How Quickly Should Bactrim DS Stop Cystic Acne?

Several tetracyclines have failed ( doxy, mino, solodyn) as have topicals (evoclin, triaz, duac, retin-a, aczone. I started Bactrim DS 3 weeks ago (2x daily) but I am still experiencing new cysts on my back ( none on my face/chest).

How soon should this stop them? Should I still be getting new cysts 3 weeks in ? They are causing raised scars on my chest & back. I am classified as 'moderate cystic acne with very mild rosacea'. My derm has me taking it until July and re-evaluating at that time.

Doctor Answers 3

Bactrim for Acne

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Bactrim is not an antibiotic that I typically prescribe for Acne as it is a rather "big gun" antibiotic for serious infections.  As it can be very effective for acne, Bactrim has significant side effects such as causing a life threatening rash.  However, in severe acne cases I may prescribe it for 1-2 weeks for quick control of severe cystic acne prior to initiating another treatment regimen.

Houston Dermatologist

Bactrim and cystic acne

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I am generally not in favor of long-term antibiotics for acne so even if Bactrim were helpful, long-term use can cause bacterial resistance and a decrease in effectiveness over time.  You may want to discuss the option of Accutane with your dermatologist.  While Accutane has its share of potential side effects, it is a consideration when other therapies including oral antibiotics have failed.

Bryan K. Chen, MD
San Diego Dermatologist

Bactrim to Treat Cystic Acne

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The use of Bactrim in acne is one of those almost-forgotten antibiotics and when used can have a significant effect on your cystic lesions. The use of sulfa medications has its own side effects, so please make sure you are seeing a board-certified dermatologist and that you are being followed fairly regularly. Back acne usually needs an oral medication, and taking Bactrim for several months may just do the trick. If a topical medication or a procedure such as PDT or blue light or the Isolaz acne system can be added in, this may make things better faster.

If all else fails, one might need Accutane, but give the medicines a try, and see what happens – this might do the trick.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.