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We're willing to bet good money on the fact that, at some point in your life, you've taken amoxicillin. (Personally, we have vivid childhood memories of taking the distinctly pink, bubble-gum flavored liquid any time we got an ear infection.) The antibiotic is often prescribed for many common ailments, ranging from ear infections to UTIs. But can it be a beneficial medication for acne as well? We'll cut right to the chase: The bottom line is that it most likely isn't going to be your best bet, but there are certain cases where it may be an option worth considering. Here, dermatologist Joshua Zeichner, M.D., assistant clinical professor of dermatology at Mount Sinai Hospital in New York City, New York City dermatologist Michele Green, M.D., and board-certified dermatologist Dr. Morgan Rabach, founder of LM Medical and assistant professor of Dermatology at Mount Sinai Hospital in New York City explain further.
Type of ingredient: Antibiotic
Main benefits: Most commonly used to treat upper respiratory bacterial infections and urinary tract infections; sometimes used as a second-line treatment for acne.
Who should use it: Those dealing with moderate to severe inflammatory acne, and who can't take the tetracycline class of antibiotics (monocycline, doxycycline) because of allergy or pregnancy.
How often can you use it: It's usually prescribed twice daily for acne, though as with any antibiotics for acne, it should be discontinued after three to four months of use.
Works well with: Oral antibiotics are generally paired with topical medications that contain benzoyl peroxide and topical retinoids, says Zeichner.
Don't use with: Other topical antibiotics, which can increase the likelihood of developing bacterial resistance.
What is Amoxicillin?
Amoxicillin is an antibiotic that's part of the penicillin family, which covers a wide range of different bacteria. Most commonly it's used to treat upper respiratory bacterial infections, as well as urinary tract infections, and is best used for short periods of time, notes Rabach. So, how can it play a role in improving your skin? The first thing to keep in mind is that, generally speaking, any type of oral antibiotic should only be used for inflammatory acne, the kind that causes pustules and cysts, notes Green. In other words, popping a pill isn't going to be the go-to treatment for blackheads and whiteheads or the occasional pimple. Oral antibiotics can also be used to treat acne that isn't responding to topical treatment, or covers large areas of the body, such as the back, notes Zeichner. But let's talk about amoxicillin specifically...
Benefits of Amoxicillin for Acne
- Offers anti-inflammatory benefits: "Oral antibiotics work by lowering levels of acne causing bacteria called C. acnes and by acting as an anti-inflammatory. Amoxicillin is not effective at treating C. acnes, however, it may have anti-inflammatory benefits, explaining why it helps some people," explains Zeichner. A 2018 study published in The International Journal of Women's Dermatology found that acne patients taking amoxicillin showed almost an 85 percent improvement after 90 days. The big caveat? None of them were taking amoxicillin alone (they were also using other types of topical and/or oral treatments), and the study underscores that amoxicillin should not be a first choice treatment. To that point...
- Can be a good solution for pregnant women or those allergic to other antibiotics: The most important thing to note about amoxicillin? All three dermatologists we spoke with underscore the importance of stressing that amoxicillin is not considered a first line acne treatment. "It's too broad of an antibiotic for acne. More commonly, we use doxycycline or minocycline, which have better, more specific activity against the bacteria on the skin," says Rabach. She adds that it's also best used for short stints, whereas you usually need to take an oral antibiotic for weeks on end in order to see an improvement in acne. "Using it on a long-term basis would contribute to developing bacterial resistance," she cautions. That being said, there are cases in which those other two antibiotics (which are known as tetracyclines) aren't an option. For example, you can't take tetracyclines while pregnant. Hormonal treatments—birth control, pills, spironolactone—are off limits as well (not to mention that many effective topicals, such as retinoids, are also a no-no), so this is one instance where amoxicillin can come in handy. People can be allergic to tetracyclines, and for those patients, amoxicillin might be considered as well, notes Zeichner.
Side Effects of Amoxicillin
Brace yourself for a pretty lengthy list. "The side effects of amoxicillin range from mild to severe, and can include nausea, diarrhea, rash, vomiting, yeast infections, yellowing of the eyes and skin, and fatigue," says Green. It can also have negative interactions with certain medications, including birth control, so be sure to discuss any existing meds you're taking with your doctor, she adds. And, as with any oral antibiotic, bacterial resistance is a potential issue; it's why dermatologists tend to discontinue the use of any kind of antibiotic after about three to four months, notes Zeichner.
How to Use Amoxicillin For Acne
To the point of bacterial resistance, if you are taking amoxicillin orally, you should avoid using any type of topical antibiotic, since this increases the likelihood of bacterial resistance developing, warns Zeichner. (Clindamycin is one commonly prescribed topical antibiotic.) Instead, it's best paired with topical retinoids and benzoyl peroxide. The former works to stimulate cell turnover, keeping pores clear, while the latter is an antibacterial that can help knock-out acne causing bacteria. Typically, 500 milligram tablets of amoxicillin, taken twice daily, are prescribed for acne, says Green. And she adds that it's also a good idea to avoid alcohol while on amoxicillin, in order to reduce the risk of liver damage.
TL; DR: It's highly unlikely that you'll be using amoxicillin as an acne treatment unless you're pregnant with super sever acne, and/or are allergic to the other, more effective oral antibiotic options out there.
Cleveland Clinic. Amoxicillin oral suspension or pediatric drops.
Guzman AK, Choi JK, James WD. Safety and effectiveness of amoxicillin in the treatment of inflammatory acne. Int J Womens Dermatol. 2018;4(3):174-175. doi:10.1016/j.ijwd.2018.03.006
American Academy of Dermatology Association. Is any acne treatment safe to use during pregnancy?