Of the different types of acne medicine that need a doctor’s prescription, antibiotics are probably the most commonly used. How they work though in the treatment of acne is not exactly clear. For example, when antibiotics are used in the treatment of an infection such as a pneumonia, their effect by killing bacteria is quickly seen. However, in acne, antibiotics may take up to two months to show any improvement. As a result, many people give up before the medicine has had time to work.

Antibiotics can be used both as topical acne medicine as well as systemic acne medicine.

When used as topical acne medicine, they do not work as well as those taken orally. This may be because they do not penetrate the skin very well. Topical antibiotics do work well in acne of mild to moderate degree. And most people prefer to apply an acne medicine than to take it by mouth. However, they have to be used even when the acne has disappeared. The acne medicine has to be withdrawn gradually to minimise the appearance of new spots.

Examples of antibiotics used in topical acne medicine include tetracycline and clindamycin. As they are alcohol-based medicines, they may sting the skin. Tetracycline also has an interesting effect in very fair-skinned people – it becomes fluorescent under ultraviolet light ! So be careful when you go to a disco after having applied the acne medicine !

Both types of acne medicine break down after six to eight weeks and have to be replaced. It takes about two months before any benefit is obvious.

Systemic acne medicine includes oral antibiotics. Common examples include the tetracyclines and erythromycin. Teracyclines as a systemic acne medicine have been used since the 1950’s. They have been tried and tested as acne medicines. They need to be given twice a day at the beginning until a response has been achieved. A further maintenance dose is then needed for as long as necessary. It takes as long as two to three months of using one type of acne medicine before making the decision to switch if if does not work. These drugs are not well absorbed and have to be taken on empty stomachs. Perhaps the worst news of all is that in spite of taking these acne medicines twice a day for several months, the best that can be achieved is suppression of the acne. Thus, they need to be taken until the disease goes into natural remission. This may mean being on acne medicines for six to twelve months. Some may need to be on it for even longer.

Erythromycin as a systemic acne medicine is a very useful drug. It has an excellent safety record and can be used in pregnant women. Unfortunately, if it is taken for more than a week, it can cause bacteria in the gut to become resistant to the antibiotic. Using erythromycin as an acne medicine may thus render it ineffective for more serious illness.

Antibiotics are known to be very effective as acne medicine. How they work is not exactly clear. Those with troublesome acne who consult their doctor are most likely to be given antibiotics in some form for treatment of their acne.

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