person with bunch medication pills on hand

Prescription medication for the treatment of acne

There are two types of prescription medication for the treatment of acne: topical treatments, which are applied directly to the affected skin, and oral medication, which is usually taken in tablet form.

For the treatment of mild acne, most people will start off with over-the-counter products, which, when used correctly, are safe for just about everyone. For the treatment of severe acne, a doctor or dermatologist might recommend medication on prescription.

Prescription medication is generally stronger, and are aimed for use in specific people for specific purposes, which is why a doctor has to oversee this process. Stronger medication may be more effective in solving a medical problem, but the chances of side effects are also increased. That is why it is never a good idea to get prescription medication from a friend or family member. What works for one person, may have the opposite effect on someone else.

The purpose of prescription medication is to reduce oil production in your skin, to reduce the levels of bacteria on your skin, and to reduce the redness and swelling caused by inflammation. A reduction in the severity of your acne should lead to a lower risk of permanent scarring.

It is important to remember (especially if you are doing internet research) that names or prescription products can differ from country to country – your doctor will know what it is called locally.

Types of prescription medication used to treat acne

Retinoids

Topical retinoids (also referred to as Vitamin A acid) are applied directly to the skin – usually in the evening before you go to bed. Retinoids remove dead skin cells, prevent the plugging of the hair follicles, and boost production of new skin cells and unblock the pores. This is often the starting point for people with acne that is not severe. They are sold as lotions, gels and creams.

Retinoid tablets are taken orally and are aimed at reducing oil production, and to fight the bacteria that cause acne as well as inflammation. (See the separate section on Roaccutane, a very strong oral retinoid, at the end of the list).

Keep this in mind. Retinoids (both the oral and the topical kind) could cause your skin to feel dry and irritated, you could experience skin colour changes, or redness and crusting. Retinoids also tend to make your skin sensitive to sunlight. The stronger the medication, the more likely you are to need a prescription for it.

Antibiotics

Topical antibiotics

These are applied directly to the skin, and work in two ways: they reduce the number of bacteria on the surface of the skin, and reduce the inflammation in the hair follicles/sebaceous glands. All medication, whether applied to the skin or taken orally, that contains antibiotics, require a doctor’s prescription.

Oral antibiotics

These are taken by mouth and are aimed at lessening inflammation in your system, which can help to reduce or clear acne. As acne can take time to respond to treatment, oral antibiotics can be prescribed for as long as three or four months. Often other acne medication, such as benzoyl peroxide, is prescribed for use at the same time.

Keep this in mind. When antibiotics are taken for a very long time, or incorrectly, you can develop antibiotic resistance. It is important to finish the course of treatment and to follow your doctor’s instructions in this regard. You may have to take probiotics to protect your gut health. 

Azelaic acid 

This is a topical treatment that has antimicrobial and anti-inflammatory properties, so it can reduce acne inflammation, clean bacteria from the pores and prevent future outbreaks of acne. It is a naturally occurring acid found in certain grains. Research also points to azelaic acid being effective in diminishing skin blemishes. 

Keep this in mind. The preparations with a high level of azelaic acid can only be obtained with a prescription, but the ones with lower levels of the acid can be obtained straight from a pharmacy.

Oral contraceptives

These are used to treat acne in women. They mostly work by blocking or reducing levels of androgens, of which testosterone is one. Oral contraceptives contain oestrogen and progesterone, which lower the androgen levels in a woman’s body. Various oral contraceptives have different levels of progesterone. Acne can be a symptom of high androgen levels.

Keep this in mind. These contraceptives are often prescribed for women who need to use contraception anyway. It can only be used by women who have already started menstruating, and who are at least fourteen years old. There is no predicting how your body will react to a new oral contraceptive – you may have to try out different ones before you strike one that agrees with you, and reduces your acne.

Roaccutane (oral retinoid)

This is treated separately, as it is used mostly in the treatment of very severe acne, and can have serious side effects – all the more reason why close monitoring by your doctor is necessary when you take this medication. It is usually only considered for use in severe cases, where the acne can cause permanent scarring. These tablets can work within a week or ten days, and 80 percent of users have clear skin within four months.

Keep this in mind. This medication can cause your skin to become very dry. It should not be taken by people who have mental health issues, such as depression. If you have digestive diseases, such as Crohn’s disease, or if you have high cholesterol levels, high levels of vitamin A, or if you have liver or kidney disease, this medication is not advised.

General tips on taking prescription medication

  • Watch out for any adverse reactions, such as rashes, dizziness, or nausea and digestive problems. Speak to your doctor about these as quickly as possible.
  • It is very important to stick to dosage instructions about when and how many tablets you should take. Some medication should not be take on an empty stomach, or before you go to bed.
  • Make a note of any side effects, how effectively the medication is working, so that you can discuss it with your doctor when next you see him or her.
  • Keep prescription medication in a safe place, and never share your medication with someone else.
  • Remember that your pharmacist can answer many of your questions on medications, such as how they work, and what their possible side effects are.

Sources:

DermNet NZ

https://dermnetnz.org/topics/antibiotics-for-acne/

National Health System

https://www.nhs.uk/medicines/isotretinoin-capsules/

Mayoclinic.org

https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048

WebMD.com

https://www.webmd.com/skin-problems-and-treatments/acne/birth-control-for-acne-treatment#2

American Academy of Dermatology

https://www.aad.org/public/diseases/acne/derm-treat/antibiotics#:~:text=Acne%20isn’t%20an%20infection,your%20skin%20and%20lessen%20inflammation.

Drugs.com

https://www.drugs.com/condition/acne.html

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