How do oral antibiotics work to treat acne?

Oral antibiotics work by reducing the number of Propionibacterium acnes (P. Acnes) and Staphylococcus epidermidis in the skin. P.

Acnes is thought to trigger the inflammatory response in acne and therefore plays an important role in the formation of acne lesions. Also, antibiotics have an anti-inflammatory activity, which makes them especially useful in inflammatory acne treatment.

Oral contraceptives (OCs) should only be used in women over the age of 16 since in younger women they can suppress growth. The main way OCs work to improve acne is by decreasing androgens such as dehydroepiandrosterone sulfate and free testosterone, and by increasing sex hormone-binding globulin, which binds to testosterone and reduces the amount of free testosterone. In this way OCs help inhibit sebum production, which is one of the main components of acne production.

The two main active ingredients in most oral contraceptives are estrogens and progestins. Estrogens are known to reduce sebum production, with some types of estrogens being more potent than others. Progestins can increase the androgenic effect, have no effect on it, or decrease it.

Some of the progestins increase the effects of androgens directly or can act as anti-estrogens, blocking the benefits of the estrogen on reducing sebum production.

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