For years, the debate over how best to treat acne has been complex. While effective face washing and topical prescriptions work well for some of our patients, those who experience inflammatory or cystic breakouts may require a stronger treatment plan. Though it is known that both oral contraceptive pills (OCPs) and antibiotics are effective in managing acne, little research has been done comparing these two treatments until now.
Harvard Medical School recently conducted a systematic literature review of 226 publications that set out to compare the efficacy of antibiotics and OCPs in managing acne over time. Compared to a placebo, antibiotics and OCPs were both found to reduce inflammatory, noninflammatory, and total lesions. However, when comparing the two treatments with each other, researchers found that while antibiotics are more successful than OCPs in treating acne after three months of use, OCPs outperformed antibiotics at the six month mark, generating a 55% total lesion reduction rate (versus just 52.8% with antibiotics).
Complicating matters more is the emergence of antibiotic resistance as a significant public health issue. Each year more than 2 million people become infected with bacteria that are resistant to antibiotics, and 23,000 people die every year as a direct result of these infections. Correct and incorrect use of antibiotics for the treatment of acne can promote antimicrobial resistance. Long-term use, monotherapy (antibiotic use without concurrent benzoyl peroxide and/or tropic retinoids), and dosing below recommended levels further exacerbates this problem, and incorrect use of this therapy can put you, and the community at risk.
With better overall outcomes at six months of use, the latest research shows that OCPs may be a better alternative to systemic antibiotics for long-term acne management in women. Talk to your doctor or stop by Golden Gate Skin Center to get more information about this topic, and to figure out the best treatment plan for you.