Antibiotics for back acne

When are antibiotics worth considering?

Antibiotics are most useful for inflammatory acne, meaning spots with swelling and inflammation, including pus filled pimples and deeper lumps. Oral antibiotics are usually reserved for more severe cases. Acne is one of the conditions for which a clinician can prescribe antibiotics when it is unlikely to clear without them. For a few mild spots, a pharmacist can help you choose a skin treatment such as benzoyl peroxide or salicylic acid. Deep, painful lumps, widespread breakouts or developing scars deserve a medical appointment rather than another round of shop bought products.134

Which antibiotics are used?

Why do you need another treatment alongside them?

Antibiotics control bacterial growth and reduce inflammation, but acne also involves clogged pores, excess oil and hormones. Treating only the bacteria leaves other causes unaddressed. Oral antibiotics should be combined with benzoyl peroxide and other topical treatments. A topical antibiotic is also best used alongside benzoyl peroxide: the combination makes antibiotic resistance less likely. Resistance means bacteria become harder to treat with antibiotics. A topical retinoid, a medicine derived from vitamin A, can help keep pores clear and prevent acne returning. Your prescriber should choose the combination rather than leaving you to assemble several separate treatments.12

How long do antibiotics take to work?

Severe acne treatment can take two to three months to show improvement. Acne cysts, which are pus filled lumps deep under the skin, can take three months or more to clear. Oral antibiotic treatment should be limited. A typical approach is to avoid more than two or three consecutive months unless your clinician prescribes otherwise. Topical antibiotics can sometimes be used longer. Follow your prescription's dose and application directions, and have the treatment reviewed rather than extending it yourself.156

How should you care for your back during treatment?

Skin care still matters during treatment, so the bathroom shelf does not get to declare the job finished.5

• Wash your skin twice a day with a gentle cleanser.
• Avoid scrubbing, which can irritate skin and worsen acne.
• Do not pick or squeeze spots, because this can cause scars.
• Wear loose, breathable clothing, especially when exercising or sweating.

Loose, breathable clothing belongs in body acne care, giving the wardrobe a supporting role it never lists on the label.4

When should you see a doctor or change the plan?

See a GP or dermatologist if your back acne is not improving, is causing scars or is affecting your mental health. Hot, swollen or red skin can signal an infection; redness can be harder to see on brown and black skin. Very large lumps, bumps that connect under the skin or areas draining pus also need assessment. These can occur in acne conglobata, a rare, severe form of acne for which isotretinoin is the main treatment. Antibiotics alone are not the whole treatment plan. If an antibiotic and topical treatment do not clear severe acne, a dermatologist can consider a different antibiotic or isotretinoin. Once acne is clear or nearly clear, maintenance usually relies on skin care and topical medicine. Stopping all treatment can allow acne to return quickly.457