Antibiotics - maximise the benefits, reduce the risks

Topical antibiotics work to reduce visible pimples and also help prevent new ones.

Antibiotic gels, solution and lotions will be prescribed by a doctor with instructions - how often to apply it, which parts of the face it should be put on, and for how long. These instructions should be followed carefully.

A thin smear should normally be applied once or twice a day to the entire area affected by acne, not just the spots. This is because topical preparations work to reduce visible pimples but also help prevent new ones. Using them regularly over the entire area will lead to much better control of acne.

Oral antibiotics may work faster and be more effective if large areas are involved, such as acne on the face and body.

Antibiotic tablets or capsules are usually prescribed in a course and should be taken regularly to achieve the best results. Tetracycline or doxycycline increases sensitivity to sunburn so it’s best to take extra precautions to avoid sunburn.

• Try to avoid being in the sun between 10am and 2pm (11am-3pm during daylight saving) particularly in summer;
• Stay in the shade whenever possible;
• Wear a hat and other physical protection such as rash shirts at the beach; and
• Use sunscreen (labelled non-comedogenic and/or non-acnegenic) regularly.

Nausea, diarrhoea, thrush and allergy may affect a small number of people taking oral antibiotics.

Pharmacists will tell you when it’s best to take tablets or capsules and whether or not they should be taken with food. They can also provide some practical tips on how to remember to take medications.

Antibiotics are usually effective so if you’re not seeing any improvements in 8-12 weeks, talk to your doctor.

As with all antibiotics, there is concern that if they are over-used or inappropriately used, strains of the acne bacteria will become resistant to antibiotics, making them ineffective.

Taking antibiotics for the full course as prescribed and applying antibiotic creams and gels as directed will reduce this risk. Combining antibiotic therapy with other acne treatments also helps to protect against antibiotic resistance.

This is the case with the combination of benzoyl peroxide and topical or oral antibiotics.
Another way to improve effectiveness is to use a benzoyl peroxide acne wash when you are using antibiotics.