Acne Medications

When acne doesn’t clear up despite using over-the-counter topical treatments, one option is to use prescription medication. Prescription acne medication can be topical or oral and helps defeat acne from the inside out.

These medicines help clear moderate to severe acne symptoms, making it an excellent choice for those with a more complex skin condition. At Schweiger Dermatology Group, we will examine your acne and determine if medication should be a part of your treatment plan.

Over-the-Counter vs. Prescription Acne Medication

Over-the-counter (or OTC) acne medications are effective for mild cases of acne that appear from time to time or during puberty. These topicals, which typically contain salicylic acid or benzoyl peroxide, are good for clearing up blackheads and whiteheads, but they’re not necessarily made to clear severe types of acne like nodules and cysts.

Prescription acne medications are only available via a dermatologist or dermatology provider. These medications are stronger and/or contain different active ingredients designed to tackle tough cases of acne

Oral Acne Medications

When you’re ready to treat your acne with oral medication, some of the most commonly prescribed include antibiotics and hormone therapies. If those don’t work, you might be prescribed a strong acne medication such as isotretinoin.

Oral acne medications are great for those who have severe acne that warrants it and if they have trouble remembering to apply topical treatments daily. They also stay in your system through the entire treatment process, ensuring you get the medication you need to control your acne 24 hours a day.

Isotretinoin

Isotretinoin is a prescription medication tablet taken orally to treat acne by directly affecting the sebaceous (oil) glands. It has been approved by the U.S. Food and Drug Administration (FDA) and is specifically designed to treat nodular acne resistant to other medications and therapies. It can have long-term physical side effects, so it is one of the medications that is monitored closely if you take it.

Spironolactone

Spironolactone is a good medication for stubborn acne in women. It has been shown to improve acne by 50% to 100%, which is excellent for people with severe outbreaks and scarring. This hormonal treatment is also used for high blood pressure and fluid retention. It’s typically only prescribed for women due to the blocking of the androgen hormone, testosterone, which is needed in men for overall health and well-being.

Birth Control

Birth control is a hormonal medication that is sometimes used to treat acne in adult women and teenage girls. The progestin and estrogen in combination pills help limit the androgen hormone’s ability to increase oil production.

While this can be a good route for some, there are instances including tobacco use, that make this acne medication option more risky. Also, not all dermatology providers will prescribe birth control, so it’s important to check before making an appointment if this is an option you are considering.

Antibiotics

Antibiotics are a good choice for acne in some cases. Certain types, such as demeclocycline, minocycline, and doxycycline, come as acne medication pills to treat the root causes of the acne. They’re only available by prescription, and you typically will only be prescribed a short course. Why? Taking too many antibiotics can lead to antibiotic resistance, which is a serious issue providers want to avoid.

Topical Acne Medications

Topical acne medications are among the best acne treatments for teenagers and young adults. These medications typically come in creams, gels, or lotions applied directly to the skin. It’s important to use these medications as directed, starting with lower amounts and gradually increasing if there are no side effects to achieve the best results while minimizing skin irritation. Consistency in application and patience is key, as it can take several weeks to months to see significant improvement in acne symptoms.

Azelaic Acid

Azelaic acid is a versatile and effective topical treatment for mild to moderate acne. It works by reducing the growth of acne-causing bacteria, improving skin cell turnover, and decreasing inflammation. Azelaic acid is especially useful for patients with darker skin tones, as it helps reduce post-inflammatory pigmentation and melasma. Additionally, it’s generally well-tolerated, with fewer side effects compared to more potent therapies, and doesn’t cause bacterial resistance, photosensitivity, or skin bleaching.

Vitamin A Retinoids

Retinoids are a synthetic form of vitamin A. This fat-soluble vitamin can be prescribed to you as a cream to reduce wrinkles and treat acne, making it a good choice (and a favorite) among older individuals. Tretinoin is the most common generic form of topical retinoid prescribed.  It is an acne prescription cream that works to increase cell turnover, promote exfoliation, and reduce clogged pores. It’s particularly effective in treating both inflamed and non-inflamed acne lesions, as well as improving skin texture due to scars. Tretinoin is available in various strengths and comes in cream, gel, or liquid formulations. It’s important to note that tretinoin can cause initial skin irritation, dryness, and increased sun sensitivity, especially during the first few weeks of use.

Clindamycin

Clindamycin is used to treat infections, but it can also be used to treat acne. This topical drug is applied to the entire acne-affected area, not as a spot treatment. It’s easy to apply, too — simply wash the affected area with warm water and soap, rinse it, and pat it dry before rubbing the medication onto the skin. Topical clindamycin isn’t designed to clear acne completely, but it can help keep it under control. For best results, it should be combined with additional treatments.

Long-Term Side Effects of Acne Medication

The long-term side effects of acne medications can vary from one drug to the next. Antibiotics, for example, pose the risk of antibiotic resistance and may cause other complications such as nausea or diarrhea. Isotretinoin can cause severe skin dryness, joint pain, and severe birth defects. Many prescription medications will cause some form of dryness and irritation, depending on the potency and frequency of use.

Acne Medication Tips

Taking acne medication requires consistency, patience, and proper technique. Always follow your dermatology provider’s instructions carefully, as each medication may have specific guidelines for use.  Here are some other things to consider as you begin your acne journey:

  • Protect your skin from the sun, as many acne medications can increase sun sensitivity. Use a non-comedogenic sunscreen daily that contains zinc oxide daily.
  • Moisturize regularly with a non-comedogenic, oil-free moisturizer to combat dryness, a common side effect of many acne treatments.
  • Avoid using multiple acne treatments at once unless directed by your dermatology specialist, as this can increase irritation.
  • Don’t stop using your medication abruptly when your acne clears. Follow your provider’s recommendations for maintenance therapy.
  • Keep your medication away from heat and light, and check expiration dates regularly.
  • Take oral medications as prescribed with food to reduce stomach upset.

Find the Right Acne Medication with Schweiger Dermatology Group

Whether you’re interested in tackling severe acne with an oral medication like isotretinoin or you want to try a prescription acne cream that can resolve a sudden outbreak, Schweiger Dermatology Group is here to help you find a solution that will work well for your skin. We also have many alternatives to these treatments, which we would be happy to speak with you about during your consultation. Contact us today or find a location to schedule an appointment.

Reviewed by Dr. Jeremy Fenton.

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About Schweiger Dermatology Group

Founded by Dr. Eric Schweiger in 2010, Schweiger Dermatology Group began as a single office in Midtown Manhattan with a mission to deliver high-quality dermatologic care without long waits. As demand grew, so did the practice. Today we have over 120 locations across 8 states with more than 400 of the nation's leading providers and were ranked as the number one practice nationally in cosmetic and reconstructive care by Castle Connolly. In 2023, we broadened our expertise by integrating allergy care into our services. We remain committed to offering exceptional medical, cosmetic, and surgical dermatology as well as comprehensive allergy services, ensuring patients receive expert care in a modern, state-of-the art environment.

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