How safe are long-term antibiotics for acne?

[stonecircle]

I posted this in General Health but didn't get any responses so thought I would try here -

DS (shortly 18) has been taking minocycline for a year for acne. His skin wasn't horrendous but it had a very bad effect on his self-esteem. He went to the dr today for a review and was told he had to have a blood test to make sure it wasn't affecting his liver.

I was horrified to hear that this was a possibility. I took antibiotics for about 8 years and nobody ever mentioned this (although several decades ago).

I don't want ds causing himself any long-term damage, but equally, I know the devastating effect acne can have on someone.

Anyone know how safe it is to take antibiotics long term?

I'm not medically qualified in any capacity, so my answer is purely anecdotal!

I was prescirbed tetracycline for my acne, by a dermatologist last year. It was seen as a last ditch attempt before resorting to roaccutane. It did work, and quickly, but I had a blood test (for unrelated reasons) after I'd been on it for about a month, and my liver function was slightly abnormal. I asked the practice nurse whether she thought it could be the AB and she thought it was likely (I don't drink that much alcohol so I knew it wasn't that). I came off it straight away because I was more worried about my liver than my acne (but the worst of my acne was on my back, and I'm sure it would have been a more difficult decision if it were on my face).

I could be wrong, but I don't think ALL antibiotics affect the liver like this. It might just be particular types of AB. The one your son is taking is a derivative of the one I was on, I think.

In your shoes, I would wait for the results of your son's blood test and make a decision from there.

It's can be very difficult to decide about taking serious drugs for a 'cosmetic' issue (albeit, a very troubling one) so you and your son have my sympathies.

DS1, who's now 20, was on antibiotics for acne for about 18 months from the age of 15. They cleared the acne completely and he doesn't seem to have had any ill effects. I'm a bit embarrassed to admit that he never actually got round to having a blood test, though I do remember the GP saying he should do so after a year. As far as I can remember, he started to cut down the dosage after a year, and eventually stopped when the acne didn't come back.

DS & I definitely felt the treatment was well worth doing.

It's just so difficult isn't it? DS1's skin was probably worse than DS2's but it never bothered him or became an issue. DS2 is just so appearance conscious and his skin was affecting him socially. I suffered from terrible acne from my teens until my early thirties so I'm trying hard not to project my own anxieties onto DS2.

I suffered years of indifference from doctors so it was my suggestion that DS2 went to the doctor in the first place - I'm now feeling anxious that I've pushed him into something that could harm him.

Plus, slightly perturbed that I took antibiotics on and off for many years and nobody ever suggested they might damage my liver!!!

Same here. I have taken Tetracycline on and off for years and no GP ever mentioned LFT. Having said that I had one for other reasons and all was well so no harm done.
DS1 took it for acne, as did many of his friends. It improved it but didn't cure it. Again no LFT offered. He has pretty much grown out of the acne now at 18.
My main concern was the potential staining of teeth. I thought this only affected the teeth in children but there was a definite affect on DS's teeth.
I urge you to ask the dentist for advice.

Oh god - something else to worry about! He's been taking minocycline since January and so far there's not been any effect that I can see on his teeth (which are beautiful, straight and white so it would be awful if they were stained).

I'm hoping that after that length of time if it was going to effect his teeth it would have done so by now?

DS had Lymocycline so maybe different.

Long term antibiotics are never ever good for general health - this sort of treatment is generally reserved for extremely serious infection cases.Used for Acne [and many other non life threatening problems] is [a] the lazy doctor syndrome -ie give them a script and say goodbye and [b] one of the reasons we are running out of effective antibiotics.Chloramphenicol was the anti biotic of last resort many years ago and is now prescribed for conjunctivitis.
Insist on seeing seeing a consultant dermatologist...now

Abilly - no I won't insist on seeing a consultant dermatologist now!

I am very well aware about the general problems with over-using antibiotics. However, the point most people don't seem to get is that it is not just about how severe a problem seems to an objective onlooker but how it is perceived by the sufferer. It's not as simple as saying acne is not life-threatening so doesn't merit antibiotics in anyone - it depends entirely on how badly it affects each individual. I had severe acne in my teens and twenties - not only did it shape the person I am, impede social activity and result in me taking time off work when it was just too bad to face the world, it made me feel suicidal. I'd say that was pretty life-threatening wouldn't you?

As I said earlier, DS2's skin was certainly no worse than DS1 but DS1 wasn't particularly bothered by it - though did use an antibiotic lotion. DS2's self-esteem was quite badly dented by the condition of his skin. I am trying to tread a fine balance between getting him enough treatment to ensure his self-esteem and skin do not suffer long-term damage and not reinforcing his belief that his skin is a major problem. I regularly tell him he's looking good - what would he think if I told him I felt he needed to see a specialist? If I went with him to the doctor and 'insisted' that it was a serious problem which needed specialist treatment? Not to mention the fact that no doctor is going to refer him without trying to treat him first. Obviously I would take him to one privately if I thought that was the right thing to do but at the moment it's not.

And what do you think a dermatologist would do? The dermatologist I saw for about 6 years treated me with antibiotics before moving onto heavy duty roaccutane - and more antibiotics before my 2nd and 3rd courses of roaccutane.

stonecircle Very well put. I agree entirely with your strategy. I also have trodden that fine line between gently suggesting a problem needs medical attention while trying to bolster self esteem (though not in fact over the acne).
DS1's acne was horrendous on his back but he was fortunate that his face wasn't bad. Oddly enough it helped him that all of his friends seemed to suffer as well. His skin was improved by use of ABs together with Differin cream.
DS2 on the other hand has lovely skin but is beside himself over the odd spot..

Generally your liver processes drugs in your system. Long term regular use of any drug should be monitored as we all react differently & all drugs can potentially cause you harm.
A blood test is just the best way to watch out for any potential problems & stop them before they become a serious issue.
This is very common.
If there was serious potential for harm they would monitor it far more closely. I take a drug for my RA that initially I had to have weekly blood tests to monitor my liver function for, after many years with no problems I'm now allowed to only have it tested every 2 months.
I would think of it as a yearly MOT rather than something to worry about too deeply.
Antibiotic resistance is a growing problem though so if it were me I would be interested in finding out if there were other treatment avenues to explore.

Thanks Secret and Wonky for your posts. But Wonky, having suffered from mild acne from the age of 13, severe acne from the age of 16 (which was held at bay with antibiotics until my early twenties), suffered years of misery and self-imposed social isolation in my twenties (including years of handing over a small fortune to various quacks, sorry, ''practitioners of alternative treatments"), years being treated by a dermatologist and still this morning (at the ripe old age of 55) find myself dabbing concealer on a few spots, I am hugely (no doubt overly) sensitive to any problems my sons may have in that area.

So, believe me, I don't just feel I have a good grasp of other treatments for myself but, have explored other possible treatment avenues for my sons including those which weren't necessarily available in the dark ages!! If anyone can suggest a treatment for acne which has fewer potential side effects than antibiotics but which isn't based on over the counter remedies (none of which work) or diet (DS2 has a hugely healthy diet and plays a lot of sport) I would love to hear about it.

Interestingly, the only time I had near perfect skin was each time I was pregnant and for a year or two afterwards. Not an option for DS2!

Ironically mine was worse during pregnancy and I then developed Rosacea after each baby. Only goes to show there is no definitive pattern.
We also rejected diet, over the counter remedies and all forms of snake oil. DS very scientific and his response to the subject of any kind of quackery is to ask the question;
"what do you call an alternative medicine that works?
Answer
"medicine"

Dd also takes tetralysal for her skin. She was on it for 3 months it worked really well. She stopped for 2 months and the acne got worse than ever. She's retaking it but after 6 weeks there is no improvement. Is it possible to become resistant? She is almost 15 and starting to avoid going out. She has the worst skin in her year :-( I could cry for her though actually, it has made me so active at bolstering her self esteem - always saying how nice she looks, how pretty she is. I don't think I would have been so complimentary had she had perfect skin

Oh it really is awful Pennywenny - my sympathies to your daughter. Don't over-egg it though. My mum used to look at me with my trowel-applied concealer over my horrendous lumps and bumps and tell me I looked fine and that you couldn't really see anything. I knew she was lying. Ditto the doctor who said that when I walked into the room he noticed other things about me before my skin. I knew he was lying.

It's a god-awful thing to suffer and I don't know why it doesn't get taken more seriously (I came very close to topping myself in my 20s because of my skin). I know I posted above that I wouldn't take my ds to a dermatologist but i think if it was starting to impact on him the way you say it is with your daughter - ie avoiding social situations - then i would take him to a specialist.

If it's any consolation, DS1's skin was pretty awful around 13-15 but now, at 19, it's gorgeous. DS2 had gorgeous skin until he was 16. Makes me wonder if you start it early it might go early? But it's different with everyone so who can tell.

Hello ladies,
I found your thread the most informative about taking AB for acne. My dd just turned 13 and was prescribed lymecycline for hers as it's really affecting her. It's on chest and back as well. But now that I'm not seeing the effects I started doubting myself for having started the course of AB altogether. 4 years on after your thread, what's the update on your children? Did it cure it? We are 5weeks in since started and can't wait to stop at 8 weeks. Worried about her teeth, her growth and now liver after reading your posts.
Please someone reply and share your story!

Hi my dd15 was on lymecycline for 2x 3 month courses. The first course worked brilliantly at clearing the acne but after around 4 months the spots stated to come back. Unfortunately the second course had no effect and the GP then prescribed the combined pill which she’s been on for 3 months. I took her for a private dermatologist appointment about 3 weeks ago (while we wait for her to move up the NHS list) and he has prescribed a topical retinol tretinoin and another course of antibiotics this time doxycycline. The consultant told us that to qualify for Roaccutane on NHS you need to have been on two separate antibiotics so he said that at least when we get the nhs appointment she will qualify. So far there’s little change 😭 but from past experience I know the antibiotics take a while to kick in. The Retin A gel is horrible as it’s so drying but she is persevering. My dds acne is probably fairly mild compared to some peoples but I believe that if something is bothering you then it’s an issue, hence why I’m happy for her to seek treatment

Watching with interest. I don't know what to do about Ds1. His skin is not AWFUL. It's not chronic acne.
But it's very spotty and bumpy.
I had very very greasy skin, and still do, but no real spots.
Dh had not much spots.

We do all the normal things.
I don't know what to do about his skin because it's bad, but not THAT bad?

Quick update, over the past month my DD skin has really cleared up with the antibiotic and topical treatment. She has a second private appointment in February with the dermatologist as we are still waiting for 1st NHS appointment. I recently rang the Consultants secretary who said she’s unlikely to get NHS appointment until after summer 2019😱 so looks like we will have to continue with private treatments 😮

Hi op,

Dd (16) has just started using the Neutrogena Light Mask, which uses red and blue light for 10mins a day and she has seen very fast results in just a few days.
www.boots.com/neutrogena-visibly-clear-light-therapy-acne-mask-10229137?psid_medium=cpc&psid_source=google&psid_term=%5Bneutrogena%20light%20mask%5D&psid_campaign=go-gb-eng-ps-neutrogena-visiblyclear-lighttherapymask-bp-exa-rn-brand&gclid=EAIaIQobChMIi7qtrqzF3wIVCrTtCh1C1wjYEAAYASAAEgIUB_D_BwE&gclsrc=aw.ds

I’m not sure whether there is something similar for the back but you could try and find something.

I was on oxytetracycline from 17-22.

My son has been in lymecycline (sp?) and the Neutrogena livhtbox for several months.

Nothing we have ever tried (either of us) has made any difference at all.

I had acne from 9-35!

Following this thread with interest...
I am 34 and have been using the contraceptive pill for acne on and off since I was 16. Was a single parent for 5 years during which I was on oxytetracycline (I think?)
My father is 63 and still takes medication for his spots so I’ve come to terms with the fact I will probably be medicated for life for this.
My eldest son is 14 and is now suffering with bad skin on his face, I am wondering at what age/stage do you decide it is time for medication? I don’t know how much is normal teenage skin

Gt84 - your ds needs treatment if:

a) the spots are bad enough to cause permanent scarring

and/or

b) his self-esteem is being affected.

People often make the mistake of looking at other people's acne subjectively. What one sufferer feels is a minor inconvenience another feels is a major embarrassment which impacts their ability to interact with others.

Two of my dcs had teen acne (though thankfully neither as severe as mine). One wasn't particularly bothered. The other, whose acne was milder, was acutely embarrassed by it and would avoid activities like swimming and keep his fringe overly long to hide his spotty forehead.

I remember my df would get outbreaks of acne in his 70s. My db and I also suffered from horrendous acne (years of antibiotics and Roaccutane for me). If it's any consolation though, none of my dcs, suffered very badly in their teens. They're now in their 20s - all with very clear skin - so am hoping the acne gene has passed them by. Hopefully your ds will be the same.

Thank you tinstar, that’s really good advice. I guess I look at him and remember how I felt about it and what I went through at that age as I was badly teased for my spots and it made me miserable.
He doesn’t seem bothered at the moment and I don’t think they will scar.

It's so easy to project. I remember being out for a family meal when ds1 was about 13/14 and I was agonising about his spots and determined he wouldn't suffer the way I did. I was all ready to whisk him off to the best consultant I could find, whatever the cost.

Half way through the meal he looked at me across the table and said, "mum, will you stop looking at the big spot on my chin!" I could never have drawn attention to myself like that so it made me realise he wasn't feeling half as bad as I assumed he would be.