Antibacterials for Skin

Sometimes we can think that the insides and outsides of our bodies are 2 completely different worlds, but this isn't the case.

Our skin is our body's largest organ, and it performs many functions to keep us healthy. It regulates our temperature, allows us to touch the world around us, and acts like a barrier between our delicate insides and the harsh outside world [1].

So, when our skin becomes inflamed, it makes sense that we treat it like we'd treat any other part of our bodies — and antibacterials are one highly effective treatment option we can consider for acne-prone skin.

What are the benefits of antibacterials for the skin?

Antibacterials are often used to fight infectious diseases and bacterial infections — including ones that affect the skin.

Although acne isn't a skin infection, in moderate to severe cases, opting for an antibacterial treatment can help in 2 ways: by minimising inflammation and by controlling bacteria. Let's dive into these benefits to understand how antibacterials can help clear your skin.

Minimise inflammation

Anyone who has had acne will be familiar with the inflammation that comes along with it. It can be painful and can leave red marks and swelling that lasts even after the pimple itself has healed.

There are 2 schools of thought around why this inflammation occurs: the first suggests that a bacteria called propionibacterium acnes breeds in the serum inside our hair follicles, and this excess of bacteria and sebum causes a pimple, which provokes an immune response from our bodies that includes swelling [2][3].

The second — and newer — school believes that inflammation starts long before a pimple is even formed. This school of thought suggests that acne is an inflammatory condition and should be treated as such, with anti-inflammatory medications used to clear up pimples and acne lesions [4].

While these theories put forward different ideas as to how and why pimples are formed, what they have in common is that they both acknowledge that inflammation is a big part of acne. 

Several different kinds of antibacterials treat inflammation in different ways: some inhibit the production of molecules that signal inflammation, and others inhibit overactive enzymes that can attack the hair follicle and sebaceous gland [5][6].

Your health practitioner or dermatologist will be able to recommend the right treatment for your skin, and they'll do so by taking into account the inflammation that your acne causes.

Control bacteria

The propionibacterium acnes bacteria that can contribute to acne is present on our faces all the time, even when we have no active pimples or acne lesions.

As this bacteria is a part of our normal healthy skin bacteria, antibacterials that clear up acne work to control it rather than kill it completely. Some newer studies even suggest that antibacterials don't need to target p. acnes at all [6].

This is because over time, p. acnes — like many bacteria — can become resistant to antibacterials [7]. While oral antibacterials are less likely to induce bacterial resistance than topical, bacterial resistance is still something that some doctors and dermatologists are concerned about [8].

This doesn't mean that oral antibacterials will never work against acne, but it does mean that there are a few things you may have to do to ensure your treatment has the best chance of working.

What skin infections can antibacterials help treat?

Antibacterials are often used to treat mild and uncomplicated skin infections.

Impetigo, for example, is a bacterial infection that can be minimised with antibacterials. It usually starts in spots where the skin is broken, like a cut or insect bite, and shows as red spots that can grow into blisters.

If the infection only affects a small area of the skin, topical antibacterials should be effective in treating it. In more severe infections, there may be a need to take oral antibacterials.

Antibacterials can also be used to treat eczema, an inflammatory skin condition that can cause dryness, itchiness and, in some cases, other skin infections [12].

For more complicated skin and soft tissue infections, empirical antibacterial therapy may be recommended [13].

Who can and can't use antibacterials for their skin?

Your practitioner or dermatologist will be able to confirm if oral antibacterials are right for you. Generally, they are used for more severe cases of acne, or cases where the acne has spread across areas of the body that would be impractical or inconvenient to apply a topical treatment.

Not all antibacterials are safe for pregnant women to take, so if you're pregnant — or plan to be — you should let your practitioner know before beginning a course of treatment [14].

How to use antibacterials to treat acne

Your practitioner will be able to advise you on how many tablets to take, and when. If you start to see your acne clearing up before the course of antibacterials is over, you shouldn't stop taking them — instead, continue as advised until they're finished. 

You also shouldn't take more antibacterials more often in the hope it will clear your acne quicker, as this may cause side effects. Only ever take medication according to the directions given by your practitioner.

Use antibacterials alongside a topical treatment

Antibacterials are not capable of tackling everything that causes acne, like excess sebum production or follicular keratinization, so it's important to use them alongside something that can treat these mechanisms.

Benzoyl peroxide is commonly recommended for use alongside antibacterials, and it has been shown to reduce the prevalence of antibacterial resistance in p. acnes [8][9].

Salicylic acid can also help wash away acne-causing bacteria while also unclogging debris and trapped oils in pores. Software's Salicylic Acid Foaming Wash does both of these while also injecting hydration to reveal balanced and brighter skin. Plus, you can use this wash across your face, chest and back 2-3 times per week to target breakouts.

Topical retinoids, niacinamide, and azelaic acid can also be used alongside antibacterials.

Try a custom treatment

If you're navigating acne, you might like to consider a custom treatment like Software.

Software's acne treatment takes the guesswork out for you, as it contains ingredients formulated to work effectively with minimal effort on your part.

Simply take our online consult and a Software health practitioner will create a formula based on your individual skin needs. This formula will then be compounded just for you and sent straight to your home. And, you can access ongoing, follow-up support as you use your treatment.

Use antibacterials for a short period of time

Long-term use of antibacterials is not recommended due to the chance of bacterial resistance [10]. Most practitioners will aim to recommend antibacterials for as short a time as possible, which may be a few months [11].

This allows the treatment enough time to do their work while avoiding the chance of building resistance.

Are there any side effects?

Oral antibacterials do occasionally come with some side effects. They can sometimes cause slight nausea, diarrhoea, and thrush. If you experience headaches or any signs of an allergic reaction, you should stop using the treatment and see your doctor [15].

You should also be aware that some antibacterials can cause increased sensitivity to the sun, not just on your face but across your entire body [15]. If you're not already using sunscreen, now's the time to start.

Opt for a non-comedogenic and hypo-allergenic one, which will prevent clogged pores and allergic reactions on the skin. Make sure it provides SPF30+ coverage as well. Software's Daily Sun Defence SPF50+ is formulated with UVA and UVB filters and designed for sensitive and acne-prone skin, making it a stellar option for anyone hoping to get rid of acne.

Finally, it's important to know that different antibacterials can cause different side effects, so if one isn't right for you because of its potential side effects then your practitioner may be able to recommend another [16].

What can I expect?

When using antibacterials with a topical skin treatment, you can expect to see a reduction in acne inflammation within 6-12 weeks [15].

If your acne has not begun to clear by this stage, you may consider seeing your health practitioner again for a different treatment method.

Can I use antibacterials for skin in the long term?

Because of the potential for antibacterial resistance, antibacterials are not suitable for long-term use. Think about these as a tool that gives you a ‘head start' at fighting inflammation and bacteria, and then use topical treatments to continue this work.

It's important to continue using topical treatments after acne has begun to fade and to incorporate them into a skincare routine that you can follow every day.

We recommend starting with a non-comedogenic, hypo-allergenic cleanser and toner, then using your medical topical treatments. Top this off with a moisturiser: a heavier cream or lotion like Software's Ceramide Moisturiser Repair Balm will suit dry skin, while a lighter gel or serum will suit oilier skin. You should then continue using your sunscreen.^‍