- Traditional Treatments
Oral Antibiotics
Kills acne-causing bacteria
Oral antibiotics lower the bacteria and inflammation that drive moderate to severe acne, usually as one part of a combination plan.
What are Oral Antibiotics?
Oral antibiotics are medications taken by mouth that kill acne causing bacteria (C. Acnes) inside the oil glands of the pores. They also work by reducing the inflammation in the skin, thereby lessening inflammatory lesions (e.g., pustules, pimples, zits, and deeper cysts).
Oral antibiotics are usually prescribed continuously for 3 to 4 months until inflammatory acne is improved. During that time, the topical acne regimen is optimized and then the oral antibiotic is discontinued. Studies show that if patients do well on oral antibiotics AND have an optimal topical skin care regimen, then about two thirds of the time, patients will do well even after stopping the antibiotic. – This is only if the patient remains on the optimal topical regimen. Because skin bacteria can develop resistance against any antibiotic, topical benzoyl peroxide is often prescribed simultaneously to minimize this occurrence.
About Oral Antibiotics
Seysara
In 2018, Sarecycline (Seysara) became the first antibiotic FDA approved specifically for the treatment of acne. Seysara is unique in that it kills the bacteria on the face that promote acne, but it spares the bacteria in the gut (i.e intestines). Therefore, it makes sense that Seysara does not have increased risk for yeast infections or diarrhea, as other antibiotics do. It is very well tolerated, dosed once daily based on weight, and may be taken with or without food. It is wise however to avoid consuming dairy simultaneously as this may affect the absorption. Seysara also has the advantage of not producing significant increased sensitivity in sunlight. Seysara is a brand and does not have a generic alternative and is sometimes costs more to obtain through prescription.
Doxycycline
Doxycycline is a commonly prescribed oral antibiotic. It is well-tolerated though it may cause some abdominal pain which is minimized by coadministration with meals. Doxycycline often makes a person prone to sunburn, so sunscreen is essential. It should always be taken with a large glass of water. Also, one should avoid dairy simultaneously as this may reduce the absorption of the antibiotic.
Minocycline
Cefadroxil/amoxicillin
Cefadroxil/amoxicillin are penicillin derived antibiotics which may be used in lieu of the above antibiotics and are reasonably well tolerated. Potential bacterial resistance is a concern.
Bactrim
Bactrim – this is a sulfa-based antibiotic with higher risks of drug reactions such as hives. In rare circumstances, very serious drug reactions that produce blistering of the skin, eyelids and mouth may occur (Stevens Johnson syndrome). Bactrim is sometimes used as a ‘last resort’ antibiotic before isotretinoin. In addition, it is sometimes co-administered at the initiation of isotretinoin to prevent pseudo-acne fulminans reactions.
Taking a probiotic while taking oral antibiotics may be useful to replenish normal gut bacteria. And there are data to suggest that probiotics may help reduce acne as well.
Frequently asked questions
How do oral antibiotics treat acne?
Oral antibiotics are taken by mouth to kill the acne causing bacteria (C. acnes) inside the oil glands of the pores. They also reduce inflammation in the skin, which calms pustules, pimples, and deeper cysts. They are usually one part of a combination plan alongside a topical regimen.
How long will I take an oral antibiotic?
Oral antibiotics are usually prescribed continuously for three to four months until inflammatory acne is under control. During that time the topical regimen is optimized, and the antibiotic is then discontinued.
Will my acne stay clear after I stop the antibiotic?
Studies show that when patients respond to an oral antibiotic and stay on an optimal topical skin care regimen, about two thirds remain clear after stopping the antibiotic. Maintaining that topical regimen is what keeps the results.
Why is benzoyl peroxide prescribed along with the antibiotic?
Skin bacteria can develop resistance to any antibiotic over time. Topical benzoyl peroxide is often prescribed at the same time because it lowers the chance of resistance developing.
Which oral antibiotics does the Acne Center of Michigan use?
Common options include Seysara (sarecycline), the first antibiotic FDA approved specifically for acne, along with doxycycline and minocycline. The choice depends on your skin, tolerance, and response. Some antibiotics increase sun sensitivity, so sunscreen matters, and several should be taken with water and away from dairy.
Schedule an acne consultation
Craig Singer MD Dermatology is located at 31000 Telegraph Rd., Suite 260, Bingham Farms, MI 48025. Call (248) 792-3785 to schedule a consultation.
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About Craig Singer MD Dermatology
Located in Bingham Farms, Acne Center Of Michigan was founded by Dr. Craig Singer, a board-certified dermatologist.
We specialize in the treatment of acne and acne scarring, offering numerous therapeutic options tailored to each patient’s needs.
Dr. Singer experienced significant acne when he was in college and has personal experience with his teenage children’s acne as well. He has helped thousands of patients look their best.
Acne Center of Michigan offers the most advanced acne treatments, drawing from both traditional and alternative approaches. Dermatologists across the region refer their most complex acne-scar cases to Dr. Singer, and patients travel from across Michigan, neighboring states, and Canada for his care.
Board-Certified
Dermatologist
Thousands of patients
Helped look their best
