Overview
What is it?
Oral antibiotics and topical retinoids are commonly used treatments for acne vulgaris. Oral antibiotics, such as tetracyclines and macrolides, are medications taken by mouth to reduce bacteria and inflammation. Topical retinoids, like adapalene and tretinoin, are creams or gels applied directly to the skin to help unclog pores and reduce acne lesions. These treatments are often used together to target different aspects of acne development.
How does it work?
Oral antibiotics work by reducing the number of acne-causing bacteria on the skin and decreasing inflammation. Topical retinoids help normalize the shedding of skin cells, preventing clogged pores and reducing the formation of comedones (blackheads and whiteheads). When used together, they address both the bacterial and structural causes of acne, making them a powerful combination for treating moderate to severe acne .
What are the benefits?
The combination of oral antibiotics and topical retinoids is highly effective for treating moderate to severe acne. Research shows that this combination can significantly reduce the number of acne lesions and improve skin appearance. For example, studies have found that combining oral tetracyclines with topical retinoids and benzoyl peroxide can reduce total lesion counts by up to 43% compared to placebo . Additionally, this combination helps prevent scarring and improves overall skin texture over time .
Effectiveness
What does the research say?
Research supports the use of oral antibiotics combined with topical retinoids as an effective treatment for acne. Studies indicate that this combination is more effective than using either treatment alone. For instance, oral antibiotics like tetracyclines, when paired with topical retinoids, have shown significant reductions in both inflammatory and non-inflammatory acne lesions. This combination is particularly beneficial for patients with moderate to severe acne who may not respond well to topical treatments alone .
Side Effects
Skin irritation
Topical retinoids can cause skin irritation, including redness, peeling, and a burning sensation, especially when first starting treatment .
Dryness and redness
Dryness and redness are common side effects of both topical retinoids and benzoyl peroxide, which is often used alongside retinoids. Moisturizers can help alleviate these symptoms .
Increased sensitivity to sunlight
Topical retinoids can make the skin more sensitive to sunlight, increasing the risk of sunburn. It is important to use sunscreen daily while using these treatments .
Gastrointestinal discomfort
Oral antibiotics, particularly tetracyclines, may cause gastrointestinal discomfort, such as nausea or stomach upset. Taking the medication with food can help reduce these effects .
Tooth discoloration (with tetracyclines)
Tetracyclines, such as doxycycline and minocycline, can cause tooth discoloration, especially in children or when used for long periods. This side effect is less common with short-term use .
Evidence
Clinical Studies & Trials
[1] Guidelines of care for the management of acne vulgaris.
This paper provides guidelines for managing acne vulgaris, emphasizing the use of oral antibiotics and topical retinoids as effective treatments.
View study[2] Management of Acne Vulgaris: A Review.
This review discusses the impact of acne vulgaris and the effectiveness of treatments, including oral antibiotics and topical retinoids.
View study[3] Acne treatment review and future perspectives.
This review highlights the use of oral antibiotics and topical retinoids as first-line treatments for acne, along with emerging therapies.
View study[4] A systematic review and network meta-analysis of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris.
This meta-analysis evaluates the effectiveness of combined treatments, including oral antibiotics and topical retinoids, for acne vulgaris.
View study[5] Managing acne vulgaris: an update.
This review provides an update on the management of acne vulgaris, focusing on the use of topical retinoids and oral antibiotics.
View study[6] New Developments in Topical Acne Therapy.
This review discusses new developments in acne treatments, including novel formulations of topical retinoids and their combination with oral antibiotics.
View study[7] Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.
This review compares the effectiveness of various topical treatments for acne, including azelaic acid and retinoids.
View study[8] Tetracycline and other tetracycline-derivative staining of the teeth and oral cavity.
This review discusses the side effects of tetracyclines, including tooth discoloration, which is relevant for patients using oral antibiotics for acne.
View study[9] Use of Retinoids in Topical Antiaging Treatments: A Focused Review of Clinical Evidence for Conventional and Nanoformulations.
This review focuses on the use of retinoids in skincare, including their role in treating acne.
View study[10] Acne aestivalis.
This case report discusses a rare form of acne and the use of tretinoin as a treatment.
View study