Antibiotics for Acne: How Much Is Too Much?
Taking oral antibiotics long-term isn’t just dangerous, it’s not an effective way to treat acne. Instead, a Cleveland Clinic dermatologist recommends finding the right combination of topical treatments.
Health experts warn that taking too many antibiotics can do more harm than good. Just look at the increase in antibiotic-resistant “superbugs.”
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That’s why more dermatologists are trying to crack down on the long-term use of oral antibiotics for acne. Joan Tamburro, DO, a pediatric dermatologist at Cleveland Clinic, says it’s not uncommon to see teens popping antibiotic pills for six months or longer.
“We need to stop that,” she says. “Today, common belief is you shouldn’t take oral antibiotics for more than two or three months in a row.”
Antibiotics alone are not enough to treat acne, says Dr. Tamburro. Acne is a complex condition involving four factors:
“Antibiotics will help control bacterial growth,” says Dr. Tamburro. “But if we don’t address the other factors as well, we won’t treat acne successfully.”
For the average kid or teen with acne, Dr. Tamburro recommends:
“Usually, we start with skin washes and add topical retinoids next,” says Dr. Tamburro. “We only add a topical antibiotic if the first two treatments aren’t enough.”
It’s critical to use topical antibiotics with benzoyl peroxide, she notes. Benzoyl peroxide kills bacteria in a different way than antibiotics. Using them together makes it less likely that bacteria will become antibiotic-resistant.
Oral antibiotics are for severe cases. However, applying antibiotics to the skin can cause fewer side effects than swallowing antibiotics that circulate through your body.
“In general, topical antibiotics can be used longer than oral antibiotics,” says Dr. Tamburro.
For severe acne that doesn’t respond to standard treatment, there are other options:
You may think of acne as a teenage problem, but it’s not uncommon for acne to appear around age 9. The earlier it comes, the earlier it may go. However, those who start puberty later may have acne into their 20s.
“Acne usually subsides on its own, but treatment is important if your child is bothered by his or her appearance,” says Dr. Tamburro. “It’s also important if you’re concerned about long-term effects. Severe acne can eave scars and cause skin discoloration.”