- Prescription acne medication is often prescribed when a person with moderate to severe acne doesn’t get relief from over-the-counter treatments
- Topical and oral prescription medications are available for acne, and some may be used in combination with one another.
- Topical prescriptions for acne include retinoids, alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs) and antibiotics.
- Oral prescriptions for acne include retinoids, hormone medications and antibiotics.
- Side effects of prescription acne medications range from mild to severe.
Prescription acne medication is a powerful treatment for acne. Acne treatments that come in prescription strength include topical creams, gels and oral medication. These medications must be prescribed by a dermatologist, and are not appropriate for everyone.
Prescription-strength acne medication helps to clear severe breakouts, preventing scarring in the process. They also help regulate the production of oil in the skin, encourage turnover of damaged and dead skin cells, reduce inflammation and combat bacteria.
It could take four to eight weeks to begin seeing results of prescription acne medication. For many people, it can take months–possibly even years–before breakouts completely clear up.
Who Should Use Prescription Acne Medication?
People whose acne doesn’t respond to over-the-counter (OTC) treatments sometimes need prescription acne medication to clear their breakouts. The specific type of medication prescribed depends on the specific type of acne, the age of the patient and how severe the symptoms are.
Who should avoid them?
Women who are pregnant, trying to conceive or breast-feeding should avoid certain oral and topical acne medications, particularly isotretinoin (brand name Accutane and other similar prescriptions).
People who take isotretinoin should be watched closely by their doctor, as this medication has a high risk of adverse events and is considered a controversial treatment. Teens are at a high risk of developing severe side effects.
Acne medications should be prescribed on an individual, case-by-case basis that takes each patient’s health into account.
Prescription acne medications come in a variety of formulations, including topical gels and creams. These treatments address a range of acne conditions, from inflammatory acne to blackheads.
Azelaic acid is an antioxidant-rich, anti-inflammatory, antibacterial, anti-keratinizing product that is regularly prescribed to treat acne rosacea and acne vulgaris. It works as a gentle exfoliant, evens skin tone and smooths skin.
Cream containing 20% azelaic acid is often recommended for topical use twice daily for four weeks or more. When combined with erythromycin ointment, azelaic acid is even more powerful.
Azelaic acid is considered safe for people who are pregnant or breast-feeding. Speak to your doctor before beginning a new treatment, especially if you’re pregnant.
Topical prescription retinoids (and drugs that are formulated like retinoids) are vitamin A-derived and available in gel, cream and lotion forms. These drugs include adapalene, tretinoin and tazarotene. Retinoids gently promote skin cell turnover and help to clear pores in the process.
Retinoid treatments such as tretinoin may be safely used long-term and may take up to 12 weeks to produce noticeable results.
Salicylic acid is an excellent treatment for non-inflammatory acne symptoms, such as blackheads. It’s available in OTC and prescription concentrations, and is used to help clear pores and prevent them from becoming blocked with sebum and dead skin cells.
Salicylic acid is available in facial cleansers and spot treatments.
Topical antibiotics for acne can help to kill acne-causing bacteria, alleviate redness and may be used short-term (up to three months at a time) to treat acne symptoms. These include:
Some topical antibiotics are used alongside benzoyl peroxide or retinoids to boost effectiveness.
For some patients with severe acne, topical medications alone aren’t effective enough. Sometimes, a combination of oral and topical medications are recommended to get severe acne symptoms under control.
For female patients who don’t experience improvement from other forms of prescription acne medication, spironolactone (brand name Aldactone may be an appropriate alternative. Spironolactone keeps androgen from influencing the production of sebum.
Isotretinoin is a retinoid drug that’s prescribed for moderate to severe acne when other acne treatments are ineffective. It helps to regulate sebum production, helps to clear pores and fights inflammation.
Isotretinoin is considered a controversial medication because it’s associated with a high incidence of birth defects. People taking isotretinoin should be monitored closely by their doctor. Isotretinoin has been associated with depression and psychological disturbance, but research is unclear as to whether the drug was the factor that caused the symptoms.
Antibiotics are often prescribed short-term for moderate to severe acne. Prescription antibiotic medications for acne help to fight the bacteria and inflammation that contribute to acne.
Oral contraceptives (birth control pills)
Some teen and adult women experiencing moderate to severe acne may take oral contraceptives to control their symptoms. Contraceptive pills that include both progestin and estrogen are often prescribed for acne, as acne can be linked to a hormonal imbalance.
It may take a few months to observe results from oral contraceptives for acne. Your dermatologist may recommend combining other treatments with oral contraceptives, especially at first.
Best Prescription Medications for Adult Acne
The best prescription medications for adult acne depend on each person’s individual condition. People with acne should start with OTC acne treatments first, then move on to consulting their doctor if needed. Salicylic acid or benzoyl peroxide would be a great choice to start out.
For those with moderate acne, prescription topical treatments tend to work well and may be combined with oral medication. For severe acne, a combination of medications works best.
Are There Side Effects?
Prescription acne medications have a wide range of side effects, depending on the drug and the way it’s used. Side effects of prescription acne medications range from mild to severe.
|Prescription Acne Medication||Type||Potential Side Effects|
|Azelaic acid||Topical||Dry skin|
Changes in skin color Irritation
|Topical antibiotics||Topical||Abdominal pain|
Changes in skin color
Sensitivity to sunlight
|Salicylic acid||Topical||Dry skin|
|Spironolactone||Oral||Menstrual discomfort or pain|
Tender, painful breasts
Changes in liver function
Changes in triglycerides
Sensitivity to sunlight
Worsened night vision
Sensitivity to sunlight
|Oral birth control||Oral||Fatigue|
Heightened risk of blood clots
High blood pressure
Tender, painful breasts
Over the Counter Alternatives
Some people prefer to start with OTC alternatives to prescription acne medication, including:
- Alpha hydroxy acids (AHAs) such as glycolic acid
- Beta hydroxy acids (BHAs) such as salicylic acid
- Benzoyl peroxide
OTC acne medications are appropriate for mild to moderate acne symptoms. If you don’t see any improvement in your symptoms after using an OTC treatment for a few weeks, talk to your dermatologist about your options.
Prescription acne medications are effective acne treatments when OTC treatments aren’t effective. They are most appropriate for moderate to severe acne, and some prescription treatments may be used in combination with one another.
Topical prescription acne medications consist of skin-resurfacing and antibiotic formulations. Alternatively, oral medications such as isotretinoin (a retinoid), antibiotics, anti-androgen medication or oral contraceptives may be recommended.
Side effects of prescription acne medication range from mild to severe. Check with your dermatologist about which medications are most appropriate for your condition. You may also decide that trying an OTC alternative is right for you.
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