Acne (and Rosacea) Link to MRSA

There is growing evidence that the major cause of MRSA is the inappropriate over prescribing of antibiotics by general practitioners. This is not news and it is common knowledge that most infections are viral and do not require antibiotics.

Also it is well known that antibiotics upset gut bacteria and lead to overgrowth of the intestinal tract with fungi such as Candida which is present in everyone’s guts, but normally kept in check by the probiotic bacteria surrounding it and which also produce chemicals to keep it in check. Antibiotic use can reduce the probiotic bacteria and allow the fungus to grow which over time can lead to inflammation and misdiagnosis of IBS later in life and open another chapter in prescribing. A downward spiral we don’t want to promote. Candida overgrowth and dysbiotic guts probably affect millions of ‘20 something’s’ who have just had years of antibiotics for acne, or million of 40 something’s who have been put on antibiotics for rosacea. We have clever ways of restoring the normal bacterial balance and reducing Candida without harsh antifungals.

However the use of antibiotics for skin infections such as acne and rosacea often at low doses and often for 3 to 6 months at a time is probably the biggest cause of MRSA (multi resistant Staphylococcus aureus) in hospitals. Let me explain.

It doesn’t matter whether oral or cream antibiotics are used they cause the same problem. In acne if you have many blocked ‘pores’ (pilo sebaceous ducts) then the anaerobic bacteria propiobacterium acnes (p.acnes) can start to colonise the area under the plug and cause inflammation and damage. This bacterium only survives in normal skin at very low levels as it likes to live in an environment where there is little or no oxygen. When you create a blockage as with acne, you create the environment for p.acnes. So antibiotics can help to reduce p.acnes, but they also hit other friendly skin bacteria and herein lies the problem.

Staphylococcus epidermidis (s.epidermidis) lives on our skin and helps keep other nasty bacteria away. It likes an oxygen rich environment. The same antibiotics that reduce p.acnes often hit the s.epidermidis as well. This attack puts selective pressure on the bacteria to survive and within three or four weeks you can isolate resistant strains s.epidermidis on skin being treated with antibiotics.

Now Staphylococcus epidermidis is related to Staphylococcus aureus (s.aureus) (cousins if you like). S. aureus lives inside the body and s.epidermidis lives on the skin. They meet at places such as the nose and other entrances into the body. They can pass information to each other through the use of things called plasmids and it is highly likely information for developing resistance is transferred.

Hey presto we have started the super bug development. The acne sufferer ends up in hospital for an operation. They get a wound infection either from their own bacteria but also through other bugs already there. S.aureus is a typical bacterium that infects wounds. The antibiotics used for wound infections are often the same or similar to the one that has been used for the patient’s acne, and it is not surprising they find the antibiotics don’t work as the bugs are already resistant. This resistant strain becomes the dominant resident s.aureus in the hospital and is extremely difficult to remove and can go on to infect many other patients.

Using a product such as Aknicare which has 4 antibacterial agents which control p.acnes by changing conditions in the area under the plug rather than directly destroying it means you can prevent damage and inflammation without breeding resistant bugs. Aknicare can reduce p.acnes and all the other key causes of an acneic skin (inflammation, oil production, cell turnover) all without breeding resistant bugs.

As a final thought the main treatment for rosacea recommended on PRODIGY, the GP prescribing database recommends ROSEX creams and gels. Rosex contains the antibiotic metronidazole. Rosacea patients often use it for months and years. It works in a few. Metronidazole is also a powerful antioxidant and it is these properties that help with rosacea symptoms, not the antibiotic properties. Rosacea is not caused by bacteria. It is a sobering thought that the antibiotic most used in theatre to prevent infections during and shortly after surgery is metronidazole. Imagine if you had been using it for months or years before that operation.

It is concerning to think the antibiotic you are using today could end up leading to someone dying in hospital in the near future. Change prescribing habits for acne and rosacea now and have an impact on MRSA in hospitals.

Use Aknicare, a new medical device with a CE mark . Once in the drug tariff this should be prescribed by GPs. PCTs should act now