Is it safe to drink alcohol with acne medicines?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 7, 2024.

Acne is a common skin condition that often begins during puberty and commonly appears on the face, neck, chest, back and shoulders. Topical medications for acne do not react with consumed alcohol, but several oral acne medications, including isotretinoin and some antibiotics can have interactions.

What causes acne? 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, too.

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. 

For mild acne without a prescription, consider antiseptic washes, gels or creams containing benzoyl peroxide (Acne Clear, Benzac AC) or adapalene (Differin).

Your doctor may prescription a topical agent to apply to acne lesions such as: azelaic acid (Azelex, Finacea), adapalene and benzoyl peroxide (Epiduo, Epiduo Forte), benzoyl peroxide and clindamycin topical (Duac, Acanya), dapsone topical (Aczone), clascoterone topical (Winlevi) or tretinoin (Avita, Retin-A).

Other topical options for acne include: Cabtro gel (clindamycin phosphate, adapalene, and benzoyl peroxide), Twyneo (benzoyl peroxide and tretinoin), and Arazlo (tazarotene).

Learn More: What are the available topical acne agents? 

Oral antibiotics are more effective when used with topical retinoids and benzoyl peroxide. Examples of oral antibiotics used for acne include doxycycline, minocycline, and sarecycline. Spironolactone, an oral prescription medicine, has also been used off-label to treat acne for decades. Oral contraceptives may also be used in women to control acne. Low-dose combination oral contraceptives, often used with other acne products, do not have major interactions with alcohol.

The American Academy of Dermatology updated their guidelines for acne treatment in 2024. Overall, the recommendations state:

• Benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline are strongly recommended for use.
• For acne that is severe, causing psychological burden or scarring, or failing standard oral or topical therapy, oral isotretinoin is strongly recommended.
• Topical clascoterone (Winlevi), salicylic acid, and azelaic acid, as well as oral minocycline, sarecycline (Seysara), combined oral contraceptive pills, and spironolactone were conditionally recommended. 

Many acne medicines cannot be used during pregnancy. If you are considering a pregnancy and use acne treatments, speak with your doctor first.

Be sure you check all of your food and medicine labels for alcohol if you need to avoid alcohol with your acne medicine. It is important to tell your healthcare provider about all the medications you use, including over-the-counter drugs, vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Learn more: Medications used to treat acne

Alcohol Interactions with Common Acne Medicines

Isotretinoin (Absorica, Absorica LD, 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 effects. You will need to use 2 forms of birth control, meet with your doctor regularly, and participate in a risk management program called iPLEDGE while using this treatment.
• 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". Be sure to check your food and medicine labels to see if these products contain alcohol.
• Topical retinoid drugs such as tretinoin (Avita, Retin-A), adapalene (Differin) and tazarotene (Tazorac, Avage) do not have drug interactions listed with alcoholic beverages.

Doxycycline (Doryx, Oracea)

• Doxycycline is an antibiotic in the tetracycline class 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. Oral tetracycline and minocycline do not list interactions with alcohol.
• 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. Erythromycin is used topically (applied to the skin) to treat acne, sometimes in combination with benzoyl peroxide.
• Alcohol when combined with oral 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 "off-label" 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 to treat acne.
• Using spironolactone and alcohol together may lower your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and changes in your heart rate. Use caution when getting up from a sitting or lying position. These side effects may decrease over time, but let your doctor know if you develop these symptoms.
• Avoid driving or operating hazardous machinery until you are familiar with how alcohol may affect spironolactone.

This is not a complete list of all possible alcohol interactions with acne medicines. Always follow your prescriber's directions. Tell your doctor and pharmacist about all the medications you use, including over-the-counter (OTC) drugs, vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Further information

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

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