Skip to Content

Acne Medicines and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 16, 2019.

Acne is a common skin condition that often begins during puberty. Acne commonly appears on the face, neck, chest, back and shoulders. The oil-producing (sebaceous) glands of the skin overproduce sebum and the hair follicles become clogged with bacteria and dead skin cells, leading to redness, pimples, and pustules often seen in acne. Hormones, diet, stress and medications may worsen acne.

Acne is often initially treated with over-the-counter or prescription topical creams and antibacterials, but oral medications, such as antibiotics or isotretinoin may be used in more severe cases. Oral antibiotics are most effective used with topical retinoids and benzoyl peroxide. Oral contraceptives are also used effectively in women to control acne. Spironolactone has also been used off-label for treatment of acne for decades. Topical medications for acne do not react with consumed alcohol, but several oral acne medications have interactions.

Alcohol Interactions with Common Acne Medicines

Isotretinoin (Absorica, Amnesteem, Claravis, Myorisan, Zenatane)

  • Isotretinoin is a retinoid, a form of vitamin A, used in severe acne treatment. It is very effective but can also cause severe birth defects and other severe side effect. You will need to use 2 forms of birth control, meet with your doctor regularly, and participate in a risk management program.
  • Alcohol consumption should be avoided during oral isotretinoin therapy. The combination may lead to unpleasant side effects like fast heart rate, flushing, a tingly feeling, and nausea and vomiting. This interaction is also called a "disulfiram-like reaction".
  • Topical retinoid drugs such as tretinoin (Avita, Retin-A), adapalene (Differin) and tazarotene (Tazorac, Avage) do not have interactions with alcoholic beverages. 

Doxycycline (Doryx, Oracea)

  • Doxycycline is an tetracycline antibiotic used to treat acne vulgaris, as well as blemishes, bumps, and acne-like lesions caused by rosacea.
  • Alcohol does not usually change the effectiveness of doxycycline or cause unpleasant side effects. However, if you drink alcohol most days (chronically) it is possible that the levels of doxycycline might decrease, lowering the effect of your medicine. This occurs due to an increase of enzymes in your liver.
  • Discuss this interaction with your doctor, as a dose adjustment may be needed.

Erythromycin (E.E.S.)

  • Due to intolerable stomach side effects and possible resistance, oral erythromycin is infrequently used for acne treatment over a tetracycline.
  • Alcohol when combined with erythromycin ethylsuccinate may slow gastric emptying. This interaction can delay the absorption of the antibiotic into the bloodstream and lower the therapeutic effect. Your doctor may prefer you avoid alcohol if you are taking erythromycin ethylsuccinate.
  • It is not known if other erythromycin salts are affected in this way. 

Learn more: Can You Drink Alcohol With Antibiotics?

Spironolactone (Aldactone)

  • Spironolactone (Aldactone) may be considered as an option for women and adolescent girls if conventional treatments are not effective or you are not a candidate for isotretinoin. It works by blocking hormone effects in oil glands on the face. Spironolactone is not FDA approved for this use, but has been used for decades for acne.
  • Using spironolactone and alcohol together may lower your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and changes in your heart rate. These side effects may decrease over time.
  • Avoid driving or operating hazardous machinery until you are familiar with how alcohol may affect spironolactone.

Other antibiotics used for acne such as tetracycline (Achromycin V) or minocycline (Dynacin, Minocin, Solodyn) do not list alcohol as a possible interaction in their product labeling.

In addition, low-dose combination oral contraceptives (brand examples: Ortho Tri-Cyclen, Yaz), often used in combination with other acne products, do not have major interactions with alcohol. However, always check with your doctor pharmacist for possible interactions with any medication, including prescription drugs, over-the-counter (OTC) medications, and herbal or dietary supplements.

Types of Drug Interactions With Alcohol

Sources

  1. Neuvonen PJ, Penttila O, Roos M, Tirkkonen J Effect of long-term alcohol consumption on the half-life of tetracycline and doxycycline in man. Int J Clin Pharmacol Biopharm 14 (1976): 303-7.
  2. NHS Choices. Can I drink alcohol while taking antibiotics? Accessed Nov. 15, 2019. https://www.nhs.uk/common-health-questions/medicines/can-i-drink-alcohol-while-taking-antibiotics
  3. Hansten P, Horn J. The Top 100 Drug Interactions, A Guide to Patient Management. 2017 Edition. H&H Publications, LLP. Freeland, WA. Accessed Nov. 15, 2019.
  4. Friedman A. Spironolactone for Adult Female Acne. MD Edge Dermatology. Cutis. 2015 October;96(4):216-217. Accessed Nov. 16, 2019
  5. Muhlemann M, Carter G, Cream J, et al. Oral spironolactone: an effective treatment for acne vulgaris in women. Br J Dermatol. 1986;115(2):227. Accessed Nov. 16, 2019 at DOI: 10.1111/j.1365-2133.1986.tb05722.x
  6. Morasso MI, Chavez J, Gai MN, Arancibia A Influence of alcohol consumption on erythromycin ethylsuccinate kinetics. Int J Clin Pharmacol 28 (1990): 426-9. Accessed Nov. 16, 2019 at PMID: 2258252.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.