Acne Antibiotic Treatment

Tomorrow when we arrive into clinic (or this afternoon if you are reading this during your lunch break), we will invariably be greeted with patients who struggle with one of the most common diseases we treat – acne.  More than likely, we will reach for topical retinoids, topical antibiotics, and the occasional systemic antibiotic.  Evidence supports the short-term use of systemic antibiotics to gain control of acne and help our topical regimens overcome the disease process. Yet, in an era when concerns of antibiotic resistance are ever-present and our knowledge of the microbiome is ever-increasing – are we doing the right thing? How can we be stewards of proper antibiotic use in light of resistance concerns while simultaneously bringing out the best skin for our patients?

During the 2020 GW Virtual Appraisal of Advances in Acne Conference, Dr. Neal Bhatia, Director of Clinical Dermatology at Therapeutics Clinical Research in San Diego, CA, helped us fine-tune our use of these effective, but sometimes misused, elements of our armamentarium against acne. In his lecture, Use of Antibiotics in Acne, Dr. Bhatia displayed his eminent ability to breakdown important research and guidelines to help us answer clinically relevant questions.

Before we get into the full review, here are my “practice barometers” – what I took away from the lecture that may change my practice or confirm my standards:

Acne Treatment Algorithm Suggested By Gollnick Et Al. (2003) [5]....

Consider anti-inflammatory dose antibiotics, photodynamic therapy, hormonal therapies, and other adjuncts in a patient who needs longer-term control, but is not a candidate for isotretinoin

Per capita, what specialty writes the greatest number of oral antibiotic prescriptions? Answer: dermatologists.  It should be no surprise that the majority are in the tetracycline class.  These tetracyclines have multiple effector points on the pathogenesis of acne – but how? Prior to comedogenesis, there are elevated inflammatory markers in uninvolved skin of patients with acne (increased CD4+ T-cells, increased macrophages, follicular IL-1 expression, aberrant integrin expression).  So, what comes first, the comedone or the inflammation? Note, a similar discussion is occurring in hidradenitis suppurativa. Either way, tetracyclines are able to inhibit the activation or impact of matrix metalloproteinases (MMPs), kallikrein 5 (KLK5), and human cationic antimicrobial protein 18 (hcap18) which lead to inflammation in acne lesions. In that light, maybe our script pads are being used correctly!

I am sure we have all considered, or even prescribed, other antibiotics for treatment of acne.  Each comes with advantages and disadvantages.

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Guidelines and consensus statements in the JAAD support the use of systemic antibiotics in patients with moderate to severe acne – but only when used with the right patient

So, it seems we are prescribing the right medicine.  But do we use a low dose? Regular dose? Dr. Bhatia presents a study that shows slightly better results with inflammatory lesion counts when treated with doxycycline 40mg modified-release as opposed to the traditional doxycycline dosed at 100mg daily in patients with moderate to severe acne

This information was presented by Dr. Neal Bhatia at the GW Virtual Appraisal of Advances in Acne Conference held July 30th, 2020. The above highlights from his lecture were written and compiled by Dr. James Contestable, staff dermatologist at Naval Medical Center Camp Lejeune. Images of slides courtesy by Dr. Neal Bhatia

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The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government. The author is a military service member.

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Antibiotics For Acne: Oral And Topical Options + Faqs

In this series, we take a deep dive into the literature and guidelines to give you a quick reference on the use of new or complex therapies.  This series will become your go-to for information about dosing, potential interactions and laboratory monitoring, just to name a few.

Get your free copy of the Next Steps in Derm Guide, the expert’s guide to post-residency career choices and practice management advice from experienced physicians.The Center for Surgical Dermatology & Dermatology Associates is the preferred choice for dermatology care in Westerville, Ohio. At our comfortable and accredited clinic, your health is our priority. 

Our team of board-certified dermatologists, Mohs surgeons, and medical professionals use industry-leading treatments and provide personalized care to achieve outstanding results. We are here for you, no matter what dermatology services you need.

Antibiotics For Acne: Pros And Cons (updated March 2020)

The Center for Surgical Dermatology is a specialized clinic in Westerville, Ohio, that provides a broad spectrum of dermatology services that help patients optimize and maintain the health of their skin, hair, and nails. 

This can include professional examinations and diagnoses, treatment for common skin conditions, such as psoriasis and eczema, dermatologic surgery like Mohs surgery or surgical excision, and cosmetic treatments, including Botox and dermal fillers.

Dermatology is a highly specialized field of medicine. If you would like to know more about it before scheduling an appointment with our experienced team, read through our FAQs section. Our providers address common questions and concerns, such as if dermatology is covered by insurance and, if so, what type of insurances we accept, the different types of dermatology services we provide, and why it is important to see a dermatologist.

Antibiotics For Acne: Topical, Oral, And Other Options

The Center for Surgical Dermatology is based in Westerville, Ohio, a northeastern suburb of Columbus. Our address is 428 County Line Rd W, Westerville, OH 43082 , across the road from the Westerville Community Center.

If you are interested in visiting with one of our experienced providers, you can schedule an appointment by calling our dermatology clinic at (614) 847-4100 or requesting an appointment online using our online form .

Coverage varies depending on your insurance plan. In many cases, necessary and preventive dermatology care are covered by insurance providers, while elective treatments are not. We recommend you consult with your specific insurance provider for more information on the extent of your coverage. 

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At the Center for Surgical Dermatology, we accept all major insurance plans. If you have a question about a specific healthcare insurance, give us a call at (614) 847-4100 . We are here to answer any questions and help you have access to the best possible dermatology care in Westerville, Ohio. 

Our dermatology clinic in Westerville, Ohio, offers a wide range of dermatology services, including general, surgical, and cosmetic dermatology services. For instance, we provide the evaluation, diagnosis, and treatment of the following skin, hair, and nail conditions: 

This list is by no means exhaustive. On average, our dermatologists can identify and treat over 3, 000 skin conditions. If you have a question or concern about a skin, hair, or nail condition, give us a call today at (614) 847-4100 and schedule an appointment with one of our friendly providers. 

Acne Patients . . . Have Patience!

In addition to the list above, we also offer several cosmetic treatments, including Botox, dermal fillers, chemical peels, microneedling, dermaplaning, sclerotherapy, laser treatments, dermatologist-recommend facials, skin care consultations, and customized skin care regimens.

Don’t put off visiting a dermatologist any time you have an issue or concern regarding your skin, hair, and nails, as well as your mucous membranes (i.e. the moist lining of your mouth and nose). For example, this could be a wart-like growth, irritating rash, or eczema flare-up, or suspicious mole (which could be skin cancer!). 

A dermatologist is specially trained to evaluate, identify, and treat conditions affecting these areas to improve and optimize your health for long-term results. 

Doctors Warn Acne Could Become Resistant To Antibiotics

If you need a dermatologist in Westerville, reach out to the team at the Center for Surgical Dermatology and schedule an appointment. Call us at (614) 847-4100 or contact us online .

At the Center for Surgical Dermatology, our highly trained and experienced team provides examinations, diagnoses, and treatments for nearly all common and uncommon skin, hair, and nail conditions. Whether you need to treat a suspicious mole, irritating rash, uncomfortable eczema, troublesome acne, or skin cancer, we are here for you. You can expect outstanding services at our dermatology clinic in Westerville and trust that our services are of the highest caliber. Dr Anil empowers patients to build skin confidence through world class results from expert lead treatments; be it for Acne or Anti-ageing purposes. 

A recent study by the British Association of Dermatologists has highlighted that acne patients are being asked to take antibiotics for excessive periods of time before being referred to a specialist.

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“oral antibiotics, which are routinely prescribed for acne, are being used for durations that exceed recommendations, despite concerns about antibiotic resistance. Dr Alison Layton and the dermatology team at Harrogate and District NHS Foundation Trust, say that reliance on oral antibiotics beyond the recommended duration is harmful for two key reasons. The practice could cause the emergence of antibiotic-resistant Propionibacterium acnes, the bacterium implicated in acne, making acne harder to treat in some cases. Worryingly, the use of oral antibiotics is also likely to drive resistance in other bacteria, unrelated to acne*