Antibiotic Treatment of Chronic Acne
Acne is an unsightly and sometimes painful skin condition that often affects teenagers and young adults, but also can strike people in their thirties, forties and even beyond. Occasional mild acne usually goes away with careful skin care or with the use of over-the-counter treatments, but those with chronic acne, whether it's mild, moderate or severe, may need to consult a dermatologist, who often treat chronic acne with antibiotics.
Antibiotics in Acne
According to the American Academy of Dermatology (AAD), there are four main causes of acne. They include clogging of pores, too much skin oil production, inflammation of the sebaceous oil-producing glands in the skin, and infection with a bacteria called Propionibacterium acnes (P. acnes). Antibiotic treatment of chronic acne targets the P. acnes bacteria in an effort to eradicate the infection. Oral antibiotics are the best treatment for moderate and severe chronic acne, acne that affects large areas of the skin, and acne that has not responded to topical acne treatments, such as benzoyl peroxide.
There are many possible antibiotic choices for a physician seeking to treat a case of chronic acne, including tetracycline and others from that family of medications, erythromycin, azithromycin and trimethoprim, according to the AAD. A dermatologist might choose to combine oral antibiotic therapy with a topical prescription medication to help manage chronic acne; retinoids, which are related to Vitamin A, often are used for this purpose. Oral antibiotic treatment for chronic acne usually lasts from four to six months, and it can take up to two months to begin to see results, the AAD says.
Antibiotics can cause gastrointestinal effects, such as upset stomach and diarrhea. This is especially common with tetracycline, which must be taken on an empty stomach, dermatologists say. Antibiotics also can cause vaginal yeast infections in women. Other, less likely potential side effects of antibiotic treatment for chronic acne include sensitivity to light, allergic reactions and vertigo, depending on the medication chosen. A dermatologist will take a medical history and determine which prescription medication is best suited to treat each individual case.
Antibiotics are very effective in treating chronic acne. In a 2006 study published in the medical journal "Archives of Dermatology," clinicians compared treatment with the oral antibiotic minocycline with a topical treatment in 189 patients who had moderate to severe acne. The antibiotic reduced acne lesions by about two-thirds after 12 weeks of treatment, while the topical treatment reduced acne lesions by about 60 percent, the study found. Another study, published in "The Lancet" in 2004, compared five different treatment regimens and reported good results for the antibiotic regimens studied.
Antibiotic resistance could cause antibiotic treatment of chronic acne to be less effective, dermatologists say. Some strains of P. acnes are becoming resistant to the antibiotics used to treat chronic acne. For example, the clinicians comparing five different treatments in "The Lancet" noted that pre-existing tetracycline resistance reduced the effectiveness of both tetracycline drugs tested in the study. Because antibiotic resistance is becoming a bigger problem, dermatologists often attempt to treat chronic acne with topical products before prescribing antibiotics for chronic acne.
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