Using Oral Tetracycline as a Treatment for Acne

Tetracycline is used to treat lots of different ailments, including acne. In fact, tetracycline along with its close cousins minocycline and doxycycline is the oral antibiotic most commonly prescribed for acne.

This is a prescription medication, so you'll need to visit your healthcare provider to get it. It's quite likely your healthcare provider will also prescribe a topical medication (like Retin-A or azelaic acid) to be used along with oral tetracycline.

Tetracycline is also used topically to treat acne in the form of a cream, but not as frequently as other antibiotics.

Woman examining pimple
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How It Works

Tetracycline works by slowing down the growth of the bacteria that cause acne. It also acts as an anti-inflammatory, so it helps make pimples less swollen and red.

Tetracycline is used to treat moderate to severe acne, although it’s sometimes prescribed for mild inflammatory acne that is particularly stubborn. Other oral antibiotics used to treat acne include clindamycin and erythromycin.

Your healthcare provider will know which dosage, taken by mouth, is best for you. Often a higher dose is prescribed at first and then tapered down once you are improving, generally to between 125 and 500 milligrams daily or every other day. 

The ultimate goal is not to take tetracycline daily if acne can be kept under control with a topical treatment. Some people, though, may need to take this antibiotic for longer periods of time to keep acne at bay.

Possible Side Effects

All acne medications can cause side effects, and tetracycline is no different. Luckily, most people can take this medication without any problems. But some common side effects to tetracycline include upset stomach, vomiting, diarrhea, sore throat, vaginal yeast infections and/or oral thrush, rash, dizziness and less commonly, sun sensitivity.

Let your healthcare provider know about any side effects.

When Tetracycline Is Not Right for You

If you're pregnant or breastfeeding, tetracycline isn't the right acne treatment choice for you. Oral tetracycline can affect your baby's bone growth and also cause your baby’s teeth to come in stained.

Young children also shouldn't take tetracycline because it can cause permanent stains on their teeth. Although sources generally say tetracycline should not be used by kids younger than 8, some recommend holding off on tetracycline use until children are at least 12.

Tetracycline sometimes can cause tooth discoloration for older kids and young adults, too, but these are usually temporary. And, tetracycline has been known to decrease the contraceptive effect of oral birth control pills. A backup birth control method while on tetracycline is recommended.

Tetracycline can't be taken with isotretinoin (Accutane) because these medications can interact with one another.


Tetracycline is most effective on an empty stomach but may be taken with food if it causes gastric distress. Antibiotics work best when there is a constant amount in your bloodstream. Try to take your medication at regular times each day. Taking it at the same time daily also will make it easier to remember to take it.

Drink a full glass of water when taking your medication. This will help to prevent esophagus irritation. Lying down right after taking tetracycline can cause esophagus irritation as well, so don't take it immediately before going bed.

Take your medication for as long as your healthcare provider instructs you, even if your skin is looking better.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Leyden JJ, Del rosso JQ. Oral antibiotic therapy for acne vulgaris: pharmacokinetic and pharmacodynamic perspectives. J Clin Aesthet Dermatol.

  2. Tetracycline Hydrochloride Capsules (tetracycline hydrochloride) dose, indications, adverse effects, interactions... from

  3. Cross R, Ling C, Day N, McGready R, Paris D. Revisiting doxycycline in pregnancy and early childhood – time to rebuild its reputation?Expert Opin Drug Saf. 2016;15(3):367-382. doi:10.1517/14740338.2016.1133584

  4. Second Meeting of the Subcommittee of the Expert Committee on the Selection and Use of Essential Medicines.

  5. Tetracyclines - Infectious Diseases - MSD Manual Professional Edition. MSD Manual Professional Edition.

Additional Reading
  • NIAMS/National Institutes of Health. Questions and Answers About Acne [Brochure]. Bethesda, MD: U.S. Department of Health and Human Services.

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.