Acne, characterized by swollen red pimples, occurs when skin pores are blocked by oil, dead skin cells, and other substances. It is not a new problem as most people believe, this condition has been affecting people for thousands of years. Hippocrates and Aristotle have even documented them, calling them varus and ionthoi respectively.
Acne mostly affects teenagers, but it can have an impact on older adults as well. In 2015, it was tagged as the eighth most common disease on the planet, affecting 633 million worldwide. As it continues to affect more and more people, new treatments are being developed – while old solutions also come into play.
To date, two of the most popular remedies are antibiotics and probiotics. So how do they differ? Which is better? Read on to find the answer to the age-old question "Probiotics or Antibiotics: who's the clear winner when it comes to acne?"
The German physician Paul Ehrlich was the first one to develop an antibiotic. He called his discovery arsephenamine – a cure for syphilis - 'chemotherapy' back then. He was not wrong though as chemotherapy means "chemical substances that treat disease." However, it was Dr. Selman Waksman – inventor of 20 antibacterial formulations - who first used the term 'antibiotics' formally.
Technically speaking, antibiotics work by destroying or stopping the growth of microorganisms. Much has changed since its first discovery, as more and more antibiotic generations are now being developed every year.
As for the mode of action, antibiotics work by eliminating the pathogen Propionibacterium acnes, one of the known biological pathogen that causes acne. Antibiotics can help reduce skin inflammation as well.
Antibiotic treatment comes in different types. For oral intake, the most common medications include Doxycycline, Tetracycline, and Erythromycin. As for topical applications, the usual examples are Clindamycin, Clarithromycin, and Erythromycin.
While they are generally effective, antibiotics come with a slew of side effects. Dryness, itching, peeling, and burning might occur with treatment. On the other hand, research shows that swelling or inflammation of the colon might develop in patients taking topical Clarithromycin.
Another untoward event that can come with antibiotic therapy is the possibility of bacterial resistance, where microorganisms can resist the drugs that could usually kill them. Another concern is cross-resistance, where a person acquires resistance from the same form of the drug – so his/her condition is no longer properly treated with a similar type of drug. With these potential problems, antibiotics are usually dispensed in the shortest period possible, apart from being prescribed together with other acne treatments.
Probiotics are derived from the Latin term that means "for life." These beneficial bacteria and yeast are widely present in fermented food such as kefir, yogurt, cheese, bread, even beer. Historians claim that the presence of probiotics can be traced back to 10,000 years ago – to the dawn of the human age.
Probiotics have been used for a variety of conditions, most specifically those affecting the gastrointestinal system. It was in the 1930s, however, when physicians John Stokes and Donald M. Pillsbury discovered the connection between digestive health and acne. This theory, known as the gut-brain-skin axis, states that a change in intestinal microbiota (the bad microbes outnumbering the good) can bring about permeability and systemic inflammation. Inflammation, as with Propionibacterium acnes, can cause acne.
Different probiotic strains boast of multiple benefits, especially when it comes to skin health. Lactobacillus plantarum may reduce inflammation and decrease the number of acne lesions, according to a study published in the Journal of Cosmetic Science. Lactobacillus paracasei, on the other hand, can lower the levels of Substance P, a material responsible for inflammation and subsequent acne breakouts.
Probiotics, while generally safe, come with minor side effects such as bloating and gas. Severe side effects such as blood infections may also occur, but this is usually limited in individuals who are immunocompromised (do note that probiotics are NOT recommended to this population.)
Who's the Clear Winner? Probiotics, Of Course
Antibiotics and probiotics both work against acne, but evidence shows that probiotics are a better choice. Most probiotics are naturally occurring and are widely considered safe. They are generally available for consumption – or, you just need to consume a lot of fermented foods (Yogurt, Kampuchea, Miso, Kavas, Kimchi, etc.).
If you dislike the edible examples stated above (though this seems impossible,) you can always take probiotics in the form of supplements. But, take time to understand the supplement labels about the probiotic genus and species and their effects on various indications. Most of the probiotics on the market are made in GMP certified facilities according to the FDA guidelines and are generally considered safe and free from side effects. Compared to antibiotics, probiotic supplements might be cheaper depending on the manufacturer and where you buy them from.
As if drug prices are not expensive enough, antibiotics are usually taken with other medications such as topical retinoids or benzoyl peroxide. With these additional drugs, acne treatment can turn out rather expensive – and potentially full of side effects, since you will be taking two meds at the same time.
Antibiotics and probiotics both have merits, but it's apparent that the latter is the more superior option when it comes to breakouts. Probiotics are considered generally safe, effective, and relatively cheaper – making them the obvious winners in the race to control acne.