If topical exfoliants, retinoids, and antibacterial agents don’t provide satisfactory results, an oral antibiotic prescribed by a doctor may be an option to kill stubborn, blemish-causing bacteria. Several studies have shown that oral antibiotics, used in conjunction with topical tretinoins or topical exfoliants, can control or reduce many acne conditions. (Sources: Cutis, August 2008, pages S5-S12; and InternationalJournal of Dermatology, January 2000, pages 45-50.)
As effective as oral antibiotics can be, they should be a near-last resort, not a first line of attack. Oral antibiotics can produce some unacceptable long-term health problems. Some dermatologists tend to give the negative side effects of oral antibiotics short shrift and prescribe them as if they were nothing more than candy for their acne patients. Oral antibiotics are anything but candy. They kill the good bacteria in the body along with the bad, and that can result in chronic vaginal yeast infections as well as stomach problems. A more worrisome side effect is that the acne-causing bacteria can become immune to the oral antibiotic. According to an article in the American Journal of Clinical Dermatology (2001, volume 2, issue 3, pages 135-141), “The main cause for concern following the use of systemic antibiotics is the emergence of antibiotic-resistant strains of P acnes.” Similarly, a paper presented at the General Meeting of the American Society for Microbiology in May 2001 (www. asmusa. org/memonly/abstracts/AbstractView. asp? AbstractID=47544) stated that “antibiotic treatment in patients with severe acne causes development of antibiotic resistance…. The prevalence of antibiotic resistance to tetracycline, erythromycin, clindamycin and trimethoprim-sulphamethoxazole.” was found after two to six months. “When patients with acne are treated with antibiotics, the risk of development of antibiotic resistance should be realized. The use of antibiotics to treat acne should be restricted and other regimens should be tested.”
This means that if you have been taking an oral antibiotic to treat your acne for longer than six months it can stop being effective. It also explains the situation that leaves many women puzzled, since initially the antibiotic they were taking gave incredible results, but then became ineffective. (Source: Seminars in Cutaneous Medicine and Surgery, September 2008, pages 183-187.)
An even more serious argument against taking oral antibiotics was discussed in the American Journal of Clinical Dermatology (July-August 2000, pages 201-209), which stated: “At a time when there is global concern that antibiotic resistance rates in common bacterial pathogens may threaten our future ability to control bacterial infections, practices which promote the spread of antibiotic-resistant bacteria must be fully justified.”
The decision to use oral antibiotics should not be taken lightly. The course of action you take should be discussed at length with and monitored by both you and your dermatologist.