Acne treatments: antibiotic tablets

More than half of the young people we talked to had taken antibiotic tablets for their acne. Often they had tried topical treatments first and antibiotic tablets were seen as the ‘next step’. Some people used a combination of acne treatments, such as topical treatments and antibiotic tablets. Rebecca felt more comfortable using topical treatments than swallowing a medicine, but some people preferred taking antibiotic tablets. Tom spoke to his GP and “decided that it would probably be easier to go for like a tablet, because you can’t really do wrong with a tablet”. Ollie thinks tablets are a more practical treatment for acne on the chest and back because these are difficult places to reach when applying topical treatments.
There are different kinds of antibiotics – such as lymecycline, tetracycline and erythromycin. Sometimes a person’s acne doesn’t respond to one type of antibiotic, but does to another. This can mean trying different antibiotics before finding an effective one – something that Molly, Hester, Chris, Emma and Rachael had all done. It can be time-consuming though as it is recommended you try an antibiotic for a few months to see if it helps. Some people, like Marga, noticed a quick improvement in just two weeks. Others waited months to see if their skin cleared up. Chris found it hard to tell if antibiotics were helping as his acne seemed to be at a constant level. Emma stayed on antibiotics for a long time as she wasn’t confident telling her GP that she would like to try another acne treatment. Hester took antibiotics for two and a half years.

Antibiotics are prescribed in different dosages (how many tablets and how often you take them). Antibiotics are thought to work in two ways: by reducing inflammation, which is why they are taken for long courses, and by getting rid of the bacteria involved in the development of spots. Tom’s GP chose which type of antibiotic to prescribe him and a starting dose of one a day. He thought the antibiotics were working, but Tom added that his GP might increase the dose to two a day at his next appointment. Often antibiotics were trialled for a month or two. Marga pays for her prescriptions and found it expensive having to get one month trials of different medicines like antibiotics. The dose varies from person to person depending on the severity of their acne. Both Marga and Rachael remember times when they took four antibiotic tablets a day.

Most people took their antibiotic tablets in the morning after breakfast. This helped some people get into a routine of taking the pills. Molly’s mum used to remind her to take her antibiotics every day when she was younger. When Marga was taking four tablets a day, she took two in the morning and two at night before going to sleep.

Some people found it difficult or scary to swallow tablets. Some people were worried about antibiotic resistance (when bacteria stop responding to antibiotics) and that the chances of this increased if they sometimes forgot a tablet. Nina talked about it being time-consuming having to go back for repeat prescriptions and worried about running out if she forgot to do so. Some people were uncomfortable about being on tablets altogether – Marga didn’t want to be “completely medicating myself” and Deborah disliked the idea that she was “ill”.
Antibiotic tablets can have side effects for some people, but not everyone. This includes some antibiotic tablets having an unpleasant after-taste, as Naomi and Rachael found. Abbie got stomach aches when she took antibiotic tablets. Hester had an upset tummy but her GP was “very dismissive” that it was caused by antibiotics. Nina had sun sensitivity and staining of her teeth. No one we talked to had this, but Tom and Nina heard that antibiotics can give unusual side effects like turning the tongue a different colour. Others, like Tom, were less concerned about possible side effects and thought reading the information leaflet with the antibiotic medication would make him become “paranoid”.
People had different outcomes from using antibiotics. Some found they helped clear up their acne. Marga is due to stop taking her antibiotics soon but worries that her acne might return. Other people didn’t find antibiotics effective, even after trying a few different ones. Will gave each type of antibiotic he was prescribed “a good shot” but eventually was referred to a dermatologist for isotretinoin (e.g. Roaccutane) tablets. A few people wish they had been more committed to trying antibiotics for their acne. Shu En says she “didn’t take the antibiotics very seriously” and often missed them, which she thinks caused her acne to become resistant to the medicine. The size of the antibiotic tablets Deborah took meant she didn’t take them as regularly “because I didn’t enjoy taking them”.


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