Antibiotic Treatment for Acne: What to Expect

Acne antibiotics

I started taking the orange and blue antibiotics doxycycline and amoxicillin for two days, and I'm still developing some small pimples.
Is this normal? My symptoms seem to be papular acne, with some pimples having small white pus in the center.
The pimples are small, and some are comedones.
I previously took doxycycline in green capsules for two to three weeks.
Could I have developed antibiotic resistance? When I took it before, I noticed improvement within a few days, but this time it seems like I'm not getting better and new small pimples are appearing.
I've also developed some whitehead comedones on my forehead and between my eyebrows, and on the other cheek, there are slightly larger pimples.
I have three or four on my chin, and I've noticed a few more appearing over the past two days.
I've been using a gel called Lezinc, but it seems like the more I apply, the more pronounced the acne becomes.
My skin used to be very smooth, and suddenly developing these small pimples is quite alarming.
A couple of weeks ago, I had two very red, large, and painful pimples—one on my chin and one on my nose—but they have since resolved, leaving scars.
During this period of acne, I have hardly gone out, but I do use a heater at home every day, and I change my pillowcase every three to four weeks.
Could you help analyze my symptoms and tell me how long it might take for these medications to be effective? Thank you.

Qiao Qiao, 20~29 year old female. Ask Date: 2018/02/15

Dr. Wu Yuxin reply Dermatology

You should consult your attending physician about this issue, as they are the most familiar with your medical condition.

Reply Date: 2018/02/15

More Info

When it comes to treating acne, particularly with antibiotics like doxycycline and amoxicillin, it's important to understand both the nature of your symptoms and the expected timeline for improvement. Based on your description, it seems you are experiencing papular acne, which can manifest as small red bumps, some of which may contain pus. This is a common form of acne, and it can indeed be frustrating when new lesions appear even after starting treatment.

Firstly, it’s not unusual to see some new breakouts during the initial days of antibiotic treatment. Antibiotics work by reducing the bacteria that contribute to acne, but they do not provide an immediate solution. It can take several weeks for the full effects of the medication to be realized. Typically, you might start to see improvement within 4 to 6 weeks of consistent use, but this can vary based on individual skin types and the severity of the acne.

Regarding your concern about antibiotic resistance, it is possible for bacteria to develop resistance to certain antibiotics over time, especially if they are used frequently or not taken as prescribed. However, doxycycline and amoxicillin are generally effective against the bacteria associated with acne. If you previously had a positive response to doxycycline and are now experiencing less effectiveness, it could be due to several factors, including the severity of your current breakout, changes in your skin condition, or even the possibility of a different underlying issue.

The presence of whiteheads and the development of new pimples can also be influenced by various external factors. For instance, environmental conditions such as heat from a heater, which you mentioned, can exacerbate acne by increasing oil production and clogging pores. Additionally, infrequent changing of pillowcases can contribute to bacterial buildup, which may worsen acne. It’s advisable to wash your pillowcases regularly—ideally once a week—to minimize this risk.

As for the use of topical treatments like the gel you mentioned, it’s important to note that some products can cause irritation or may not be suitable for your skin type, potentially leading to increased breakouts. If you notice that the gel seems to be making your acne worse, it might be worth discussing with your dermatologist whether to continue its use or to try a different topical treatment.

In summary, while it’s normal to feel anxious about the appearance of new acne lesions, it’s crucial to give the antibiotics some time to work. If you do not see any improvement after a few weeks, or if your condition worsens, it would be wise to consult your dermatologist. They may consider adjusting your treatment plan, which could include changing the antibiotic, adding topical treatments, or exploring other options like hormonal therapies or retinoids, depending on your specific case.

Lastly, remember that acne treatment is often a process of trial and error, and patience is key. Keeping a consistent skincare routine, maintaining a clean environment, and following your healthcare provider's recommendations will help you achieve the best results.

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