Bacteria-fighting oral antibiotics such as tetracycline, erythromycin,
clindamycin, and doxycycline are often prescribed for people whose
acne does not respond to topical antibiotic treatment. Oral antibiotics
are absorbed through the digestive system, into the bloodstream,
and then into the skin and hair follicles. Here they kill
acne-causing bacteria and reduce inflammation. This helps stop
new acne lesions from forming and gives the skin a healthier appearance
by lessening redness.
However, most oral antibiotics are
absorbed into the bloodstream quickly. Consequently, they are eliminated
from the body rapidly. Therefore, in order to maintain a constant
level of bacteria-fighting medication in the bloodstream, oral
antibiotics must be taken frequently for an extended period of time.
Indeed, some people with acne take antibiotics two or three times
each day for six months to a year.
Moreover, once treatment with
oral antibiotics is stopped, unchecked bacteria often cause new acne outbreaks. In an effort to prevent this from occurring, when the skin
begins to clear, treatment with oral antibiotics is gradually tapered
off, rather than stopped abruptly, and replaced with topical antibiotic
treatment. This helps restrain the growth of acne-causing
bacteria.
Despite these drawbacks, treatment with oral antibiotics can be
quite successful. A patient describes how treatment with tetracycline
helped him. “I used benzoyl peroxide and medicated pads,
but they didn’t help. My acne was too bad. It took tetracycline to
get it under control. It helped a lot, not 100 percent, but a lot. Even
with the tetracycline, I still had some little pimples, but not those
big old welts. Once the tetracycline kicked in I wasn’t embarrassed
about my appearance anymore.”
