Medically reviewed by Sophia Yen, MD, MPH – Written by Mary Francis Garcia  


Acne is something that many individuals experience at some point throughout their life. Nonetheless, it’s unpleasant to have. Sometimes, washing your face just doesn’t cut it- you still have severe acne. What’s up with that? So you go to your dermatologist and they prescribe you a pill. Now you’re thinking: “A pill? To treat my skin?” Yes, what your doctor just prescribed to you is most likely an antibiotic. 

The above situation is totally normal, albeit maybe a bit scary. So let’s discuss everything you need to know about oral ant

What is an oral acne treatment?

Oral acne treatment consists of an antibiotic pill that is taken on a schedule determined by the doctor who prescribed it. Being that this method is very strong, it is usually reserved for patients with moderate to severe acne. Noticeable effects of this type of treatment may take anywhere from weeks to months. 

Do oral antibiotics treat severe acne?

Tldr: Yes, oral antibiotics are effective at treating severe acne. 

Oral antibiotics are normally seen as one of the last resorts for treating moderately severe acne after other alternative methods (i.e. topical creams, increased face-washing, etc.). In some cases, oral antibiotics might be paired with other treatments, like light therapy.

What is the best oral antibiotic for acne?

The best oral antibiotic for acne largely depends on the person. The doctor might start by prescribing a tetracycline or a macrolide. However, in the event that these are not working, implementing a stronger antibiotic, such as oral isotretinoin (a type of retinoid) might be necessary. 

Do oral antibiotics increase your skin’s sun sensitivity?

The skin’s sensitivity to sun as a result of taking oral antibiotics is referred to as phototoxicity. This occurs when the drug in your skin absorbs the UV light emitted from the sun. 

Oral antibiotics are phototoxic. The absorption of UV rays causes them to change on a molecular level, resulting in molecules that are very toxic to skin cells. This typically appears on the skin as a bad sunburn and/or rash

Thankfully, this can be largely prevented with the conscious use of hats, shade, and sunscreen when you go outside. 

Oral Antibiotics for Acne

Before learning about the different types of oral antibiotics that are used to treat acne, it’s important to understand what an antibiotic does. “Anti” means ‘against’ and “Biotic” roughly translates to ‘life’. Therefore, antibiotics are “anti-life”. But that doesn’t mean it’s going to hurt you – the ‘life’ in this case is the bacteria that causes your acne. In short, antibiotics stop the growth of bacteria to remedy acne. 

Oral antibiotic treatments are prescribed by physicians and should be used as directed. There are many oral antibiotics on the market including, but not limited to: Erythromycin, Tetracycline, Minocycline, Doxycycline, Sarecycline, Trimethoprim/Sulfamethoxazole (TMP-SMX), Azithromycin, Isotretinoin

It is also necessary to note that oral antibiotics do not cure acne. While they reduce inflammation caused by bacteria, they may not prevent acne from returning. Furthermore, taking additional precautions (i.e. avoiding scented soaps, managing stress, and moisturizing) may be necessary to maintain healthy skin. 

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Side effects of oral antibiotics

Side effects from oral antibiotics are uncommon, but may occur in some individuals. While the most frequently reported symptoms relate to the digestive system, the following are also possible: 

  • Nausea and/or vomiting
  • Diarrhea
  • Bloating and indigestion
  • Loss of appetite
  • A raised, itchy skin rash
  • Coughing and/or wheezing
  • Tightness of the throat

If you are taking oral antibiotics and notice any of the above side effects (or others), consult your doctor as soon as possible. In some cases, you may need to decrease the dose or stop the medication altogether. 

Controversies over the use of antibiotics

As previously mentioned, it’s important to remember that oral antibiotics should be used as directed and may only be necessary as a last resort. If an individual takes antibiotics too often, they may develop a resistance, in which case this treatment may not be as effective in the future. For this reason, physicians typically prescribe oral antibiotics for a short period of time.

Bacterial resistance to antibiotics

Antibiotic resistance occurs when bacteria is still able to grow despite the presence of antibiotics, which are implemented to bacterial growth in the first place. Using an antibiotic for a prolonged period of time increases the chances of this happening because bacteria can multiply very fast, preventing the antibiotic from being able to work properly. If this is the case, acne is more likely to persist even when antibiotics are taken. 

Thankfully, there are many ways to avoid this resistance. First, the individual can simply not use oral antibiotics as an acne treatment. Instead, they can try other treatment options in order to determine which works best. Additionally, making sure to only take the medication as prescribed will prevent overuse, in turn, reducing the likelihood that bacteria will become resistant. Lastly, the doctor might prescribe a narrow spectrum antibiotic, which is effective against certain groups of bacteria and not others.

If an individual cannot take antibiotics due to former allergic reactions, their doctor may recommend an over-the-counter topical treatment such as benzoyl peroxide. This helps treat acne by killing bacteria under the skin and preventing pores from getting clogged. In some cases, this may even be prescribed for individuals who simply prefer not to take antibiotics, as it may be just as effective. 

What’s the takeaway?

Oral antibiotics help treat acne by preventing the growth of bacteria on the skin. While they can be very effective, they may not be the first method prescribed, as they can lead to bacterial resistance. Furthermore, when resorting to oral antibiotics, it is necessary to take them with caution and update your doctor on their effectiveness. 

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Disclaimer: The above information is for informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.