Do long-term acne antibiotics have side effects?

Hello,

Welcome to icliniq.com

I understand your concern.

You have grade 2 inflammatory acne with few comedones. Azithromycin is an antibiotic that is effective for inflammatory acne, Azithromycin is usually given as pulse treatment for three months, the way you are prescribed.

It is fine to take Azithromycin as instructed by your Dermatologist. You will also need topical creams like Tretinoin 30 grams, 0.025 % along with oral antibiotics as you have comedones (blackheads and whiteheads). Are you using any topical creams for acne? Let me give you some information regarding acne-

1. Acne is a disorder of the pilosebaceous unit, pilo-hair, sebaceous- oil-producing gland. These pilosebaceous glands are densely distributed over the face, neck, chest, back, shoulder, and arms. It also has a genetic component, meaning the appearance/ severity of acne depends on the genes from parents.

2. The sebaceous gland produces oil, that is expelled out through the duct which opens on the skin surface.

3. As long as this duct is intact, oil flows freely out onto the skin. If there is any blockage in the duct, the oil cannot come out, and then it starts irritating the surrounding skin and causes comedones (black and white heads).

4. Our skin has a commensal harmless bacteria, called Propionibacterium acne (P acne). This bacteria acts on the oil collected inside and causes inflammation leading to red bumps, pustules, cysts, or nodules as it progresses. If acne is not treated on time, it will leave scars.

5. Hormones have a strong effect on acne, increased androgen hormone can cause thickening of the wall of the duct, leading to its blockage causing comedones (black and white heads). PCOD/PCOS - Polycystic ovarian disease/syndrome, is the most frequent hormonal disease causing acne in teenagers as well as adult women.

6. Environmental or External or Emotional factors: Hot and humid climate, causing increased sweat, can clog the pores. The application of oil oil-based cosmetics or steroid cream is another cause of acne. Psychological stress is one of the important factors in acne.

Yet I would like to mention a few general acne skin care tips here-

1. Face Wash: Wash your face with mild cleansers like Cetaphil cleanser if your face is dry, or use Benzoyl peroxide face wash if your face is oily. Wash your face three times a day to remove excess oil and dust, that accumulates over time on the face.

2. Sunscreen: Use a good sunscreen with SPF 50, and apply it to the whole face 30 minutes before you step out irrespective of the presence of sunlight. UV rays will always be there during day hours (even if cloudy). Apply every four hours for maximum benefits. This is because sunscreen can protect your skin from UV rays for four hours. Hence you need to repeat every 4 hours. Always use non-comedogenic sunscreen.

3. Do not prick or squeeze your acne: It will leave dark pigmentation and scars, which are even more difficult to treat.

4. Regular physical exercise: Very much essential to keep hormones under check. Exercise for at least 40 minutes a day, six days a week.

5. No oil massage: Avoid oil massage to the scalp, as it will aggravate dandruff. If there is oil flow on the facial skin, it can clog the pores leading to comedones.

6. Vitamin A and Water: Eat vitamin A-rich fruits and vegetables like papaya, mango, musk melon, pumpkin, carrot, and beetroot- these have Beta carotene in them, a good antioxidant- very helpful for healthy skin. Drink two to three liters of water per day, this keeps the skin hydrated.

7. Cosmetics: Always use water-based cosmetics, which have the “non-comedogenic” label on them.

8. Stress management: Stress (mental as well as physical) causes acne breakouts. Meditation is very helpful for controlling mental stress.

9. No waxing of hair on the face: Waxing irritates hair follicles and can aggravate pimples. However, threading to remove unwanted hairs over the face is fine. Threading does not affect acne.

10. Never use steroid cream: Steroid causes very bad acne, it make skin very thin and sensitive. Avoid over-the-counter (OTC) steroid creams like Betnovate, Panderm.

I hope this helps.

Kindly follow up if you have more concerns.

Regards.

Thank you.

Hello,

Welcome to icliniq.com

I understand your concern.

Clindamycin is a topical antibiotic, and Duac is a combination of Clindamycin and Benzyl peroxide, it is very helpful for inflammatory red bumpy acne, Topical Retinoids like Tretinoin or adapalene are best for comedones. Each Dermatologist treats acne differently, and you are on the right regimen for acne. In addition, I would have suggested topical Retinoids for your comedones. You can discuss with your Dermatologist about this, your doctor may add more during follow-up.

I hope this helps.

Kindly follow up if you have more concerns.

Regards.

Thank you.