Why do antibiotics work on inflamed acne? Does that mean I have a bacterial problem?
I've only taken two rounds before in the last 4 years (they keep me clear for maybe 2-3 months after im off them only) but that makes me think that there is some bacterial issue there that maybe i can address in another way?
How do I solve that?
Antibiotics, in addition to killing bacteria, force your body to shut down its inflammatory response. This anti-inflammatory effect happens regardless of whether or not you have a bacteria problem.
Antibiotics fail 81% of women in acne cases. Acne is really not a primary bacteria problem. See the study in the Acne Research board.
You will see temporary visible "improvements" in acne (reduction in redness and swelling) from antibiotics because of its forced anti-inflammatory effect. Kind of like putting ice on a wound. Ice will make the swelling go down because the temperature forces a constriction. Does it solve what caused the wound in the first place? No.
Antibiotics decrease inflammation in the vast majority of cases because clearing an infection removes the reason for the inflammation. However, a number of studies since the 1990s have contributed to the idea that some antibiotics might also directly limit or change the inflammatory response, as discussed in the December 2007 issue of Rhinology. Several classes of antibiotics, including the macrolides, tetracyclines and the beta-lactams, when used in certain chronic illnesses, appear to decrease inflammation in addition to their antibacterial effects. This research represents a mix of experimental and clinical studies, some performed only on cell cultures rather than patients. The antibiotics mentioned show a variety of ways they might affect the inflammatory response, including changing inflammatory cell metabolism, altering cytokines and other chemicals that stimulate and help maintain inflammation, and speeding the breakdown and removal of inflammatory cells. Any or all of these mechanisms could act to decrease inflammation.