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However welcome back to my channel today i thought i talked about quite a contentious topic which is the use of antibiotics in the management of acne and the idea of this video is triggered after seeing a patient last week for the first time we’ve literally been on tetracycline antibiotics all years and absolutely terrifying about the notion of stopping them
But equally realizing that it’s not a good thing to be on antibiotics long time and i think the reality is that w-h-o do not want us prescribing courses of antibiotics for acne for longer than six months but in order to get people off them you have to put a proper strategy in place so i thought i would talk to you today about the things that we have that are
Antibiotic free there are also key to a great success in managing your acne so when i see someone for the first time if they have quite active inflammatory acne so lots and lots of red spots and red spots with white ed’s nodule sis that sort of thing and i think that risk is going i will attempt to almost always use something oral where it’s suitable in that
Patient just because it switches off the acne fairly quickly and limit the amount of damage there’s inflamed spots i’m doing whilst we get to work on the root cause which are the closed comedones so that means starting a retinoid at the same time and the great thing about using retinoids is that they work on both the inflamed and the on inflamed spots so they
Do so quite slowly and that’s why i think about the three-month mark and the six-month mark in terms of mapping out progress and they do sometimes make you purge a bit at the beginning but they are fundamental to getting acne under control and also from making your skin look great so rex nodes are great and what we know is that by the time you’ve got 50 percent
Improvement in your acne whilst on oral antibiotics you can pretty much stop the antibiotic because most of the hard work is going to be done there on in with the retinoid so i always say to someone for example this person coming off and to be able to the first time in four years it’s absolutely essential to put those foundations in place and i said we didn’t
Stop the antibiotics there and then this is something you have to wean someone off of where they can go cold turkey so retinoids are great next thing we know is that benzoyl peroxide is a fantastic drug to use in acne now this is not just because it works brilliantly an inflamed lesions it also has some benefit in those close comedone to bumpy clogs that you’ll
Often see along the jaw line are sitting here as little time bombs waiting to go off and the added bonus is that they reduce the chance of you becoming of the bacteria in actually becoming resistant to your antibiotics both in the topical format and orally so another great thing to having a very complete acne regime just because it makes it safer for everyone
So that’s a benzoyl peroxide based treatment with or without topical antibiotics combined with it you’ve got your retinoid and then you might be on oral antibiotics until things quieten down and i think about it as putting stabilizers on your bicycle you take the stabilizers which the oral antibiotics away whenever you’re ready to ride the bike and that means
That the skin is being conditioned properly with your use of topicals and i think that makes for the least stressful scenario for stopping something like antibiotics by martha you may have been on for ages the other agent that we have and i often think about adding that in it’s with a three to six month mark is azelaic acid which is again a great alternative to
Using antibiotics and it has activity in both kama domes the inflammatory lesions but also rather brilliantly in treating dark marks and uneven texture so it’s a fabulous agent to bring in when you’ve got control with your retinoid the number of new spots is right down you’re getting very few new spots and you’re into that i called the tidy up base you’re just
About making your complexion look fantastic and by the time summons on those agents so they’ve got some benzoyl peroxide for the old breakthrough new spot they’ve got their azelaic acid they’re retinoid going you know you’re in the right space to stop oral antibiotics in someone who’s needed them at their beginning so that would be the average moderately severe
Acne patient but i think then looking at the final option really for avoiding the use of antibiotics is the use of racketing or isotretinoin or accutane if you’re in the us and it’s probable that in some instances we were delaying using isotretinoin longer than we should and i think that’s an important thing as a finished position to be aware of and of course
That is something that there is no concern with in terms of bacterial resistance so as you can see lots of options for treating acne and i think the most important part is to get good results in a safe way that doesn’t compromise the health of humans as a whole in terms of overuse of antibiotics is a cohesive structured strategy that is designed for a long-term
Maintenance of a tennessee for acne and a very happy future for acne prone skin that’s antibiotic free interested to hear your thoughts on this i hope that was helpful bye for now you you
Transcribed from video
The Good The Bad and The Ugly of Antibiotics and Acne By Dr Sam Bunting
