Topical Antibiotics

One major disadvantage of taking antibiotics orally is that in order to treat acne on the face or chest, your whole system has to be unnecessarily exposed to the effects of the antibiotics. Topical antibiotics were developed to answer the need for antibiotics that work only where they are needed. Today, many patients who once would have required oral antibiotics may be treated with topical antibiotics. For more severe cases, however, your dermatologist may prescribe both a topical and an oral antibiotic.

Topical antibiotics are available as lotions, creams, or ointments. Lotions, which are usually alcohol-based, tend to be more drying and are usually reserved for patients with oilier skin. Creams and ointments, because they are moisturizing, are particularly useful for individuals with dry skin or for use during cold, chapping winter weather. Clindamycin, erythromycin, and tetracycline are three of the most commonly prescribed topical antibiotics. Your dermatologist may have the pharmacist tailor a topical antibiotic specifically for your needs or he or she may prescribe one of a variety of commercially available prescription preparations. Effective commercial preparations include Cleocin-T (clindamycin), Staticin lotion (11/2 percent erythromycin), TStat and Erymax lotions (2 percent erythromycin), Topicycline lotion (tetracycline), Meclan cream (tetracycline derivative), and Akne-mycin ointment (2 percent erythromycin).

Erycette lotion is a recently introduced topical erythromycin. Individually prepackaged in sterile foil packets, Erycette consists of erythromycin-saturated towelettes. Many people like the convenience of this product, although it is more expensive.



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Acne Antibiotic Treatments

Oral Antibiotics

Although acne is not an infection, the bacterial organism Proplonobacterium acnes, as you learned in Chapter 3, is nevertheless believed to play an important role in acne development. These bacteria are responsible for breaking down and converting the oils and debris trapped within clogged pores into irritating, acne-causing fatty acids. Both oral and topical antibiotics effectively suppress these bacteria.

Antibiotics are a mainstay of acne therapy. At one time, only oral antibiotics were available. Tetracycline has been a favorite for over thirty years. Erythromycin and minocycline are two other frequently prescribed oral antibiotics. However, since the introduction of topical antibiotics, oral antibiotics are now more frequently reserved for treating the most severe forms of acne.

When used to treat infections, oral antibiotics usually begin to work in a matter of hours. In treating acne, however, oral antibiotics usually do not bring about improvement for about three weeks.

Fortunately, the three oral antibiotics most commonly prescribed-tetracycline, erythromycin, and minocycline-have proven themselves generally safe even for long-term use. Minor, and often temporary, side effects include upset stomach, diarrhea, headache, and vaginal yeast infections. Your doctor is best able to choose the right oral antibiotic for your condition and may even switch you from one to the other, depending upon your response to treatment. Some of the more common brands of oral antibiotics prescribed include Achromycin (tetracycline), Erythrocin, EES-400, and Eryc capsules (erythromycin), and Minocin (minocycline).