Oral Pimple Treatments

Oral medications are used to treat moderate to severe pimples. Oral medication is normally prescribed by doctor after topical treatment failed to lessen inflammatory acne such as, the risk of scarring is very high such as in nodulocystic acne, or when the patient needs a faster acne treatment.

Oral medications include antibiotics, hormonal therapy and isotretinoin (Accutane).

Oral Antibiotics

Oral antibiotics are effective against P. acnes bacteria which cause inflammatory acne. An effective oral antibiotic therapy can reduce the P. acnes population by as much as 90%.

The effectiveness of oral antibiotics usually will be shown in the fourth to sixth week after taking them. During this initial period, oral antibiotic should be taken regularly as prescribed. Most failures of oral antibiotics are usually caused by irregular intake. Inflammatory acnes normally take three to six months for them to be totally clear, so adhere to your doctor’s advise and do not stop your consumption of oral antibiotic too early on your own.
The most commonly used antibiotics against acne are tetracycline, doxycycline, minocycline, erythromycin, and cotrimoxazole.

Tetracyclines

Tetracyclines are often the first line of treatment for oral acne therapy. Tetracycline inhibits the growth of P. acnes bacteria rather than killing them. They also have anti-inflammatory properties which stop the action of pro-inflammatory and reduce inflammatory in moderate to severe acne.

There are three versions of tetracyclines

1. “Plain” tetracycline
2. Doxycycline
3. Minocycline

Side effects of tetracyclines

The main side effect of tetracycline is discoloration of teeth.
Any children under the age of ten should not use tetracyclines at all. It will cause permanent discoloration of teeth while using it during the teeth development period of the child.

Taking it while being pregnant or breastfeeding will cause harm to the baby. The baby might have a bone growth problem and there is the risk of permanent discoloration of the teeth.

Adults taking tetracyclines might face temporary discoloration of their teeth.
Tetracyclines like any other broad spectrum oral antibiotics might result in a overgrowth of the fungus Candida in the vagina. This result in vagina yeast infections know as candidal vulvaginitis or candidosis which is evidenced by the increase in white vaginal discharge for several days to weeks after starting the therapy.

Mild indigestion and abdominal upset is common with any antibiotics intake.
Rashes are uncommon but some people get them severe rashes after starting on tetracycline therapy.

Tetracycline can also cause your skin to be more photosensitive to light, resulting in frequent sunburns.

“Plain” Tetracycline

“Plain” Tetracycline is the cheapest of the 3 types of tetracyclines, however its effectiveness again acne is also the weakest of the 3 types. Initial dosage is usually 500mg twice daily. This dosage is maintained until significant improvement on your acne condition can be seen. It may take six to eight weeks for improvement to be visible. Afterward the dosage will be reduced.

Plain tetracycline should be taken at least one hour before meal on an empty stomach. The presence of food and daily products will obstruct the absorption of tetracycline into the body, reducing its effectiveness. All dairy products like mike and cheese should be avoided.

Doxycyline

Doxycycline is a newer generation of tetracycline. It is more expensive than “plain” tetracycline but cheaper than minocycline. It effectiveness against acne is still weaker than minocycline. Its absorption is not affect by the presence of food. The initial dosage is usually 100mg twice daily. It is recommended to take doxycycline after meals to reduce gastric upset.

However the main disadvantage of doxycycline is that it causes the skin to be photosensitive to sunlight. The photosensitivity side effect is the highest against the other two tetracyclines. You should put on more sun protections while on this antibiotic.

Minocycline

Minocycline is the most expensive but the most effective against pimples. Its initial dosage is usually 50mg twice daily. Its absorption into the body is not hampered by the presence of food and dairy products. The dosage will be reduced once lesions on the skin are improved.

It has the lowest photosensitivity effect and the probability of getting vaginal yeast is extremely low with minocycline.

However its side effects are also more severe than the other two tetracyclines. It can cause more dizziness and vomiting. It also cause the skin and gums to have a bluish pigment, however it is reversible with the stoppage of using minocycline. Permanent discoloration of teeth has been reported in some rare cases. A more severe and extremely rare side effect is that minocycline can cause drug-induced erythematosus. However this side effect will gradually resolve itself within weeks or months of stopping minocycline.

Other Antibiotics

Erythromycin

Erythromycin is useful to those people who cannot take tetracycline such as pregnant women and children below 10.

The starting dosage is usually 500mg twice daily. People with other medical conditions should inform the doctor, as some of the other medication can interact with erthromycin.

It can cause some side effect such as stomach upset, vomiting and flatulence. However in most cases these side effects are only mild and temporary.

Same as most broad spectrum antibiotics, erythromycin can also cause vaginal yeast infection to reappear.

Trimethoprim sulfasoxazole

Trimethoprim sulfasoxazole is very effective against acne. It is usually prescribed when all the other antibiotics failed. The starting dosage is usually 2 tablets twice daily.

Although it is useful, however it can cause severe side effects. It can cause severe allergic reactions like rashes. In the first few weeks of using Trimethoprim sulfasoxazole, you must keep a daily lookout for any skin rash or mouth ulcers. Medication of Trimethoprim sulfasoxazole should be stop immediately if the a rash or ulcer developed. Go see a doctor immediately.

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