiotics we come up with to fight P. acnes, the bacterium seems to find a way to outwit us and become resistant to our latest weapons. It's like trying to fight computer viruses that find ways to adapt to ever-changing methods we use to destroy them. Despite the well-founded concerns about creating bacterial |      resistance, these drugs have a long track record of safety They're effective, efficient treatments for many people who have acne as well as acnelike disorders, such as rosacea.

 

Purported links between oral antibiotics and breast cancer: A well-publicized study suggested that the long-term use of antibiotics is associated with an increased risk of developing breast cancer. The study indicated that the risk was dependent on the cumulative dose and the amount of time a woman was taking antibiotics. The study had many flaws and never came to the conclusion that there was a direct causal link between antibiotics and breast cancer.

 

Antibiotics' influence on the efficacy of birth control pills: Studies have shown that none of the antibiotics used commonly to treat acne interfered with the efficacy of oral contraceptives. But a woman can get pregnant while on any brand of birth control pill, whether taking antibiotics or not.

 

A recent study has suggested that the ingestion of oral antibiotics as well as the use of topical antibiotics in the treatment of acne may be associated with an increased risk of infectious respiratory diseases such as strep throat infections.

 

The best take-home message for you is that you should try your best to limit long-term use of antibiotics as much as possible until further studies and more data become available.

 

Worry about the safety of long-term oral medications has lead to a recent interest in the use of physical treatments such as lasers and other special light therapies to treat acne.