November 9, 2015

Many physicians prescribe antibiotics to treat acne based on the principle that skin bacteria are a triggering agent for the inflammation of the acne pustule. While this is true, what is the cost?

The big concern with this approach is two fold: 1) excessive antibiotic use triggers antibiotic resistance which detrimental to us all 2) it adversely affects the micro biome of our intestines that causes long term disease risk of the autoimmune and allergic type.

The long and short of this issue is: what is your outcome expectation? Acne is somewhat of a right of passage in the developing world with the excessive exposure of our bodies to flour and sugar foods during puberty that kick on insulin and hormones related to acne. Are we expecting a perfect completion at the expense of our gut and resistance issues?

The answer in this hyper self indulgent world is yes! My partner, Dr. Koontz, once gave a lecture to a group of high school students about the risks of performance enhancing steroids. When asked if they would take them despite the risks, the answers were a resounding yes! What this tells us is that the teenage mentality is clearly focused on the superficial. It thus is beholden upon us to discuss the risks of this course of action.

I for one do not agree with this therapy unless the acne is clearly disfiguring because of all the literature on the damage to our gut microflora.

For those of you with teenagers out there, know that this a clear case of cosmetic benefit with inherent long term disease risk.