Antibiotics For Acne Just Aren't Working Like They Used To

Illustration for article titled Antibiotics For Acne Just Arent Working Like They Used To

Acne suffers will likely find the following news both unsurprising and disheartening: The Wall Street Journal reports that an increasing number of dermatologists are leaning away from prescribing antibiotics to treat acne, because they're not working with the same efficacy that they used to.

As The Cut points out, doctors have found that antibiotics like clindamycin and doxycycline, once commonly used among young people and adults to treat acne, just aren't cutting it anymore:

"We used to get more success with oral antibiotics," says Dr. Bowe. But the bacteria responsible for causing acne have become so resistant to the drugs "that our ability to treat moderate to severe acne has become compromised," she says.

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Some doctors are particularly concerned about how the use of antibiotics for acne can make young people more susceptible to diseases like meningitis (!!!) and pneumonia. The Journal continues:

In a study in Britain, antibiotic-resistant strains of Propionibacterium acnes, the bacterium involved in acne, were found in 56% of all acne patients in 2000, up from 35% a decade earlier. Many countries now report that more than half of P. acnes strains have developed a resistance to antibiotics.

Concerned dermatologists—in conferences, medical journals and professional newsletters—are urging more judicious use of antibiotics for acne. The American Academy of Dermatology is expected to issue updated acne guidelines later this year in part to address antibiotic resistance.

This decrease in antibiotic treatment has lead doctors to explore other treatments. Many are prescribing isotretinoin, a.k.a. the generic version of Accutane, for people who previously wouldn't have been considered candidates for that drug (it's typically given to those with severe acne). Accutane has a long and controversial history, and certainly can have cause severe side effects (incredible skin dryness at one end, plus endless debate over its potential to cause Crohn's disease or depression), but for those who have used it successfully, it worked when nothing else did. Doctors are also relying on topical treatments, as well as newer, more experimental technologies, like lasers and chemical peels.

In general, this piece makes it sound as though doctors are starting to have to get more creative and piecemeal about their treatments, which, when you have skin problems, can be endlessly frustrating and exhausting. But that's just a life dependent on drugs! They give and they take take take. At least it's not a very long time ago when we had nothing...right?

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Image via George Marks/Retrofile/Getty

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DISCUSSION

Growing up, I had moderate to severe acne. It was certainly a cause of embarrassment and ridicule. I went to who was purported to be one of the best dermatologists in my (admittedly small) state, and got lot of rounds of prescribed gels and creams. Nothing really changed. But every time I went to see her - 6 months' wait for an appointment, and hour-plus wait in the waiting room - she'd pop in for four minutes, tell me I was looking good and better (I wasn't) and leave. I was a kid. All I could think to do was eventually bring in small bullet-point lists and insist she stayed in the room with me until my basic concerns were addressed. I had to proactively make medication and treatment suggestions to get them approved, rather than her offering me anything more.

I had two friends who later told me that their dermatologists - different guys, different states - treated them the same way. Why? What's going on? Do acne-ridden young adults just not warrant the time because their conditions are the product of puberty, nothing more?

TL;DR: Dermatologists are more in demand than a 2013 Cronut.