Most acne patients  are  otherwise fit and, with  the possible exception of the contraceptive pill, are rarely on other medications. However, occasionally a female patient may be taking oral iron tablets for menorrhagia and  a somewhat older  patient may be on antacids for dyspeptic symptoms. Both these preparations will chelate with oral antibiotics; the antacids and iron can be taken after foods, the antibiotics hour before food.

 

  There has been increasing anxiety about the  possible interaction between the  contraceptive pill and oral antibiotics. Dermatologists  and general practitioners have given these two therapies together for fifteen years or more and there is  litle evidence in the acne literature that  the administration of such antibiotics reduces the efficacy of the contraceptive pill. This point will  be discussed again  later  but an  ongoing study in this author's department has failed to demonstrate an increased risk of conception in patients receiving the two therapies. Patients are told  that if they develop diarrhoea while taking the antibiotics - whatever the cause - or intermenstrual  spotting, then  they should use other contraceptive measures. This warning is given both verbally and in writing.