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How Can You Treat Acne Without Antibiotics?

Dermatologists suggest that an old drug, spironolactone, might be quite effective for treating women's acne and spare them years of antibiotics.

When you mention acne, most people think of teenagers. Indeed, an estimated 85 percent of people between the ages of 12 and 24 are troubled with pimples and at least minor acne at some point. However, a surprising number of adults also suffer with this condition. Approximately 50 million American adults have acne, and many of them take antibiotic pills or use topical antibiotics to treat it. That adds up to an awful lot of people on antibiotics!

Can Antibiotics for Acne Be Replaced?

Dermatologists at the University of Pennsylvania suggest that many women could take an old-fashioned diuretic called spironolactone instead (Barbieri et al, Journal of Drugs and Dermatology, June, 2018). Originally marketed under the brand name Aldactone, this water pill has anti-androgen activity. As a consequence, it is inappropriate as a treatment for men’s skin problems. But women often respond quite well.

When patient satisfaction was compared between spironolactone and oral tetracycline, there was no significant difference between the two groups.

The authors conclude:

“spironolactone may have similar clinical effectiveness to that of oral tetracycline-class antibiotics.”

Because so many people take antibiotics for acne, substituting spironolactone could significantly reduce the amount of antibiotic used by the population. This in turn would be a step to help reduce antibiotic resistance in bacteria.

Sulfur Soap to Calm Acne:

Prescription antibiotics and spironolactone aren’t the only treatment for blemishes that may be helpful. Sometimes over-the-counter remedies work surprisingly well. One woman described her success with a very old-fashioned approach to clearing the complexion.

Q. I am a 41-year-old woman who never experienced acne until the past few years. I tried several medications, soaps and creams, but I found nothing to be particularly effective.

Recently, a friend recommended sulfur soap. I find it on the Hispanic product aisle.

After using it for a few weeks, my face is starting to clear up. Is this product safe? How could a bar of soap costing less than $3 be more effective than salicylic acid or benzoyl peroxide?

Sulfur Soap Is Antibacterial:

A. Topical sulfur is an old-fashioned skin treatment that has antifungal and antibacterial activity (Journal of Drugs in Dermatology, Jul-Aug., 2004). For decades, doctors have recommended its use for seborrheic dermatitis, rosacea, dandruff, scabies and warts, as well as acne. It does appear to be safe, although a few people may have a mild skin reaction.

Sulfur is found not only in bar soap, but also in some liquid face washing products and certain creams and lotions. It may be a helpful addition to an anti-acne regimen.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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