Can amoxicillin be used for acne?

In this article:

• Amoxicillin for acne
• Side effects
• Usage instructions
• Amoxicillin vs. other antibiotics
• The bottom line

In this article

• Amoxicillin for acne
• Side effects
• Usage instructions
• Amoxicillin vs. other antibiotics
• The bottom line

Amoxicillin is a generic antibiotic that treats bacterial infections over the course of a few days. It comes in three forms: tablet, capsule, and oral solution.

Amoxicillin can be used to treat certain kinds of acne vulgaris (more commonly known as acne), but this is not usually the first-line treatment of choice. 

Does amoxicillin help with acne?

An amoxicillin dosage can reduce acne by slowing the growth of acne-causing bacteria and reducing inflammation, according to Dr. Mariano Busso, MD, a board-certified cosmetic dermatologist. 

It’s also a relatively safe and well-tolerated prescription drug. According to Dr. Justine Park, MD, a board-certified dermatologist at Skin and Beauty Center, people who are pregnant, trying to become pregnant, or nursing can typically take it. She says people allergic to other antibiotics can also usually take this one, and it has few interactions with other medications.

At the same time, amoxicillin is not necessarily a dermatologist’s first choice. “For acne that isn’t responding to topical treatments, some antibiotics can offer relief, but amoxicillin isn’t the ‘go-to,’ tetracycline is,” Dr. Busso says.

A 2018 International Journal of Women’s Dermatology study states that amoxicillin may be “a valuable second-line treatment option in inflammatory acne.” While it was successful for many participants, it wasn’t a quick fix. The post-treatment assessment in that study showed that 84.6% had a positive treatment response at the first follow-up visit, approximately 90 days after taking the medication.

As an antibiotic, it’s more helpful in some cases than others. “It is quite efficacious in the inflammatory type of acne (e.g., pimples and pustules) but not for comedonal acne (e.g., whiteheads and blackheads),” Dr. Park says.

Side effects of amoxicillin

Generally speaking, there are side effects of using broad-spectrum antibiotics, such as amoxicillin, long-term. For one, broad-spectrum antibiotics kill both good and bad bacteria, and it can take up to two years for the good bacteria in the gut to recover. 

When healthcare providers prescribe antibiotics, they may also encourage the consumption of extra probiotic-rich foods, such as yogurt, kefir, and buttermilk.

Besides killing good bacteria, amoxicillin has other side effects. The most common side effects include skin rash, diarrhea, headache, nausea, vomiting, stomach pain, tongue discoloration, yeast infection, elevated liver enzymes, and high white blood cell counts.

Serious side effects (that are less common) include superinfections, clostridium difficile-associated diarrhea, liver problems, blood disorders, seizures, swelling of the brain and spinal cord membranes, and severe allergic reactions.

How to use amoxicillin for acne

First, Dr. Busso says amoxicillin should only be considered for acne treatment when other means have failed—especially since it can kill good bacteria. “Using amoxicillin or any other antibiotic too frequently (or for the wrong reasons) can lead to bacterial resistance, which becomes problematic when your body no longer responds to even the most powerful antibiotics,” he says. 

Dr. Park also recommends the shortest course necessary for that reason; however, this is tough since acne is a chronic condition. According to Dr. Busso, the antibiotic may take three to four months to clear the skin. 

Additionally, Dr. Park explains that “one of the most important factors to consider is that monotherapy with just an oral antibiotic is never ideal for the acne patient,” so it is best if amoxicillin is not used alone. “The cause of acne is multifactorial, therefore, it is crucial that other treatments, such as topical medications and skincare, are employed in the treatment of acne in addition to the use of oral antibiotics when needed.”

Again, be sure to talk to a healthcare provider before starting, stopping, or changing the dosage of amoxicillin (or any other medication). The provider can ensure the use and dosage are safe and effective for you specifically.

Talking to a dermatologist or another medical professional is especially important, given amoxicillin’s interactions with other foods and medicines. While on amoxicillin, avoid blood thinners, gout medications, antibacterials, birth control pills, alcohol, oral live vaccines, bromelain, and guar gum.

Amoxicillin vs. other antibiotics for acne

With so many antibiotics able to treat acne, which one should people go for first?

Dr. Park says a medication in the tetracycline class—such as doxycycline or minocycline—is often the first-line oral antibiotic “due to its high safety profile, limited use for other indications, and specificity for the bacteria that cause acne pimples.”

As far as topical treatments, she lists clindamycin, erythromycin, dapsone, and minocycline. “Depending on the patient’s needs, one of these generally should be used in combination with oral antibiotics for acne,” she adds.

The “best” option also depends on the severity of the acne. “For mild to moderate acne, topical antibiotics like erythromycin can be applied to the skin as a lotion or gel,” Dr. Busso says. “For more severe cases, the most prescribed antibiotic is tetracycline, but if you are allergic to it, pregnant, or suffer from kidney or liver issues, amoxicillin is a good option.”

For those who have had no luck and have had these treatments fail, Dr. Busso says the most potent drug is isotretinoin, a retinoid. He explains that it slows the production of sebum, the natural substance that lubricates the hair and skin and is also the primary cause of acne.

The American Academy of Dermatology (AAD) also recommends isotretinoin for patients with severe acne or for whom oral and topical antibiotics haven’t worked. When oral or topical antibiotics are taken, the AAD suggests combining them with benzoyl peroxide, which can also prevent the development of antibiotic resistance.

Additionally, according to that same 2018 study, systemic antibiotic therapy plus topical retinoids, benzoyl peroxide, hormonal therapy, and topical antibiotic use is indicated for moderate-to-severe inflammatory acne.

Comparing antibiotics for acne
Drug name	Form	Dosage	Savings options
Amoxicillin	Oral	500 mg every 12 hours or 250 mg every 8 hours	Amoxicillin coupons
Tetracycline Hcl	Oral	250 to 500 mg every six hours	Tetracycline Hcl coupons
Ery-Tab (erythromycin)	Topical	Apply 2% topical solution or gel twice a day	Ery-Tab coupons Erythromycin coupons
Absorica Ld, Claravis, Amnesteem, Zenatane, Accurate (isotretinoin)	Oral	1 mg per kg of body weight per day, taken in two divided doses	Absorica Ld coupons Claravis coupons Amnesteem coupons Zenatane coupons Accutane coupons Isotretinoin coupons
Cleocin (clindamycin Hcl)	Topical	3 to 12 grams a day	Cleocin coupons Clindamycin HCl coupons
Aczone (dapsone)	Topical	Apply a thin layer once a day	Aczone coupons Dapsone coupons
Minocin, Solodyn, Minolira, Dynacin (minocycline)	Oral	1 mg per kg of body weight a day for 12 weeks	Minocin coupons Minocycline Hcl coupons

The bottom line

Amoxicillin can be used to treat acne, especially inflammatory acne, such as pimples and pustules. It can also be a helpful option for people who are pregnant or have liver or kidney issues. The first-line treatment for acne is usually a tetracycline medication, and amoxicillin is usually a second-line treatment. 

People who take amoxicillin for acne need to be aware of its side effects. The common ones include killing helpful bacteria, a skin rash, diarrhea, headache, nausea, vomiting, stomach pain, tongue discoloration, yeast infection, elevated liver enzymes, and high white blood cell counts.

Ultimately, the best step for people with acne is to talk to a dermatologist who can provide an individualized, specific, comprehensive treatment plan.