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If Antibiotics Barely Work And Cause Lots Of Side Effects, Why Do Dermatologists Still Prescribe Them?


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#1 AcneIsACurse

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Posted 30 August 2012 - 07:16 PM

In all the reviews I read and hear about antibiotics, most say that it helped their acne initially, some say it didn't help their acne at all, some say it completely cleared them up, but ALL of the reviews I've read say that the acne comes back; sometimes worse than ever. If this is true then why do dermatologists have this in their arsenal? I understand topicals like differin, epiduo, retin-a, aczone, and things like that can help and work long term with minor side effects on the skin that go away eventually, and accutane even though it has harsh side effects has a pretty high success rate for complete remission. But antibiotics just put the acne on hold, and once the acne bacteria has become immune to the antibiotics or once the good bacteria has been completely wiped out by the antibiotics, the acne comes back stronger than before. And plus there are the side effects like having to take it with meals and not being able to lie down or whatever after you take them. I heard that dermatologists themselves know that antibiotics are only a short term solution, but if that's so then why do they prescribe it if it's just going to waste the acne sufferer's time and money in the long run?

#2 ClearDreaming

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Posted 30 August 2012 - 07:20 PM

I think the idea is that by killing a good portion of the bacteria you give the body a fighting chance of coping with the rest on it's own. Also to buy time for people who may grow out of it.

My Dr told me that the antibiotics she prescribed me were more to reduce the inflammation.

Edited by ClearDreaming, 30 August 2012 - 07:21 PM.


#3 Green Gables

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Posted 30 August 2012 - 08:29 PM

In all the reviews I read and hear about antibiotics, most say that it helped their acne initially, some say it didn't help their acne at all, some say it completely cleared them up, but ALL of the reviews I've read say that the acne comes back; sometimes worse than ever. If this is true then why do dermatologists have this in their arsenal? I understand topicals like differin, epiduo, retin-a, aczone, and things like that can help and work long term with minor side effects on the skin that go away eventually, and accutane even though it has harsh side effects has a pretty high success rate for complete remission. But antibiotics just put the acne on hold, and once the acne bacteria has become immune to the antibiotics or once the good bacteria has been completely wiped out by the antibiotics, the acne comes back stronger than before. And plus there are the side effects like having to take it with meals and not being able to lie down or whatever after you take them. I heard that dermatologists themselves know that antibiotics are only a short term solution, but if that's so then why do they prescribe it if it's just going to waste the acne sufferer's time and money in the long run?


1) Money. What doctors use is largely influenced by what pharmaceutical companies can patent and sell. There is a real unfortunate link between what people are taught in med school and where the research money is. The first time I had a prescription for Oracea, even with relatively good insurance, it cost me $250 a month. They can't patent probiotics which are already in use and make tons of money off of them. The most premium brand of probiotics only costs $50 a month, and I can still get other great brands for $20.

2) Free samples. Pharma companies advertise heavily to doctors and give them free samples while convincing them of all the great reasons this medication will cure their patient's problems. Doctors generally want to help their patients and often think they are doing the right thing by giving you the latest and greatest drug.

3) History. There has been more research done on antibiotics. It has been tested more. Precious little in comparison has been done on probiotics. I just saw a probiotics commercial on TV the other day. A few years ago that would have been unheard of. Probiotics is just now gaining ground.

4) Time lapse for education. Cutting edge research can take 10 years or more to make it into medical school literature. Many practicing doctors do not keep up on their med journal readings after they get busy with patients. I remember when Finacea first came out and I had to explain what it was and what it did to two different highly respected dermatologists. And this was after the drug was a year old.

5) Many doctors have not had serious health problems and they just DON'T GET IT. I mean this in the kindest way possible. But you get a whole new perspective on things when you've had a chronic issue for years and years. You really have the motivation to hone in and find any and every way possible to cure your disease. Most of my dermatologists had never had acne. They have no idea what it's like to try treatment after treatment and to only have the problem get worse. Half the time I would go in, after becoming resistant to yet another antibiotic, and they wouldn't believe me! They would tell me that I must not have taken my pills regularly, and that it was my fault that I still had acne.

6) Disconnected attitude. There is an attitude in medical school that you are a great doctor if you give out great bandaids. There is no sense of working with your body to help it heal itself. Naturalists are made fun of. Instead of respecting that a healthy body is fully capable of healing itself, they try to do all the work. Many medical approaches are like taking a sledgehammer to a nail. They don't really respect how complex the body is and how easy it is to permanently disrupt your body's natural functioning.

Edited by Green Gables, 30 August 2012 - 08:33 PM.


#4 Beender20

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Posted 30 August 2012 - 09:46 PM

6) Disconnected attitude. There is an attitude in medical school that you are a great doctor if you give out great bandaids. There is no sense of working with your body to help it heal itself. Naturalists are made fun of. Instead of respecting that a healthy body is fully capable of healing itself, they try to do all the work. Many medical approaches are like taking a sledgehammer to a nail. They don't really respect how complex the body is and how easy it is to permanently disrupt your body's natural functioning.


Okay, I mean this in the kindest way possible but do you even go to med school? How do you know the attitudes and values being taught? Because at my school we are taught that CAMs (complementary alternative medicine) aka holistic remedies are always taken into consideration when treating a patient for anything including acne. And of course we respect the complexity of the body and how easily the natural flora is to disturb. At the end of the day its the patients responsibility to understand what drugs they are taking and what the possible side effects may be. You have to be responsible for yourself.

Anyways, antibiotics are usually prescribed when you are also given a retinoid. Retinoids tend to cause an initial breakout for ~3 months and it is thought that by taking antibiotics for the first 3 months along with the retinoid topically, you can avoid a huge breakout. Of course you will have to keep using the retinoid once the antibiotics are up to maintain clear skin.

#5 Green Gables

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Posted 30 August 2012 - 10:02 PM


6) Disconnected attitude. There is an attitude in medical school that you are a great doctor if you give out great bandaids. There is no sense of working with your body to help it heal itself. Naturalists are made fun of. Instead of respecting that a healthy body is fully capable of healing itself, they try to do all the work. Many medical approaches are like taking a sledgehammer to a nail. They don't really respect how complex the body is and how easy it is to permanently disrupt your body's natural functioning.


Okay, I mean this in the kindest way possible but do you even go to med school? How do you know the attitudes and values being taught? Because at my school we are taught that CAMs (complementary alternative medicine) aka holistic remedies are always taken into consideration when treating a patient for anything including acne. And of course we respect the complexity of the body and how easily the natural flora is to disturb. At the end of the day its the patients responsibility to understand what drugs they are taking and what the possible side effects may be. You have to be responsible for yourself.

Anyways, antibiotics are usually prescribed when you are also given a retinoid. Retinoids tend to cause an initial breakout for ~3 months and it is thought that by taking antibiotics for the first 3 months along with the retinoid topically, you can avoid a huge breakout. Of course you will have to keep using the retinoid once the antibiotics are up to maintain clear skin.


Nope, but I have many family members who are doctors.

P.S. Are you at a DO school? They have always been more focused on the whole person approach. Only recently have allopathic schools started adopting that philsophy. If you're going for a MD I'm glad to see that philosophy gaining ground.

I'm glad your school recognizes alternative medicines but many do not. Practicing doctors, of course, are decades behind what you are being taught currently.

Yes, antibiotics can stop a breakout because they kill harmful pathogens and reduce inflammation. They also KILL ALL THE GOOD BACTERIA in your gut, which in med school you should have learned is one of your bodies primary defense mechanisms.

Have they taught you about how the microbiome is seeded with the necessary gut flora through breastmilk? That there is no evidence currently that a baby deprived of breast milk in its first few weeks can EVER sustain the proper levels of gut flora because of how the babies gut rapidly changes? This has huge ramifications considering how many babies are formula-fed in the last century. Low gut flora contribues to acne and insulin sensitivity. What is suprisingly prevelant in the last few decades? Acne and type 2 diabetes and celiac. Why is celiac disease a sudden epidemic when we've been eating bread for centuries? Take a formula-fed baby, give him a bad Westernized diet and few courses of antibiotics and make zero effort to re-populate the gut with necessary bacteria, and are you surprised how many fat type 2 diabetic zit-faced celiacs we have now?

Doctors over many years put me on ten different antibiotics just for acne. I've been on more for various illnesses. Only two even told me to "eat yogurt" ocassionally for the health of my gut. I got yeast infections the first time I was on tetracycline and the doc just told me to eat yogurt and take monistat. I had recurring yeast infections for the 6ish months I was on 500mg of tetracycline twice a day. Completely missed the point that most yogurt do not contain live cultures, the ones that do only contain three strains, and a healthy gut contains around 100 strains of different bacteria and billions of live bacteria there. There is no way eating yogurt will replenish what antibiotics completely wiped out.

No, not all doctors are crocks. I applaud you for going through medical school. But I really doubt the majority of doctors and even med school students are actually educated on the long-term effects of repeated courses of antibiotics. It's just not something your community focuses on. Doctors see the immediate need (pussy zits in the skin or potential IB from a retinoid), and prescribe the easiest thing to prevent that. Antibiotic. Do they follow up with that teenage patient when they're 25 and their immune system is shot? Probably not.

Edited by Green Gables, 01 October 2012 - 03:05 PM.


#6 Beender20

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Posted 30 August 2012 - 10:11 PM

Nope, but I have two uncles, a brother-in-law, a cousin and a grandfather who are doctors.

I'm glad your school recognizes alternative medicines but many do not. Practicing doctors, of course, are decades behind what you are being taught currently.

Yes, antibiotics can stop a breakout because they kill harmful pathogens and reduce inflammation. They also KILL ALL THE GOOD BACTERIA in your gut, which in med school you should have learned is one of your bodies primary defense mechanism.

Doctors over many years put me on ten different antibiotics. Only two even told me to "eat yogurt" ocassionally for the health of my gut. I got yeast infections the first time I was on tetracycline and the doc just told me to eat yogurt and take monistat. I had recurring yeast infections for the 6ish months I was on 500mg of tetracycline twice a day. Completely missed the point that most yogurt do not contain live cultures, the ones that do only contain three strains, and a healthy gut contains around 100 strains of different bacteria and billions of live bacteria there. There is no way eating yogurt will replenish what antibiotics completely wiped out.

No, not all doctors are crocks. I applaud you for going through medical school. But I really doubt the majority of doctors and even med school students are actually educated on the long-term effects of repeated courses of antibiotics. It's just not something your community focuses on. Doctors see the immediate need (pussy zits in the skin or potential IB from a retinoid), and prescribe the easiest thing to prevent that. Antibiotic. Do they follow up with that teenage patient when they're 25 and their immune system is shot? Probably not.


Yes I agree. I believe even 3 months is too long for a course of antibiotics. It will completely mess up the natural flora of your GI tract. In your first post it just seemed like you had some deep-seeded hatred towards doctors or something and you think they are all insensitive and money hungry. I didn't want you to think that.

#7 Green Gables

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Posted 30 August 2012 - 10:22 PM


Nope, but I have two uncles, a brother-in-law, a cousin and a grandfather who are doctors.

I'm glad your school recognizes alternative medicines but many do not. Practicing doctors, of course, are decades behind what you are being taught currently.

Yes, antibiotics can stop a breakout because they kill harmful pathogens and reduce inflammation. They also KILL ALL THE GOOD BACTERIA in your gut, which in med school you should have learned is one of your bodies primary defense mechanism.

Doctors over many years put me on ten different antibiotics. Only two even told me to "eat yogurt" ocassionally for the health of my gut. I got yeast infections the first time I was on tetracycline and the doc just told me to eat yogurt and take monistat. I had recurring yeast infections for the 6ish months I was on 500mg of tetracycline twice a day. Completely missed the point that most yogurt do not contain live cultures, the ones that do only contain three strains, and a healthy gut contains around 100 strains of different bacteria and billions of live bacteria there. There is no way eating yogurt will replenish what antibiotics completely wiped out.

No, not all doctors are crocks. I applaud you for going through medical school. But I really doubt the majority of doctors and even med school students are actually educated on the long-term effects of repeated courses of antibiotics. It's just not something your community focuses on. Doctors see the immediate need (pussy zits in the skin or potential IB from a retinoid), and prescribe the easiest thing to prevent that. Antibiotic. Do they follow up with that teenage patient when they're 25 and their immune system is shot? Probably not.


Yes I agree. I believe even 3 months is too long for a course of antibiotics. It will completely mess up the natural flora of your GI tract. In your first post it just seemed like you had some deep-seeded hatred towards doctors or something and you think they are all insensitive and money hungry. I didn't want you to think that.


Not at all, got a lot of med people in the family that I care about deeply. I've known some great caring doctors. Just frustrated at how far the med community can get from the best thing for the patient. It's often a case of the system overriding what any one doctor can do. It's just too hard after you've spent a decade in med school + residency and you're trying to practice and pay off your loans...to really fight against bad practices or big pharma or quick fixes.

#8 rentedname

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Posted 16 September 2012 - 10:13 PM

from my experience doctors are either apathetic or they're just clueless when it comes to your unique set of symptoms. In the end, doctors are just a set of possible treatment options, and if those options don't work, then you're left on your own. For acne, there's really only topicals, antibiotics, and accutane. If one doesn't work, move on to the next, and so on.

Antibiotics "work" in a sense for more severe cases where topicals fail. So when a patient doesn't respond to topicals, the doctor will suggest antibiotics. Those might work, but if they don't then just continue to exhaust the list of other antibiotics until you reach accutane with no regard for the horrific side effects incurred. As far as I know, doctors have no idea why acne gets worse after taking antibiotics or why the antibiotics didn't work in the first place. They just shrug their shoulders and send you on your way with the next level of drug treatment.

#9 Ray Lee Yit Lun

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Posted 01 October 2012 - 02:22 PM

Well antibiotics works very well for my case , when I was taking minocycline I had perfect skin , yes perfect skin .

After stopping them for a month they tend to come back but in a weaker form , and its managable .

#10 whoartthou1

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Posted 04 October 2012 - 09:16 PM

bump. Regret taking antibiotics everyday

#11 Spotthedifference

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Posted 15 November 2012 - 08:19 AM

In some cases like mine where I may possibly over come acne with age (family history of this happening) antibiotics can be prescribed to clear up some of the acne whilst I have it and hopefully when I come off the medication I'll be at that stage where it's diminishing on it's own. My doctor was very straight foward with me and said if I was 'lucky' the acne wouldn't come back once the antibiotics ended.

Personally I think the BP in the Duac cream is doing more for my acne than the antibiotics.

#12 amygims

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Posted 07 December 2012 - 07:06 PM

So I know this threads a little old but here is an article/transcript thing that I read the other day that's about this issue and I thought it was really informative. Not saying every doctor thinks like this, but this is what the good one's will be thinking imo. http://www.medscape....warticle/588328

#13 Charles23

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Posted 08 December 2012 - 08:06 PM

good question. for money i think. the pharma makes 65 billion a year. ******* messed me up with minocycline. luckily i realized and went off it before it led me to suicide.

Edited by Charles23, 08 December 2012 - 08:06 PM.


#14 John457

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Posted 28 December 2012 - 05:45 AM


In all the reviews I read and hear about antibiotics, most say that it helped their acne initially, some say it didn't help their acne at all, some say it completely cleared them up, but ALL of the reviews I've read say that the acne comes back; sometimes worse than ever. If this is true then why do dermatologists have this in their arsenal? I understand topicals like differin, epiduo, retin-a, aczone, and things like that can help and work long term with minor side effects on the skin that go away eventually, and accutane even though it has harsh side effects has a pretty high success rate for complete remission. But antibiotics just put the acne on hold, and once the acne bacteria has become immune to the antibiotics or once the good bacteria has been completely wiped out by the antibiotics, the acne comes back stronger than before. And plus there are the side effects like having to take it with meals and not being able to lie down or whatever after you take them. I heard that dermatologists themselves know that antibiotics are only a short term solution, but if that's so then why do they prescribe it if it's just going to waste the acne sufferer's time and money in the long run?


1) Money. What doctors use is largely influenced by what pharmaceutical companies can patent and sell. There is a real unfortunate link between what people are taught in med school and where the research money is. The first time I had a prescription for Oracea, even with relatively good insurance, it cost me $250 a month. They can't patent probiotics which are already in use and make tons of money off of them. The most premium brand of probiotics only costs $50 a month, and I can still get other great brands for $20.

2) Free samples. Pharma companies advertise heavily to doctors and give them free samples while convincing them of all the great reasons this medication will cure their patient's problems. Doctors generally want to help their patients and often think they are doing the right thing by giving you the latest and greatest drug.

3) History. There has been more research done on antibiotics. It has been tested more. Precious little in comparison has been done on probiotics. I just saw a probiotics commercial on TV the other day. A few years ago that would have been unheard of. Probiotics is just now gaining ground.

4) Time lapse for education. Cutting edge research can take 10 years or more to make it into medical school literature. Many practicing doctors do not keep up on their med journal readings after they get busy with patients. I remember when Finacea first came out and I had to explain what it was and what it did to two different highly respected dermatologists. And this was after the drug was a year old.

5) Many doctors have not had serious health problems and they just DON'T GET IT. I mean this in the kindest way possible. But you get a whole new perspective on things when you've had a chronic issue for years and years. You really have the motivation to hone in and find any and every way possible to cure your disease. Most of my dermatologists had never had acne. They have no idea what it's like to try treatment after treatment and to only have the problem get worse. Half the time I would go in, after becoming resistant to yet another antibiotic, and they wouldn't believe me! They would tell me that I must not have taken my pills regularly, and that it was my fault that I still had acne.

6) Disconnected attitude. There is an attitude in medical school that you are a great doctor if you give out great bandaids. There is no sense of working with your body to help it heal itself. Naturalists are made fun of. Instead of respecting that a healthy body is fully capable of healing itself, they try to do all the work. Many medical approaches are like taking a sledgehammer to a nail. They don't really respect how complex the body is and how easy it is to permanently disrupt your body's natural functioning.


Well said.