Antibacterials for Skin

It’s estimated back acne affects more than half of acne sufferers.

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Team Software
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Sometimes we can think that the insides and outsides of our bodies are 2 completely different worlds, but this isn't the case.

Our skin is our body's largest organ, and it performs many functions to keep us healthy. It regulates our temperature, allows us to touch the world around us, and acts like a barrier between our delicate insides and the harsh outside world [1].

So, when our skin becomes inflamed, it makes sense that we treat it like we'd treat any other part of our bodies — and antibiotics are one highly effective treatment option we can consider for acne-prone skin.

What are the benefits of antibiotics for the skin?

Antibiotics are often used to fight infectious diseases and bacterial infections — including ones that affect the skin.

Although acne isn't a skin infection, in moderate to severe cases, opting for an antibiotic treatment can help in 2 ways: by minimising inflammation and by controlling bacteria. Let's dive into these benefits to understand how antibiotics can help clear your skin.

Minimise inflammation

Anyone who has had acne will be familiar with the inflammation that comes along with it. It can be painful and can leave red marks and swelling that lasts even after the pimple itself has healed.

There are 2 schools of thought around why this inflammation occurs: the first suggests that a bacteria called propionibacterium acnes breeds in the serum inside our hair follicles, and this excess of bacteria and sebum causes a pimple, which provokes an immune response from our bodies that includes swelling [2][3].

The second — and newer — school believes that inflammation starts long before a pimple is even formed. This school of thought suggests that acne is an inflammatory condition and should be treated as such, with anti-inflammatory medications used to clear up pimples and acne lesions [4].

While these theories put forward different ideas as to how and why pimples are formed, what they have in common is that they both acknowledge that inflammation is a big part of acne. 

Several different kinds of antibiotics treat inflammation in different ways: some inhibit the production of molecules that signal inflammation, and others inhibit overactive enzymes that can attack the hair follicle and sebaceous gland [5][6].

Your health practitioner or dermatologist will be able to prescribe the right antibiotic for your skin, and they'll do so by taking into account the inflammation that your acne causes.

Control bacteria

The propionibacterium acnes bacteria that can contribute to acne is present on our faces all the time, even when we have no active pimples or acne lesions.

As this bacteria is a part of our normal healthy skin bacteria, antibiotics that clear up acne work to control it rather than kill it completely. Some newer studies even suggest that antibiotics don't need to target p. acnes at all [6].

This is because over time, p. acnes — like many bacteria — can become resistant to antibiotics [7]. While oral antibiotics are less likely to induce bacterial resistance than topical antibiotics, bacterial resistance is still something that some doctors and dermatologists are concerned about [8].

This doesn't mean that oral antibiotics will never work against acne, but it does mean that there are a few things you may have to do to ensure your antibiotic treatment has the best chance of working.

What skin infections can antibiotics help treat?

Antibiotics are often used to treat mild and uncomplicated skin infections.

Impetigo, for example, is a bacterial infection that can be minimised with antibiotics. It usually starts in spots where the skin is broken, like a cut or insect bite, and shows as red spots that can grow into blisters.

If the infection only affects a small area of the skin, topical antibiotics should be effective in treating it. In more severe infections, there may be a need to take oral antibiotics.

Antibiotics can also be used to treat eczema, an inflammatory skin condition that can cause dryness, itchiness and, in some cases, other skin infections [12].

For more complicated skin and soft tissue infections, empirical antibiotic therapy may be recommended [13].

Who can and can't use antibiotics for their skin?

Your practitioner or dermatologist will be able to confirm if oral antibiotics are right for you. Generally, they are used for more severe cases of acne, or cases where the acne has spread across areas of the body that would be impractical or inconvenient to apply a topical treatment.

Not all antibiotics are safe for pregnant women to take, so if you're pregnant — or plan to be — you should let your practitioner know before beginning a course of antibiotics [14]. Your Software health practitioner will provide advice on how to best take or use antibiotics if you are prescribed these as part of your personalised acne treatment.

How to use antibiotics to treat acne

Your practitioner will be able to advise you on how many tablets to take, and when. If you start to see your acne clearing up before the course of antibiotics is over, you shouldn't stop taking them — instead, continue as prescribed until they're finished. 

You also shouldn't take more antibiotics more often in the hope it will clear your acne quicker, as this may cause side effects. Only ever take medication according to the directions given by your practitioner.

Use antibiotics alongside a topical treatment

Antibiotics are not capable of tackling everything that causes acne, like excess sebum production or follicular keratinization, so it's important to use them alongside something that can treat these mechanisms.

Benzoyl peroxide is commonly recommended for use alongside antibiotics, and it has been shown to reduce the prevalence of antibacterial resistance in p. acnes [8][9].

Salicylic acid can also help wash away acne-causing bacteria while also unclogging debris and trapped oils in pores. Software's Salicylic Acid Foaming Wash does both of these while also injecting hydration to reveal balanced and brighter skin. Plus, you can use this wash across your face, chest and back 2-3 times per week to target breakouts.

Topical prescription retinoids, niacinamide, and azelaic acid can also be used alongside antibiotics. Depending on Software's prescription acne treatment features these and other medical-grade ingredients to target acne by strengthening your skin barrier, fighting acne-causing bacteria, preventing clogged pores, and relieving swelling and redness.

Use antibiotics for a short period of time

Long-term use of antibiotics is not recommended due to the chance of bacterial resistance [10]. Most practitioners will aim to prescribe antibiotics for as short a time as possible, which may be a few months [11].

This allows the antibiotics enough time to do their work while avoiding the chance of building resistance.

Are there any side effects?

Oral antibiotics do occasionally come with some side effects. They can sometimes cause slight nausea, diarrhoea, and thrush. If you experience headaches or any signs of an allergic reaction, you should stop using the antibiotics and see your doctor [15].

You should also be aware that some antibiotics can cause increased sensitivity to the sun, not just on your face but across your entire body [15]. If you're not already using sunscreen, now's the time to start.

Opt for a non-comedogenic and hypo-allergenic one, which will prevent clogged pores and allergic reactions on the skin. Make sure it provides SPF30+ coverage as well. Software's Daily Sun Defence SPF50+ is formulated with UVA and UVB filters and designed for sensitive and acne-prone skin, making it a stellar option for anyone hoping to get rid of acne.

Finally, it's important to know that different antibiotics can cause different side effects, so if one antibiotic is not right for you because of its potential side effects then your practitioner may be able to prescribe another [16].

What can I expect?

When using antibiotics with a topical skin treatment, you can expect to see a reduction in acne inflammation within 6-12 weeks [15].

If your acne has not begun to clear by this stage, you may consider seeing your health practitioner again for a different antibiotic, or different treatment method.

Can I use antibiotics for skin in the long term?

Because of the potential for antibacterial resistance, antibiotics are not suitable for long-term use. Think about antibiotics as a tool that gives you a ‘head start' at fighting inflammation and bacteria, and then use topical treatments to continue this work.

It's important to continue using topical treatments after acne has begun to fade and to incorporate them into a skincare routine that you can follow every day.

We recommend starting with a non-comedogenic, hypo-allergenic cleanser and toner, then using your prescribed topical treatments. Top this off with a moisturiser: a heavier cream or lotion like Software's Ceramide Moisturiser Repair Balm will suit dry skin, while a lighter gel or serum will suit oilier skin. You should then continue using your sunscreen.

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