Tuesday, 24 March 2015

Beauty Myths No.14 - Antibiotics work for acne

Copyright Geof Kirby
Acne. Apparently the second most searched word on the internet, after porn (obvs).

It's easily the topic of my most-asked questions and the lead search on this site.

I know I've already said this over on the cheat sheets for acne ---> and it won't be anything new to regular readers, but please, please think carefully before taking antibiotics for your acne.

Whilst there are a few forms of oral antibiotics that may kill off bacteria in your oil glands, what if your acne is hormonal? Food allergy related? Have you had it for years? Antibiotics are pointless in those situations. You may get some relief initially but as soon as you stop taking them - and in most cases before, the spots are back. Why?
Because they're not bacterial - and you may already be resistant to the antibiotics prescribed.

Prescribing long-term antibiotic use is tantamount to abuse in my eyes. Antibiotics are without doubt a wonder drug. For treating the right illness.
Strep throat? Bacterial - get a prescription for it. Sore throat? Virus. Antibiotics don't work for that. It goes without saying that if you are required to take antibiotics long-term for chronic illness, then I am not talking about your situation.
Meningitis or pneumonia? Antibiotics will save your life. Literally. I'm not bashing the drug. I'm bashing the over-prescribing of them by doctors who should know better.

And in the case of acne, especially in the UK, an antibiotic prescription is the first port of call from nearly every GP. Rather than refer you to a dermatologist or look at topical creams themselves, they write the PrX for tetracycline or erythromycin and send you on your way.

It's your body. In your desperation for answers you may want to take anything thrown at you. But I would urge you to do a lot of research, make serious adjustments to your diet and lifestyle, ask about all the other options and most importantly, think of the side effects.

Long-term antibiotic use can:



  • wreak havoc with your digestive system
  • make you incredibly sensitive to the sun
  • destroy tooth enamel
  • make you resistant to antibiotic usage for severe infections
  • give you thrush on a continuous basis - which you then also need to medicate..

  • That's just for starters. 

    I know what it's like to have bad skin, do what you have to do to make yourself look and most importantly, feel better.
    But please arm yourself with as many facts as you can before you start down this path. And if you've been taking them for months (or years) and you still have acne, listen to your body, stop taking them.






    77 comments:

    1. 100% true. I had adult acne in my 30s and the dermatologist kept prescribing antibiotics. They DON'T work long term. At age 46, I recently learned my chin (hormonal) acne seems to be very linked to milk consumption (milk has hormones in it naturally); once I cut out milk, my one huge zit on my chin disappeared.

      Caroline, I've never heard you mention this, but I've gotten Isolaz (suction and laser combined) treatments that made my skin absolutely beautiful (but several initial appointments cost around $1000 total). Even so, it was absolutely worth it.

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      1. I gave up milk which I only drank in my morning coffee anyway and my rosacea is gone. Hello coconut / almond / vanilla soy milk!

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      2. My rosacea disappeared after giving up milk, which I only drank in my coffee anyway! I saw results after a week. Hello, coco / almond / vanilla soy milk!

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    2. What cleansers do you recommend for acne prone skin?

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      1. Go to the left of the page, there are a number of cheat sheets there - the first one is for acne and it contains loads of information on which cleanser to choose.

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    3. Amen. I was on tetracycline for 18-24 months and I WISH my doctor had fully explained some of the side effects to me - 100% not worth it. My skin isn't perfect now, but it sure as hell is better than it was when I was taking antibiotics! I only wish I had heard all of your advice 8 years ago!

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    4. While I do agree completely on (almost) everything you said, I think you miss the elephant in the room (or at least scientific community) by not mentioning the long term effects of antibiotics overuse on the society and human race in whole.
      It is not so much that you get resistent to antibiotics, If you weren't you wouldn't survive it, as the bacteria in your body. While most of the bacteria will be killed off, some of them might mutate to develop resistance to this particular antibiotic. The more common usage of the same antibiotic is the more these resistant bacteria will be favoured, and via simple evolution a new strain of resistant bacteria will be created. This new strain is by no means at all isolated to you, but can transmit to other people just as well. Neither are the antibiotics, certain amounts of them pass through your body and meet new bacteria outside you.
      So by our widespread antibiotic usage (and do not get me started on the antibiotics in meat production in most countries) we don't only risk the antibiotics not working on ourselves in the future. We risk them not working at all when our grandmothers and grandfathers get multiresistent pneumonia or meningitis, we risk them not working when a friend goes through a complicated baby delivery, some cancer forms, or surgery.
      So, with the risk of sounding like a doomsday prophet. Think about all the people in your life that might not be here if it weren't for antibiotics before you try taking it for acne. This is starting to be a very real problem in the scientific community, I can come back with some references for further reading later if someone wants them. Sorry if there are any linguistic errors, english is not my mother tounge.

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      1. No I completely agree with you. Oversubscribing them - and yes, meat production is horrific - is a nightmare on every level.

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      2. By the way, I love your blog.

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      3. And this is only one of the reasons I've been vegetarian since I was 12, I'm now 46. Also anti-biotics make you feel awful in a lot of cases. I've just been put on a short course for an infection, I'm on imuno-suppresents and prone to infection, fun 'not!', and I've only taken 2 so far and feel like crap today. Too many doctors today seem to be too eager to prescribe, rather than trying to get the cause of things.

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    5. A really great post, Caroline. I wish there were many more people that also advocated for this approach to acne ie. not using antibiotics as the first port of call. I work in pharmacy (in Australia) and it is amazing how naive even some of the pharmacists can be to long term antibiotic use for acne. Thank you so much for such a wonderful post - I hope this opinion becomes much more widespread xxx :)

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    6. Great post. The most dangerous thing is the increasing amount of resistance through wrong prescription (and, to be honest, due to the horrendous amount of antibiotics used in stock breeding).

      LindaLibraLoca: Beauty, Baby and Backpacking

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    7. I would steer clear from any GP that would suggest antibiotics to treat acne.
      I have previously been given steroid creams they wreaked havoc on my skin.
      Eventually, I discovered a good cleanser and taking care of my skin was the way forward.
      Leanne xx
      nailsandteapots

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    8. Great post Caroline. Having acne for 10+ years as both a teenager and now as an adult I have been prescribed antibiotics many, many times. It's only been in the last 5 years or so that I've started resisting; if the derm doesn't like it I simply find a new one! I have had really good success with differin gel and using your skin tips. One thing I'd love to point out--reintoids take TIME. It's taken almost 9 months of consistently using differin for me to see great results and my skin got much worse before it got better. Still, I am so glad I stuck it out instead of going back to the derm and being put on yet another antibiotic.

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      1. I've been using differin a few weeks now. I've also had acne over 10 years and have used various antibiotics and creams. I was getting worried as my acne seems to be getting worse but reading your comment has given me a little more faith to keep on using it so thanks!

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    9. I totally agree as well. I wish I'd known this during my many years on tetracycline, on and off during my twenties and thirties. My skin is better now (aged 42) than it's ever been and I put it down to good advice from you, Caroline, and Sali Hughes. I'm looking after it and appreciating it now instead of loathing it and punishing it with all sorts of harsh products. Thank you x

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    10. Fantastic post - with great advice !

      With love from London, Hayley ♥

      http://thelifestylemenu.co.uk/

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    11. LOVE. From personal experience, I try to avoid antibiotics for anything and go down the natural route... Why? What I now know to be a case of minor acne, not even this, just severe form of millia taking over my face, I was prescribed 40mg of Roaccutane. I genuinely had a few spots and what looked like an acne cyst on the side of my face... the tablets did NOTHING to clear this up and what did they do? up my dosage!!!

      I eventually paid to see a private dermatologist - after seeing two prior to this decision - and they eventually told me that it was not a cyst or acne of any form, but in fact a dental cynus. I took Roaccutane for no reason what so ever!!!!

      I urge everyone with acne to get a second opinion always :)

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      1. That is rather terrifying considering the potential side effects. Just a note - accutane/Roaccutane isn't an antibiotic, it's a retinoid being as it's vitamin A. :) It is supposed to be a last resort for those people who aren't getting on with any other option. I am in the US, so I have no clue how it's prescribed and regulated in the UK, but when I was on it, it was a hassle just to get the prescription in the first place and then there were lots of hoops to jump through for the entire 6 month course. I felt a bit like a labrat. haha. Even then, my derm only prescribed it because nothing else worked at ALL and mine was primarily cystic and was everywhere (face/chest/back/scalp). Everything else dried my skin out while the acne went on its merry way. (No antibiotics though, all the derms I've encountered thought them rubbish for treating acne outside a few rare exceptions.) That there are licensed professionals handing accutane out willy-nilly is absurd and entirely unethical (again, the side effects). It's not candy, people! While it is the best thing I ever did for so many reasons, it's not exactly something I run around recommending. I definitely agree getting a second opinion is so important.

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      2. Liz, I agree it is rather scary that it was given out so freely! I live in the UK and have been trying to get Roaccutane for years! From what I have seen - we have a bit of a post code (zip code) lottery here as far as NHS treatment is concerned so it could be different in another part of the country - it is very tightly regulated. I was told by my GP that it can only be prescribed by a dermatologist. It took me 5 years to get a referral to a dermatologist and when I finally did Roaccutane was refused because I suffered with depression in my teens, I'm 28 in a few weeks and haven't had depression for years!
        I have also tried everything else they can prescribe, it was the derm who put me back on antibiotics knowing they've not worked in the past and knowing my acne is down to PCOS! She's also put me on IsotrexIN which I will persever with.

        As a side note I'm not knocking the NHS, they do some amazing things and we are incredibly lucky to have it! But I have also seen the other side when things go horribly wrongly due to a a catalogue of errors, I'm not talking about just not getting a derm referral but extremely serious life or death situations.
        Again I'm not knocking it, I'm a Type 1 diabetic, my local hospital saved my life more than once (ketoacidosis), it was a fantastic hospital well run, amazing doctors and wonderful nurses even when they had way to many patients to attend to they always, always popped their head in just to check you were OK. Sadly that hospital was shut down in 2009 after a long fight to keep it open and we now have to go to one that just can't cope the volume of people, I was speaking to one of the nurses at the hospital when a relative suffered a heart attack she said when our local was closed most of the good staff from her hospital left because they knew what was coming.

        Sorry I didn't mean to go into that so much! It just makes me so angry to see something so great being destroyed by petty politicians!

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    12. Caroline, what an awesome post! Thank you for being so informative =) you should totally do a post on how to help KP (keratosis pilaris) and also OTC options for body acne - they have all those wonderful body washes that dry the heck out of your skin.... Once again, thank you for this post - I should print it out and hand it to my GP who did the same thing to me and it totally created havoc on my digestive system. You rock, caroline!

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    13. Amen Caroline! GP's who continue to give out antibiotics time after time for acne (and other skin conditions) that could be resolved without the use of medication drives me nuts!
      Especially considering 9 times out of 10 it makes the condition worse. The health of the skin is closely linked to the health of the gut, so how is taking an antibiotic to kill off the good bacteria, as well as the bad, ever going to be a good idea for treating acne?? It's also old school dermatology to think that acne is a bacterial condition. Acne is a disease of the sebaceous gland that started way before the bacteria was allow to wreak havoc, the over-growth of p.acne is a symptom of the acne, not the acne itself, YET, GP's still target the bacteria as the root cause with antibiotics!

      Same goes for topical steroid creams for treating eczema. I know, lets thin the skin of an already compromised barrier function so the skin has even less protection! But that's another blog post.

      It's probably because the GP hasn't got access to anything else to give so prescribes what they've got access to OR it's just lack of understanding.
      Sadly a lot of people trust their GP's blindly and will take or use what ever they're given but we must remember that GP does not equal dermatologist so their specialism isn't skin. However, that said for really common skin conditions that they see on a daily basis, you'd think they would have better options available to them.
      *stands down off soap box*

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      1. Andy, I'd be very interested in hearing your views and reflection on steroid cream and eczema. As a child of the 80s my parents did what they thought best in the day (which included mineral oil based creams - the bane of my life!), and until I found Caroline's blog, steroid cream has been a given (my eczema is whole body, and face). I could not find anything that would help make the skin healthier after the use of topical cortizone, yet still suffered the thinning of the skin, which obviously just reset the cycle all over again. Can you discuss this further, somewhere? Caroline's blog has been a revelation for me, so anyone who has a similarly "radical" viewpoint is always of interest to me (radical as in, not taking the usual route, that is).

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    14. I hear you! I have lingering digestive issues and tooth problems due to three years of antibiotics in my teens. I also got strep throat every other week during the process. I had it like 20 times in 3 years.

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    15. Oral antibiotics should be used in severe cases as a short term fix just to get the acne under control while you are improving your diet and finding the right topical products. Doc puts you on low dose and weans you off after 3months. During those three months, you adjust your diet and find good topicals. Pills won't work for everyone but if acne is affecting your daily life, a healthy person should not be scared off of giving it a shot. You only get one face and scars are permanent.

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    16. I'm a guy, I don't get thrush, can any other problems arise in my 'man garden' area. I don't want a sore, itchy, red, flaky little (big) Johnny.

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      1. Actually men can get yeast infections as well. It's not limited to females. Plus thrush (candidiasis) isn't limited to genitalia, it can be oral as well.

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    17. Hear, hear! Unfortunately it's one of the many hoops the NHS makes you jump through before you can see a dermatologist. And if you see an improvement (not even a cure) with antibiotics it would seem that that is enough for many GP's to keep you on them long term. I spent four miserable years of my teens on antibiotics, because there was a slight improvement of my acne it was deemed to be working so I didn't need to see a derm. I've now had acne for over 20 years and have finally been referred to a dermatologist who wanted to give the antibiotics one last try before bringing out the big guns. A relatively short 2 month course was long enough for him to decide AB's wouldn't work and I'm now almost a month into treatment with Roaccutane. (I know, it's a drug of last resort. I've had 20+ years of trying other options.)

      Caroline, do you have any product recommendations for those on Roaccutane? The only advice I've had from the dermatologist is to stick to usual skincare routine (taking out anything that is a spot treatment, salicylic acid or chemical peel) but try cetaphil if dryness occurs. Very helpful!

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    18. Yes to this! I was put on them, it helped someone for a bit and then did absolutely nothing after a couple of months! Drs were so unhelpful when I said I wanted to come off them, I've kind of given up nowb

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    19. Thank you, Caroline! I can't speak for anything besides my own experience, but I was on antibiotics for acne between the ages of 16-18. TWO YEARS. And the second I got off them, I suffered the worst, six-week long flu I've ever had. It was borderline plague stuff. I'm in the US and received my prescriptions from my dermatologist, but growing up in a conservative part of the country, none of my (many) derms ever suggested my acne could be hormonal.

      I think the bigger issue is that we should start looking at acne as a potentially hormonal, reproductive issue. When I got on the birth control pilll, that fixed my face; it did what a round of accutane, anti-biotics, years of differin, Retin-A, etc. and thousands of dollars at the dermatologist could never do. Moms have to be less fearful and realize that the pill might actually help their daughters' acne; yes, no one likes to talk about sex with their teens, but this could seriously improve your child's life.

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    20. Are you referring to oral antibiotics exclusively or topical as well? I was on an oral and topical antibiotic (prescribed by a dermatologist) for a year in college and it actually did help my acne without side effects, but I know it doesn't work for everyone. I do agree that antibiotics are over-prescribed and people should consider the side effects that could accompany such treatment. This type of careful consideration should also apply to the prescription of birth control pills for the sole use of treating acne - these can have serious side effects as well!

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      1. Yes to this! I had really good results with topical antibiotics that treated the cystic acne around my mouth.

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    21. Caroline please help me. For the past year my skin has been extremely dehydrated, I'm talking extremely tight, oily, blackhead, acne prone and for some reason the feeling never goes away no matter how heavily I moisturize. After completely messing up my acid mantle for sure I tried your skin care tips and switched over to gentle cleansers and acid toning (which helped a bit) but my skin feels so tight and parched and it even seems like the acid toning is exacerbating my current skin dilemma. Please please help me.

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    22. Just reading that someone uses antibiotics for acne makes me cringe, it's horrific, please DON'T DO IT. Antibiotics are to be taken when you are ill, and they're not lightweight medicines as well. You NEED your bacteria to be healthy in the first place, they help you digest and absorb the food you eat and also protect you from opportunistic diseases, i.e. pathogenic bacteria that attack you because your own bacteria were killed by antibiotics. Also let's not forget that by going through rounds of antibiotics you are pushing your normal flora to select antibiotic resistance genes, and this WILL be a problem whenever you ACTUALLY have to fight a real disease. Yes acne does not look bad, but it's better to be healthy with some pimples than not having madicines to cure you and a smooth face, let's not play with this please.

      www.studentblabber.blogspot.co.uk

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    23. Caroline, great post! What's your opinion on Roaccutane?

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      1. Caroline has stated in the past that she approves of its use ONLY in the most extreme of cases. If I remember correctly, she once stated that in her entire career she has only ever referred like two people to a dermatologist for a prescription.

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    24. Caroline I love your blog and youtube vids and am a big fan of your tell it how it is attitude! I'm a doctor and the issue we face is that we are bound by guidelines. As far as I am aware, I cannot as an NHS doctor recommend skincare products to patients that are not classed as "medical" and not backed by stringent clinical trials. If I recommended something and it made their skin worse, they could potentially sue me and I would not be able to defend my case as these products are not in our guidelines for the management of acne. If you look at our guidelines for the management of acne, they recommend antibiotics if topical agents don't work, albeit a short course of antibiotics. If a patient comes to me with widespread acne then I have to at least consider antibiotics. Our referral guidelines are such that if I referred a patient to a dermatologist on the NHS without having tried at least 1 antibiotic, they would probably refuse to see the patient. Private practice is obviously different. I work in an extremely deprived area where patients cannot afford a bus to get to hospital let alone ever be able to save up to see a dermatologist and so end up in the NHS system. As someone who has had acne in the past, I have experienced the frustrations that NHS treatments can cause, but a lot of the time it isn't that GPs or other Drs are rubbish at treating acne, it's more that our hands are tied. I do try and give the best advice I can within the boundaries of our "ethics." It's a difficult situation, the NHS is crippled and we are on the one hand being told not to prescribe antibiotics due to resistance, but on the other hand could be sued for not prescribing! *rant over, goes to take makeup off.* ps can you do a blog post about "sensitive skin" myths etc? :-)

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      1. I tried responding along these lines yesterday but my phone crashed, my problem is eczema not acne and I only tend to go to the dr when it's so painful it burns because I hate the steroid/antibiotics offer.
        my current GP (who is lovely and avoids needless prescribing if possible and tells it straight) told me at my last flare up (her first with me) that my choices were suffer through til it calms down or attempt to break the cycle with strong creams and a short course of antibiotics- she said the former is horrible and the latter isn't nice either but she cannot refer me to a dermatologist without 'failing' this first step- sadly my skin cleared up within days on the treatment. She was frustrated as she knew it wasn't an appropriate long term solution but her hands were tied.

        That said I was referred to a dermatologist when I was16 for the eczema, he looked at my face wrote me a prescription for fucibet and discharged me without even following up. I only access that prescription (still on my records) when I'm super desperate as I don't want my skin any more damaged/thinner.
        I despair every October to April that the red flakiness will explode.

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      2. I would similarly resort to the topical steroid creams whenever I had a flareup, but I found they never soothed during the fire-scratching session; it would just mended the skin after the damage had been done and a wound made. I have actually found dousing the area in a really generous layer of calamine lotion takes that intense burn out immediately. As long as you can just forget about the area afterwards, the heat dies down, the weeping stops, and then the skin is calm enough to use the steroid cream if you absolutely must. I've found by finding something to just take that horrible, pit in your stomach burn out has really cut the vicious cycle - I usually soak a cotton pad in the lotion, dab it on and then just lay the whole thing on the skin and let it soak in. For smaller areas I soak a cotton bud and do the same. Just be aware the stuff does leave residue when it dries. I've used this on eczema I've found on my fingers and between my toes as well, and it seems to work a treat.

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      3. Hi C Bryan, I agree with the fire days and that's good to hear you have something to help you cope, sadly I had a massive reaction to calamine when I was 6 and mum was told to use it on my chicken pox :(.
        When I'm that bad pretty much everything stings like hell I get to stage when I'm scared to wash my face, but I soldiered on through the last bout on my face (two weeks ago) with my cream cleanser, Nip+fab pads alternate days, watermelon seed oil and that Korean starfish cream and the eczema was gone in 5 days but I don't know if others could cope with the acids and oil.

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    25. Caroline I love your blog and youtube vids and am a big fan of your tell it how it is attitude! I'm a doctor and the issue we face is that we are bound by guidelines. As far as I am aware, I cannot as an NHS doctor recommend skincare products to patients that are not classed as "medical" and not backed by stringent clinical trials. If I recommended something and it made their skin worse, they could potentially sue me and I would not be able to defend my case as these products are not in our guidelines for the management of acne. If you look at our guidelines for the management of acne, they recommend antibiotics if topical agents don't work, albeit a short course of antibiotics. If a patient comes to me with widespread acne then I have to at least consider antibiotics. Our referral guidelines are such that if I referred a patient to a dermatologist on the NHS without having tried at least 1 antibiotic, they would probably refuse to see the patient. Private practice is obviously different. I work in an extremely deprived area where patients cannot afford a bus to get to hospital let alone ever be able to save up to see a dermatologist and so end up in the NHS system. As someone who has had acne in the past, I have experienced the frustrations that NHS treatments can cause, but a lot of the time it isn't that GPs or other Drs are rubbish at treating acne, it's more that our hands are tied. I do try and give the best advice I can within the boundaries of our "ethics." It's a difficult situation, the NHS is crippled and we are on the one hand being told not to prescribe antibiotics due to resistance, but on the other hand could be sued for not prescribing! *rant over, goes to take makeup off.* ps can you do a blog post about "sensitive skin" myths etc? :-)

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    26. American here. Of all the people I know who saw a professional for acne, there was only ONE who was ever prescribed Accutane, and her experience was identical to Liz's.

      I first saw a derm when I was twelve for acne. I was prescribed Retin-a and two other topical medications. After a few years I stopped taking the two because I never felt they did anything. When in college I went back because my acne returned with a vengence in the form of giant PAINFUL cysts; I was prescribed tetracycline. Now, while in my case the Retin-A and antibiotics were probably what I needed, the other two forgotten meds were useless and you know what I (in retrospect) I find horrifying? Not A SINGLE time did any derm ever ask me about my skin care regime. No one ever explained about an acid mantle and lipid barrier (and as a teenager, I know I stripped mine using awful alcohol-ridden products.)

      As an aside, I though tetracycline was more of a hormone than an antibotic? It was explained to me that it was found in birth control pills and hey, if I wanted those instead, she'd prescribe them.

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      1. must be a misunderstanding here, Tetracycline is a broad spectrum antibiotic, and in no way found in birth control pills. on the contrary, some antibiotics mess with the effectiveness of the pill, and it is advised to use a secondary method whilst on these medications.

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      2. ah, here is the answer. true, very similar name: http://www.thepill.com/aboutortho-how

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      3. Tetracycline is absolutely an antibiotic
        Check online sources like drugs. com etc

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      4. Maybe you're thinking of Tri-Cyclen, which is the birth control pill I used to take and also is prescribed for acne.

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      5. You know, I believe you are correct! It worked like a charm.

        My complaint against the doctors who made no effort to find out how I was caring for my skin, however, still stands.

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      6. Tetracycline is no longer manufactured anymore. It's been discontinued by Watson for a couple of years now and the other two companies that could manufacture them no longer do so. It's one of the reasons doxycycline shot up in price expoteniallly a couple of years ago and is just now starting to see a decent drop in price.

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    27. Great post as always. I have learned a lot here. Thanks for sharing this.....

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    28. This is so important. I've had acne since I was a teenager, and repeatedly have been prescribed antibiotics by every doctor and dermatologist I have visited. Ive been on tetracyclines for months on months, with no changes to my acne. I've tried so many different antibiotics, often taking multiple at once. There was a point 2 years ago where I was taking 5 pills a day! That was including doxycycline where after consumption, you're not allowed to lie down for 15 minutes! My dermatologist got mad at me when I stopped my pills, and insisted I buy a clarisonic from him.Never went back to that skin devil.

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    29. 100% correct Caroline. I found out the hard way. First visit to the dermatologist he wanted me to go on Accutane, I said no way so we tried antibiotics for about 4-5 months. I had a sore throat that just would not stop, thought i had an ulcer, turns out it was thrush. Stopped the antibiotics I'm totally healthy now, with spots yes but am trying to work on them without any medication just a good diet, good supplements and a good skincare routine. So far the spots are only on one cheek and no where else, and he wanted me on Accutane! Not all doctors are looking out for your best interests.

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    30. Caroline, I have just bought the tracie Martyn Amla cleanser on your recommendation, I also use Algenist anti ageing melting cleanser as my first cleanse/morning cleanse. I'm using Sunday Riley good genes couple of evenings a week, i use Emma Hardie moisturiser and Kiehls creamy eye treatment. I have just bought murad supplements on recommendation from a friend but after reading this I'm sceptical about using them, working but then left in a constant cycle, I have dry dehydrated acne prone skin, I'm 21 and haven't been without spots/acne since I was 13 I was hoping it was a teenage thing but I feel I have tried numerous things over the years which either keep the spots or bring more, I have tried the pill but it made no difference what's so ever, various cleansers over time, I have cut out dairy and sugar, and I currently have gastroenteritis (disgusting I know!) but doctor said I need to eat vegan for couple of weeks (it's been 3/4 now and no difference in old spots just lots more bumps and whiteheads) Ive been off work so stress free and lots of sleep, neither of which have helped the appearance of my skin bar my under eyes! I've been taking 4 omega 3 tablets a day since xmas which again not much improvement in old constant spots. Feel like I'm at the end of choices-I must say I constantly fear its a lifestyle thing as I have had back acne for the same amount of time, but then sometimes on my neck and chest, occasionally red spots that don't surface on my thighs, arms all over my face rather individually than clumps, but cheeks, eyebrows, chin, forehead, nose (end of nostrils regularly?!) I have switched using sulphate free, I use a back scrub everu other shower, my hair isn't past my shoulders anyway? Do you have any suggestions at all? I feel like I need to take something internally or its something I'm taking as its all over my body? Any help will be greatly appreciated I'm so so so so sick of having to avoid outfits due to not covering my breakouts over my body

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    31. They might not be good for you but when you are covered in a layer of furious and painful spots across your face and back that make you want to weep, antibiotics can seen like a good option.
      I'm up for making changes to your skincare/lifestyle whilst the spots are being blitzed but if you at the stage of dodging mirrors to avoid looking at yourself, debating whether dairy is making things wouldn't be a priority.
      The thing that I don't is clear is what changes you should make to your lifestyle if you already believe your skincare routine is top notch and does everything its supposed to when you're spot free.

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    32. They might not be good for you but when you are covered in a layer of furious and painful spots across your face and back that make you want to weep, antibiotics can seen like a good option.
      I'm up for making changes to your skincare/lifestyle whilst the spots are being blitzed but if you at the stage of dodging mirrors to avoid looking at yourself, debating whether dairy is making things wouldn't be a priority.
      The thing that I don't is clear is what changes you should make to your lifestyle if you already believe your skincare routine is top notch and doesn't everything its supposed to when you're spot free.

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    33. I was prescribed 40 days of tetracycline from a dermatologist to fight inflammation in my skin - acne rosacea (as far as I understand). I'm afraid of antibiotics. That's why I'm considering a start of this treatment for 3-months now. Take it, or not? Any thoughts?

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    34. Great post!! Its so surprising to me that even though this is the 2nd most searched for term on the internet, doctors and pharmacists alike are generally clueless. I remember my first phase of 'not quite acne but getting there', i was so frustrated with my skin i consulted a pharmacist, he said there was nothing i could do i just had to live with it AND then after pushing him (I have a science degree you know Mr.Pharmacist, and i know that's not true!) he offered me a solution of Benzyl Peroxide, which is just going to dry skin out like crazy - safe to say i did not use that!

      Really enjoyed your post!

      www.beaucience,co.uk

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    35. I work for Proactiv+ and i could agree with you more! Spots and blemishes can be caused by so many different things and most of the time antibiotics aren't the answer. Great post, lets just hope people take notice!

      http://surreyvslondon.me/2015/03/25/berlin-day-two/

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    36. Can't agree more. I have seen loads of patients complain about the 'not working' after the antibiotics course, yet they still finished the whole course about 3 months to half a year. My god, I feel horrible by just listening To them.

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    37. I am 37 years old and I have had cystic acne since I was 14, my skin is scarred and in a constant state of inflammation and breakout. I have been referred to a dermatologist. What frustrates me the most is that not once after years of begging has any GP or dermatologist been ever interested on finding out the cause of my lifelong acne

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      Replies
      1. I know when I have my appointment I will be expected to accept Roaccutane as a solution. No investigation will be done as regards any hornone imbalance etc. which I feel I must have given the amount of years I have had constant acne. It is so frustrating!!!!!

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    38. When I tried discontinuing my topical antibiotic (Zineryt - zinc and erythromycin, in a very drying alcohol suspension) for gentler options, my skin broke out again with a vengeance. I ended up with a secondary staph infection (cellulitis) which necessitated oral antibiotics to clear. I have now gone back to Zineryt. Taking high potency zinc (50mg/day) has helped hugely as has Pai Copaiba & Zinc serum. Sunday Riley Luna (I cracked and ordered it from Sephora US) seems to be helping a lot as well.
      Lindsay

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    39. The antibiotics I took the first time I had acne actually cleared my skin up pretty well within about 3 months...but with that came the 9 months of almost constant thrush (that's right, long after my 6 month course of tetracycline finished). It was 100% not worth it, I have honestly never been so miserable in my life! The real kicker is that the acne came back as soon as I finished the antibiotics, leaving me with acne AND thrush. Self-esteem was a very foreign concept to me that year...

      You'll be pleased to know that my GPs exact words when I went back were: "We're not going to mess around with antibiotics again. I'm referring you to a dermatologist." And you can prise my Epiduo out of my cold, dead hands :D

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    40. Could you please do a 'cheat sheet' on back acne please?

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    41. What do you think of topical antibiotics? like a cream. Or other pills such as roaccutane?

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    42. I was prescribed tetracycline for acne and taking it was one of the worst periods of my life health-wise. I was already prone to thrush but got it so badly I was in agony half the time and canestan couldn't touch it. I felt sick quite a lot of the time and my dentist is certain they contributed to the deterioration in my enamel (which has genetic origins). I reported all of these side effects to my GP who basically told me if I wanted nice skin to suck it up as there wasn't anything else available. I was told I couldn't see a dermatologist on the NHS because it wasn't serious and I couldn't afford to pay privately. In the end I refused point blank to continue taking them, made a complaint about my GP's attitude, changed surgeries and resigned myself to just living with it. Several years later my current fabulous GP told me he wouldn't dream of trying antibiotics "because that's not what they're for" and suggested a change of contraception to something anti-androgenic with oestrogen. It wasn't a cure but it certainly helped and not a hint of thrush.

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    43. There was a very worrying article on BBC news this week about people buying Roaccutane from the internet or via illegal (non-proscribed) means. The one thing the article missed was WHY people might be doing this. I believe that for most people involved, it is surely an act of desperation at not receiving proper support and advice from their GP, possibly having been proscribed courses of antibiotics and this not working etc. Great post Caroline. What the F can be done to improve GP's knowledge and care of patients suffering with acne? Poor care seems to be endemic.

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    44. I developed hormonal adult acne a year ago when I turned 25. I really started to look after my skin, discovered your blog, started to double cleanse and just go about looking after my skin and in conjunction with differin, it has made a difference. I was put on medication first and my GP handed it over with no issues or warning. As a solicitor I like reading the small print and went about reading the leaflet with it. My sister works in a pharmaceutical company as a chemist and I was lucky I could go through it with her. I took the prescription for three weeks and yes my skin cleared up but I didn't feel comfortable with the potential huge side effects. So I just learnt to take care of my skin and watch what I eat. My skin is not perfect, it may never be and there is a some scaring. The hormonal acne may never go away and medication is not a long term solution. I am thankful I came across this blog through beaut.ie in Ireland and you have done more for me in understanding my skin and how to treat it than any GP could. I know the frustration involved when something like this happens and how depressing it is. It took nearly a full year before my skin calmed down and became manageable through your tips and advice. Hopefully I can keep it under control!

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    45. They've always *caused* me acne.

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    46. I did a course (9 months) of Roaccutane and the acne was back a couple of weeks later. I used Differin afterwards and my acne got worse from it. Several rounds of antibiotics, oral and topical in the years before. Topical ones don't do squat; I'm not taking oral AB long term. I'm 30. Had acne since around 11.

      My skin has been better now for only a couple of months. It could be because it's just getting better on its own, I don't know and don't want to test it. There are NO OPTIONS on the market for moisturisers that have relatively high levels of BHA and AHAs in them. None that I've found. I made my own for nighttime use. 5% BHA, about 7% different AHAs, several humectants, emollients, anti irritants. pH of about 3.5. It would not be conscionable to share the recipe but my point is that I have something that seems to work for my skin, finally, and I'm pretty sure it's mainly because of the level of BHA.

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    47. You only have one face and scars are permanent so I don't see the harm in an otherwise healthy person going on an oral antibiotic for 3 months or less. It can lessen the severity of the acne while giving you 90 days to get your diet and topicals/products on track. At the end of 3months, you slowly come off the meds.

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    48. Interesting post, Caroline. My 15 year old son has had severe acne for several years. It has finally (mostly) cleared up thanks to a course of Isotretinoin - I don't know if this is a permanent improvement as he's still taking it at the moment. I don't disagree with your point about antibiotics (they sort of helped my son a little while taking them, but as you say, the acne comes back/gets worse immediately after you stop).

      However, the point I would make is that in our experience, the NHS will not refer you to a dermatologist for acne without first trying at least six months' worth of antibiotics. I hear the same from other mothers of teenagers as well. So whilst I agree with you about antibiotics, taking them seems to be the only avenue to to get to the treatment that really works. For my son, anyway.

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    49. I've been prescribed to antibiotics for my can for years now and just recently got referred from my GP to the dermatologist. The dermatologist wanted to put me back on antibiotics saying they were the best option even after telling her about all the horrible side effects I got on erythromycin and tetralysal.

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    50. Hi Caroline,

      I recently went to a Dermatologist that I was referred to by my GP. I was prescribed Minocycline and Duac without really getting an examination of my face, just a quick glance really. I was disappointed as he is a well known dermatologist here (Bermuda). I researched everything I could on their effects and have decided to not continue the use of them (only been 4 days of use) as I feel the effects are higher than the cost of beauty. I have had a scare with antibiotics before (Penicillin) as I am allergic. I don't want to go through that kind of torment on my body again. I'm in my early 30's and was on birth control and am reconsidering it. I had pretty good results with birth control, but every now and then I had blemishes, the cystic kind I think after reading your Acne Cheat sheet. I am so happy I've come across your blog via on of my fav youtube beauty guru's BeautyCrush and I will follow the routine on how to cleanse and take care of my skin and hopefully get some results.

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    51. Dear Caroline,
      I am 15. I have spots particularly on my forehead. They are hard to describe as anything else than 'red bumps'. I have lots of these red bumps, and a few, usually 3 or 4, big 'red bumps'. Occasionally a couple develop into whiteheads. I am really struggling with them as the area around the circle of the skin is dry and when I apply foundation (bourjois healthy mix) it clings to the dry spots. My skin is, i guess, combination? Under my eyes is fairly oily, my cheeks normal, but round my nose and forehead is dry. So my foundation can look patchy after a hour or so of application and clings to the dry patches. Applying a moisturiser before i apply foundation does slightly help. I guess my main enquiries are- can you tell me about the spots I have, and how to reduce them? Is the foundation i use suitable, i have tried others and they don't work as well, however i have very little knowledge of makeup and don't know how to tell if its going to work before i buy it and of course, at 15 i don't have the money to buy different foundations often. If, unusually, my skin is clear, i wear very little makeup, or sometimes none at all. HELP ME! I will repeat by knowledge of skincare is low, although i love makeup, just don't know how to apply it!!!
      Lots of love, Abi x

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    52. Found a really interesting research article here: http://www.ncbi.nlm.nih.gov/pubmed/17448569 - basically there were positive reductions in acne lesions for those following a high protein low GL diet. Lots of links on the right hand side of the page as well for going down the rabbit hole reading about acne and diet (reading actual scientific research that is!). Thought this might be of interest to you and your readers...

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