A variety of prescription medications are used today for acne treatment. Patients taking acne medication have a wide spectrum of needs. A doctor or a dermatologist recommends a medication that you apply to your skin (topical prescription medication) or take by mouth (oral prescription medication).
A remedy that offers the best treatment for one acne patient may not be the best acne medication for a second patient. To achieve long-term control and resolution, dermatologists may use combination therapies. It is also important for these dermatologists to educate patients about the available acne medications and their expected outcomes. Acne medication can be classified into following categories:
Topical Acne Medication
Topical retinoids, benzoyl peroxide, and azelaic acid are effective topical treatments for mild acne.
Acne lotions dry up the oil, kill bacteria and promote sloughing of dead skin cells. These over-the-counter acne medications contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or lactic acid as their active ingredient. These products have been recommended for very mild acne. Azelaic acid (Azelex) may be particularly effective prescription medication for acne with post-inflammatory hyperpigmentation.
If these acne medications don’t work, then you may need to get a stronger prescription medication. Topical retinoids are considered a keystone in mild to moderately severe acne treatment. They work to unclog pores and prevent whiteheads and blackheads from forming. Tretinoin (Avita, Retin-A, Renova), adapalene (Differin) and tazarotene (Tazorac) are examples of topical retinoids.
Topical antibiotics commonly are used in conjunction with retinoids or benzoyl peroxide in patients with any degree of inflammatory acne. These combinations reduce antibiotic resistance in patients with P. acnes colonization. The most frequently used topical antibiotics as acne medications are clindamycin and erythromycin. These preparations include 1 percent clindamycin with 5 percent benzoyl peroxide (BenzaClin) and 3 percent erythromycin with 5 percent benzoyl peroxide (Benzamycin), and are equally effective acne medications.
Oral antibiotics are prescription medications for acne treatment in patients with moderate to severe and persistent acne. They work to reduce the P. acnes population which, in turn, decreases inflammation. First-line oral antibiotics include tetracycline and erythromycin. P. acnes resistance to erythromycin is increasing, and this antibiotic is becoming a second-line agent to tetracycline or other macrolide antibiotics.
Oral antibiotics used as acne medications usually begin with a higher dosage, which is reduced as acne resolves. They must be taken for six to eight weeks before results are evident, and acne medication should be continued for six months to prevent the development of microbial resistance.
Oral contraceptives (Birth Control Pills)
Oral contraceptives, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen), are effective acne medications for women. However, these should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches without the advice of their gynecologist.
Isotretinoin (Accutane) is a powerful acne medication reserved for very severe cystic acne and severe acne that has proven itself resistant to other prescription medications. It is very effective, but there is a possibility of related severe side effects.
Interlesional corticosteroid injection
To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a much-diluted corticosteroid. This lessens the inflammation and promotes healing. An interlesional corticosteroid injection melts the cyst over a period of 3 to 5 days.
The best thing for acne sufferers is to let a professional dermatologist examine their condition and suggest them appropriate acne medication.