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For many years, antibiotics have played a crucial role in the management of acne vulgaris, by reducing inflammation and Cutibacterium acnes. The role of antibiotics for moderate to severe acne, especially when topical therapies do not work, are imperative to control the condition and reduce acne scarring.
Depending on the class of antibiotics, they work by:
Their efficacy in improving acne symptoms is well-documented, and they can lead to significant improvement in both the number and severity of acne lesions.
Antibiotics are either be applied topically as creams/gels, or taken orally. Generally, topical antibiotics are prescribed for mild acne, whereas oral antibiotics are for more moderate to severe cases of acne. The most commonly prescribed antibiotics for acne in Singapore include:
Sarecycline is a narrow spectrum tetracycline antibiotic. Although it has gained FDA approval in 2018 for its use in non-nodular moderate to severe acne, judicious use of it in the management of acne is essential. Despite being well-tolerated, the common side effects include gastro-intestinal disturbances, photo-sensitivity and Candida yeast infection. It is currently unavailable in Singapore and there are concerns about the high cost of treatment.
It is important to use antibiotics judiciously to minimize potential side effects and to address the growing concern of antibiotic resistance. Typically, these medications are prescribed for a limited duration, often alongside topical treatments, to reduce the risk of resistance development and to optimize therapeutic outcomes.
Limit Antibiotic Use: Antibiotics should be used only when necessary and for the shortest effective duration (typically 3-4 months). For acne, this means prescribing antibiotics primarily for moderate to severe cases where topical treatments alone are insufficient.
Combination Therapy: Use antibiotics in combination with other acne treatments, such as topical retinoids or benzoyl peroxide. Benzoyl peroxide has antibacterial properties and can enhance the efficacy of antibiotics while reducing the likelihood of resistance.
Optimize Dosing: Ensure that antibiotics are prescribed at the appropriate dose and duration. Overuse or incorrect dosing can contribute to resistance. Following established guidelines for duration (typically a few months) helps minimize the risk of resistance.
Adhere to Treatment Protocols: Encourage patients to follow their prescribed treatment regimen closely. Premature discontinuation of antibiotics can lead to incomplete eradication of bacteria and contribute to resistance.
Use Topical Antibiotics Wisely: When appropriate, consider topical antibiotics as an alternative to oral antibiotics. Topical formulations can be effective in treating localized acne and generally have a lower risk of contributing to resistance.
Monitor and Review Treatment: Regularly review patient progress and response to treatment. Adjustments should be made based on efficacy and any signs of resistance or adverse effects.
The side effects encountered depends on the type of antibiotic for acne prescribed. Patients on antibiotics for acne should be monitored regularly to assess their response to treatment and to manage any adverse effects.
| TREATMENT | PRICE |
|---|---|
| Oral Antibiotics | from $30 |
| Topical Creams (Retinoid/Benzoyl Peroxide) | from $40 |
| Oral Spironolactone | from $60 |
| Oral Isotretinoin | from $80 |
| Injection Steroids | from $120 |
| Drainage of cyst | from $150 |
| Laser Acne Treatment | from $399 |
Antibiotics are generally prescribed for a limited duration, usually between 3 to 4 months, to avoid resistance and side effects. The exact duration depends on the severity of the acne and the response to treatment. It’s important to follow your doctor’s instructions and not to discontinue the medication prematurely.
Yes, several alternatives can be used, either alone or in combination with antibiotics:
Follow the dosage and frequency prescribed by your doctor. Some antibiotics should be taken with food to reduce gastrointestinal discomfort, while others may need to be taken on an empty stomach. Consistency is key to effectiveness, so take the medication at the same times each day.
Yes, combining topical treatments (e.g. retinoids, benzoyl peroxide) with oral antibiotics can enhance the effectiveness of acne treatment. Your doctor will guide you on how to use these treatments together to avoid irritation and maximize benefits.
If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up doses to make up for a missed one. If you have any concerns, consult your doctor.
In patients who are pregnant or lactating, tetracycline-class antibiotics should be avoided due to potential for permanent teeth discoloration and bone growth inhibition in the fetus or nursing infant
Antibiotics have been a cornerstone in the management of moderate to severe acne for decades. They work primarily by reducing the bacteria Cutibacterium acnes on the skin, which plays a significant role in acne pathogenesis, and by decreasing inflammation. Both topical and oral antibiotics can be effective, with topical formulations often being recommended for mild to moderate cases and oral antibiotics reserved for more severe or widespread acne.
Dr. Moses Ng
We treat a range of acne and acne scars at both our clinics in Woodlands and Kovan. It's important to individualize treatment based on the patient's specific needs and to monitor for potential side effects. While antibiotics can be effective in reducing acne symptoms, they should not be the sole long-term treatment strategy. Dr. Ng makes it his mission to match each patient to the most effective acne treatment according to your lifestyle, skin condition and budget. Schedule a consultation with us today, so you can find out more.
Dr. Moses Ng is a distinguished professional in the field of aesthetic medicine, renowned for his expertise in advanced cosmetic procedures. With over 15 years of experience, extensive training and a keen eye for detail, Dr. Ng specializes in a wide range of treatments, including injectables, laser therapies, and acne scar management.
Dr. Moses Ng’s commitment to excellence and patient-centric approach have earned him a reputation as a trusted clinician in aesthetic medicine. His continuous pursuit of the latest advancements in the field ensures that his patients receive the highest standard of care and the most effective treatments available.
