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A girl removing the pimple

[updated August 2019]

An article in the Wall Street Journal, The Problem with Adult Acne, highlighted some issues with prescribing long-term antibiotics for acne.

Acne is a common skin condition, and although it is usually associated with teenagers, many people suffer from acne well into their 20’s and beyond. In fact, acne is the most common skin condition in the United States.

For many years patients suffering from acne have been prescribed long-term oral antibiotics to improve the appearance of their skin. However, the article in the Wall Street Journal highlighted the concerns dermatologists have with this practice. The article starts with:

Three months after Danielle Schwarz began taking antibiotics for a severe case of acne, her doctor began to notice a disturbing pattern among her patients—this mainstay treatment for the skin condition increasingly wasn’t working.

Dermatologists Concerns

Patients with acne are increasingly becoming unresponsive to treatment from antibiotics. Bacterial resistance is the primary reason for this problem, which in turn leads to a real concern of these patients developing MRSA (methicillin-resistant staph aureus) infections.

In a previous post, we wrote about how our nurse Millie (see Millie’s story here) spent years suffering from acne as an adult. She was treated with antibiotics, however, she later developed Candida (which is the most common cause of fungal infections). The development of Candida has been linked to taking antibiotics long-term, and this link is dangerous.

Candida Develops in Many Patients

The development of Candida is common in both women and men who have been on a course of chronic antibiotics. Here at Mitchell Medical Group, we ensure our patients know that the gastrointestinal tract is not just some intricate tube system that absorbs our food. The gastrointestinal tract is a major immune organ. Inside the gut and intestines live billions of bacteria and yeast that coexist in some state of balance. We now call this our microbiome. When this balance is upset by antibiotics, we can see clinical manifestations in many places.

The most obvious for women is the vaginal area which can develop a Candida yeast infection. Less obvious areas are the stomach, which can result in constipation, bloating and even acid reflux. The more insidious symptoms can affect your ability to concentrate and the development of generalized fatigue.

At Mitchell Medical Group, we have vast experience with treating this negative outcome of long-term antibiotic use. We also have a full program of dietary changes, medications and supplements to try and fully restore your immune balance.

Acne Is a Traumatic Disease

We are all judged by our appearance, and our face is one of the first things other people see when they meet us. A person with facial acne is all too aware of their complexion and often look for ways to avoid personal interaction in social situations. There is good news however, as dermatologists now have an array of new medications that can reverse acne and avoid those dreaded scars that can result from infected acne lesions.

Acne Treatments That Are Effective Without Antibiotics

A number of retinoid treatments are available and have vastly improved the treatment of acne:

  • Derivatives of Vitamin A: have revolutionized the treatment for acne. Women and men who had “pitted acne” that didn’t respond to antibiotics, now have a medication that works at a deep level to create a clearer complexion.
  • Accutane: the oral form of retinoid that has powerful effects on regenerating healthy skin tissue. There are concerns around the use of Accutane by women of child-bearing age that became pregnant. Accutane is teratogenic, which means that if taken while pregnant, it can result in birth defects. Dermatologists with female patients on Accutane ensure these women are using some form of birth control to try to avoid pregnancy. These dermatologists also monitor their female patients with monthly pregnancy tests.
  • Topical retinoids: available for less severe acne, this medication works well to enhance a clear complexion. An additional benefit of topical retinoids is that they have been shown to decrease wrinkles. However, there is a downside to using both oral or topical retinoids. It is important that those taking these forms of medication avoid intense sun exposure, as both types can make you more vulnerable to intense sunburns.


The “bottom” line is: if you are struggling with acne, please be sure to review the non-antibiotic options that are available with your dermatologist. Acne is an unpleasant problem whether you are a shy teenager or a mature adult, but the treatment options that are available have never been better.

– Dr. Dean Mitchell, M.D.
Mitchell Medical Group, NYC

About the Author – Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell, M.D. is a Board Certified Allergist and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Clinical Assistant Professor at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma, and Immunology, and the author of Dr. Dean Mitchell’s Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room – a combination of a lively, personal and in-depth interview with top healthcare specialists.


Wechsler Linden, Dana. The Problem with Adult Acne. The Wall Street Journal, January 5, 2015.

Acne, American Academy of Dermatology Association.