Oral Antibiotics for Acne

Oral antibiotics are mainstream in the treatment of moderate to severe acne. These include erythromycin, tetracycline, minocycline and doxycycline. Oral antibiotics act by decreasing the number of bacteria, as well as the free fatty acids and lipid levels found on the skin. Moreover, they block the subsequent influx of inflammaotry white cells which lead to the lesions found in acne. One important issue with oral antibiotics is that levels of the active compound may not be detected in the sebum of patients for the first 7 days. It may require one month of therapy until the active agents in oral antibiotics are able to reach the skin surface as the molecules must become integrated into the sebum and lipids which are secreted to the skin surface.

There are numerous precautions to using antibiotics. Minocycline is known to cause dizziness, nausea and vomitting. It is recommended to take minocycline with meals or prior to bedtime. Tetracycline and doxycycline should never be taken with antacids or dairy products, and never by patients under the age of 12, as these antibiotics can cause discolouration of teeth.

Doses of Common Antibiotics used for Acne

Erythromycin: 250 mg – 1 g/day
Tetracycline: 250 mg – 1 g/day
Minocycline: 50 – 100 mg/day
Doxycycline: 100 mg/day