Bacterial resistance & long side effects with current acne prescription drugs


The current acne treatments have been formulated and researched more than 40 years ago, before the inflection point of the Human Genome Project culminated in 2000. So, they pre-date the understanding of human endocrine, nervous, immune, and bacterial systems that the scientists have accumulated since. 

Current Prescription Drugs

The first line of acne treatment today is a combination of hydrocortisone and antibiotics like clindamycin. Hydrocortisone is prescribed for its anti-inflammatory effect, but if it's used for a prolonged period of time, it suppresses the immune system and is also known to cause more acne. Antibiotics are highly controversial due to their misuse or over usage in the world, testing the limits of bacterial resistance. Antibiotics disrupt the microbiome of the skin and the gut.

There are other combinations medical practitioners prescribe. They include topical creams with a mix of antibiotics with retinols (including other Vitamin A derivatives like adapalene or Differin) or benzoyl peroxide (a bleaching agent). These ingredients have high potential to sensitise the skin and in the case of benzoyl peroxide, it is a pro-oxidant ingredient.

The orally taken retinol, or isotretinoin (Accutane or Roaccutane), another derivative of Vitamin A, is another controversial treatment. When it came out in the early 1980s, it was meant to be prescribed to the most extreme cases of acne. But nowadays, it is regularly prescribed. Its printed side effects are bad enough, but campaigners (mostly parents of those affected) try to get the drug banned, citing suicide and erectile disfunction. Anecdotal evidence shows that users can suffer not only from extreme dry skin and lips but also from back pains and other debilitating side effects. Many users require a second or third treatments as acne returns.


Current treatments include antibiotics, birth control pills, hydrocortisone creams and various vitamin A derivatives like Accutane and retinol or retinoid. 


Other prescriptions also include birth control pills for young women. It has been 60 years since the pills came to the market, but we still don’t have an accurate picture of its long-term effect on women’s health. One explanation could be the status of the pills as the paragon of female emancipation and questioning the pills have been perceived as anti-feminist, anti-woman. If the women who use them don't question the safety, the pharmaceutical firms certainly won't. The pills control acne by directly disturbing the female sex hormones (oestrogen). Anecdotal evidence shows that women who have used birth control pills to control acne have had good success rates. However, when they stopped taking the pills, many reported that acne came back aggressively. 



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