I’ve heard the questions a thousand times.

“Will antibiotics help my acne?“ "

“Are antibiotics bad for me?“

“Why has my acne come back after having antibiotics?“

I know the story.

You have acne. You go to the doctors. They give you antibiotics (and maybe the Pill, if you’re not already on it).  They either give you a relatively high dose for infective acne (taken usually for 6-12 weeks), where there’s lots of pus and inflammation… or they give you a lower dose to take for 6-12 months. 

You take them, your skin probably clears up pretty well. You finish your prescription. Either a few weeks or months following, the acne returns.

At this point, you either return to the doctor to renew your prescription, or you get put on the Pill or referred to a dermatologist who will put you on retinol cream or Roaccutane.

But maybe… just maybe… at this point, instead you read this blog and you ask yourself, “Why have antibiotics not helped my acne?”

Here’s the low down.

On the surface of things (pun intended), acne is an infection. There are always a few components that cause acne:

1. Increased oil production from sebaceous glands

2. Clogging of the follicular unit with dead skin cells (often due to hyperkeratinisation or poor function of the skin) 

3. The immune system kicks in, creating inflammation and white blood cell production (equalling pus and redness)

4. The increased oil oxidises and becomes rancid, creating more inflammation + the perfect breeding ground for Cutibacterium acnes… which is the bacteria responsible for acne infection

Using antibiotics can help to kill the bacterial overgrowth, which in acne can be quite significant.

But antibiotics used at a lower dose over a longer period of time actually aren’t working as antibiotics (although they still damage the microbiome, which is a nasty side effect of antibiotic use… hello thrush and weird gut changes!).

Low dose and longer term antibiotics actually exhibit an anti-inflammatory effect.  So, your antibiotics aren’t being prescribed for the infection, but rather to reduce the inflammation that creates the perfect environment for the bacterial overgrowth.

But, how are they working on inflammation for my skin when I’m taking them internally? I hear you, girl.

Because the inflammation driving your acne is actually an internal job, not an external one.

Inflammatory chemicals produced by bacteria and internal processes make their way into the bloodstream via the gut.  

This is why I do so much gut work when I am treating skin… and also why oral antibiotics assist with topical skin inflammation.

You might be thinking… bugger it, if taking antibiotics is easy enough then I’m fine with doing that over and over to help my skin, but here’s why that’s not a long-term solution:

1. Antibiotics disrupt the microbiome of the gut (and consequently the skin). The microbiome is a collection of bacteria, yeast, fungi that live in the gut and help to maintain health… or disease. Lots of healthy and helpful bacteria in the gut are killed or diminished by antibiotic use, which means antibiotics are often creating the problem that leads to acne and inflammation to start with… an altered microbiome. You will be left with a lot more damage.

2. Antibiotics are not treating the cause. When you stop taking them, the problem returns, because the driver of inflammation or increased sebum production causing the acne has not been addressed.

Over half of the patients that I treat have been prescribed antibiotics for their acne. They all still end up in consultation with me, with acne, trying to understand what’s happening. And the gut work I do is that little bit more intense because of the dysbiosis that the antibiotics have caused.

As always, my point comes back to this…

Think twice.

Ask the question… is this working? If so, why is the problem returning?  What long term damage is this causing for short term gain?

If you need help, you know where I am.

In the meantime, check out my free Naturopathic Skin Appraisal if you haven’t already.

Remember, it is in your uniqueness that you will find your answers.

Love,

Emily Banks (Naturopath, Skin-thusiast)