Oral Antibiotics for Acne | Side Effects and Alternatives

oral antibiotics acne

Do Oral Antibiotics Work for Acne?

Mild oral antibiotics, such as doxycycline and minocycline, are commonly prescribed for acne. The clinical data supports the use of oral antibiotics for acne in practice and in theory, suggesting that they inhibit the growth of acne-causing bacteria (Propionibacterium acnes) and reduce inflammation.1 However, antibiotics can potentially come with some unwanted side effects. Read on to learn more about why you may not want to use oral antibiotics for acne.

Oral Antibiotics Used to Treat Acne

Usually the first choice for treating acne is tetracycline — such as minocycline or doxycycline — or a macrolide.

Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance.

Oral antibiotics are best used with topical retinoids and benzoyl peroxide. Studies have found that using topical benzoyl peroxide along with oral antibiotics may reduce the risk of developing antibiotic resistance.

Oral Antibiotics for Acne Side Effects

Are acne antibiotics bad for you? Not necessarily, but antibiotics can come with a variety of unwanted side effects. Below we cover some of the most common side effects and why they occur.

1.    Gastrointestinal Problems

Antibiotics frequently contribute to gastrointestinal problems, most commonly manifesting in the form of diarrhea. Your gut is home to a complex ecosystem of bacteria known as the intestinal microbiota. Normally, when this ecosystem is balanced, the microbiota offers potential benefits to the skin, immune system, and digestive system.

Although antibiotics are effective in eliminating bacterial infections, they do not differentiate between the good and bad bacteria in your gut. Overusing antibiotics can potentially wipe out the beneficial bacteria (probiotics) in your gut, resulting in a state of imbalance known as dysbiosis. This can lead to diarrhea and other gastrointestinal issues.2

2.    Increased Rate of Upper Respiratory Infections

Some studies have found that people with acne who use antibiotics may also have an increased risk of upper respiratory tract infection. In a cross-sectional and prospective cohort study, researchers found that the patients taking oral antibiotics for acne were more than three times more likely to report a sore throat than those who did not take oral antibiotics.3 In a similar study, researchers evaluating the long-term use of antibiotics for acne found that patients using antibiotics for their acne were more likely to develop upper respiratory tract infections. The exact mechanisms and reasons for this still require further study.4

3.    Sensitivity to UV Light

Doxycycline, minocycline, and most other antibiotics used for acne are classed as tetracyclines. These are known photosensitizers, meaning that they make your skin more sensitive to sunlight and UV radiation. Tetracyclines absorb UV light and transfer that energy into the skin, resulting in the buildup of harmful compounds that can kill cells.5 Photosensitivity can make you more vulnerable to sunburn and sun damage. This photosensitivity does not occur with everyone who takes tetracyclines, though it does often occur more often with people of fair skin.6

Some studies have also found that tetracycline usage may result in pigmentation or discoloration in the skin, nails, teeth, and bones. This discoloration can vary from yellow to gray to brown.7

4.    Antibiotic Resistance

Over time, bacteria can evolve to become resistant to antibiotics. Antibiotic-resistant bacteria can potentially spread to other people, creating “superbugs” that are harder to treat and require much harsher medication.8

Along with its larger ramifications for global health, antibiotic resistance can contribute to your acne. The acne-causing bacteria P. acnes can potentially become resistant to antibiotics, which can result in your acne getting worse on antibiotics.9

Natural Alternatives to Antibiotics

Because some people experience side effects on antibiotics, they try to search for natural oral antibiotics for acne. Although there are no approved natural oral antibiotics, there are natural alternatives that can help your acne. If you experience any of the above negative side effects, you may want to try natural alternatives below.

1.    Diet Changes

The relationship between diet and acne is clear. Foods that cause spikes in insulin-like growth factor-1 (IGF-1) and blood sugar causes breakouts. Acne is known as a “disease of Western Civilization.” The typical Western diet is not the healthiest, as it is full of highly processed foods that contribute to acne.11 The processing of food removes its fiber and makes it get absorbed faster, causing spikes in IGF-1 and blood sugar.

Incorporating less processed foods higher in fiber and healthier fats will play a large role in improving your overall health and reducing your acne. Read our article about foods that may contribute to acne to learn more.

2.    Applying Retinoids

More dermatologists are recommending the use of topical retinoids as a mainstay for acne therapy. Retinoids are derivatives of vitamin A and can help to reduce inflammation, inhibit precursors to microcomedones, and increase the cell turnover rate to prevent the buildup of dead skin cells.12

As long-term use of antibiotics can lead to antibiotic resistance, dermatologists frequently recommend using antibiotics for only a few months before transitioning to retinoid therapy for acne.

3.    Dietary Supplements

One way to increase the amount of healthy fats in your diet is to increase the consumption of omega-3 oils using a dietary supplement. Omega-3 oils help to reduce inflammation is a central component of developing acne lesions.

Certain vitamin deficiencies are also more common in those suffering from acne. Zinc is deficient in up to 1/3 of acne suffers. Zinc also helps to inhibit the acne-causing IGF-1 pathway.

A comprehensive supplement for acne should include omega-3 fish oil and zinc at the minimum. DrFormulas Clear Skin Support Packets contain omega-3 fish oil, zinc, turmeric, DIM, and probiotics to help support clear skin.

Do oral antibiotics work for acne? For most people, yes. However, it’s important to understand that there is currently no cure for acne, nor is there a one-size-fits-all treatment for acne. Taking care of your acne requires a regular skincare routine, lifestyle changes, trips to the dermatologist, and patience. Now that you have learned all about oral antibiotics and acne , you may want to consult your dermatologist to help determine effective alternatives.

Read next: How to Get Rid of Acne with Home Remedies


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170416/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725362/
  3. https://www.ncbi.nlm.nih.gov/pubmed?term=22105812
  4. https://www.ncbi.nlm.nih.gov/pubmed?term=16172310
  5. https://www.scientificamerican.com/article/why-do-certain-drugs-make/
  6. https://www.webmd.com/skin-problems-and-treatments/sun-sensitizing-drugs
  7. https://www.ncbi.nlm.nih.gov/pubmed/15485524
  8. https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170416/
  10. https://www.ncbi.nlm.nih.gov/pubmed/17340019
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/