Acne Prescription Medicine

Acne prescription medicine comes in a variety of forms, all of which can be very effective in clearing acne fast. Prescription acne treatments are generally used to clear more serious cases of acne or those resistant to over the counter acne treatment .

There are two main categories of acne prescription medicine:

  1. Topical medications (applied to the skin) - used for mild to severe acne
  2. Systemic medications (works internally) - usually needed for severe acne cases and may be used for moderate acne or acne that has been resistant to other treatments

These prescription acne treatments attack the different factors that contribute to acne, as described on the pages What is Acne? and What Causes Acne? .

The following is a description of the various acne prescription medicine options that are used in the U.S. today :

1) Systemic (works internally) Medications

~ Oral antibiotics
Oral antibiotics help stop the growth of P. Acnes, the bacteria that causes acne, from the inside out. Treatment with oral antibiotics usually begins with a higher dosage, which is reduced as acne clears. Generally, antibiotics are prescribed for six months or less.

Some common oral antibiotics include Tetracycline, Minocycline, Doxycycline, and Bactrim/Septra. Tetracycline also has an anti-inflammatory effect.

~ Oral contraceptives
Birth control pills, particularly Ortho Tri-Cyclen, are often used to help clear acne in women, especially hormonal acne.

Ortho Tri-Cyclen contains progesterone and estrogen and helps to decrease testosterone levels in the body. As a result, the sebaceous glands are suppressed and breakouts decrease.

~ Isotretinoin (Accutane)
Isotretinoin is a potent oral retinoid made under the brand name "Accutane". It is a derivative of vitamin A taken in pill form for 15-20 weeks.

Doctors prescribe it for people with "severe nodular acne" that does not respond to other treatments. Nodules are inflammatory lesions with a diameter of 5mm or more.

A single course of 15-20 weeks has been shown to result in complete clearing and long-term remission of acne in many people by significantly reducing the amount of oil produced by oil glands.

However, there are many side effects and to using Accutane including dry and cracked lips, dry skin, dry nose and mouth, and mild to moderate muscle or joint aches. Additionally, Accutane should never be taken when pregnant because it can lead to birth defects in infants.

~ Cortisone shots
Cortisone shots are used for severe types of acne including nodules and cysts. These types of acne lesions are large and deep within the skin, often being resistant to topical treatment as a result.

Sometimes cysts and nodules can last for weeks or even months if left untreated, and they can ultimately scar.

If you have a cyst or nodule that you would like to get rid of quickly (whether it be for a big event or just life in general), a cortisone shot can help to quickly reduce swelling and heal the lesion. A cortisone shot can also help reduce scarring.

You can make appointments with your dermatologist or doctor for injections on an as-needed basis, but be sure to have your doctor explain any potential side effects or risks associated with the injections.


2) Topical (applied to skin) Medications

Topical Antimicrobials :

Topical antimicrobials are an acne prescription medicine that work to inhibit and kill the P. acnes, the bacteria that causes acne. There are many different forms of topical antimicrobials, listed below, and they are generally used to treat patients with mild to moderately severe inflammatory acne.

~ Azelaic acid
Made under the brand name "Azelex", this is a cream containing 20% azelaic acid, which is a naturally occuring acid found in whole grain cereals and animal products.

Azelaic acid is thought to help the skin to renew itself more quickly and prevent the buildup of cells that can plug pores. As a result, pimple and blackhead formation is reduced. It also helps to kill P. Acnes, the bacteria that cause acne.

~ Benzoyl Peroxide
Benzoyl peroxide works by killing P. acnes, however, it does not have anti-inflammatory abilities. It is available in a wide range of strengths and can also be found in many over the counter acne treatment products. Many acne treatments include benzoyl peroxide because research shows that benzoyl peroxide increases the effectiveness of some medicines, such as erythromycin and clindamycin.

~ Clindamycin
Clindamycin phosphate is an antibiotic which kills P. Acnes, the bacteria that causes acne. Clindamycin can also help to reduce inflammation. This product usually comes in a solution, gel, or lotion.

~ Erythromycin
Erythromycin is a topical antibiotic which prevents bacteria from growing. It is active against a broad spectrum of bacteria, including P. acnes, the bacteria that causes acne.

Erythromycin is also an anti-inflammatory. Sometimes topical erthyromycin is combined with benzoyl peroxide in acne prescription medicine products. The combination can prove quite effective because the patient gets the effects of two antimicrobial agents on their skin.

~ Sodium sulfacetamide
Sodium Sulfacetamide is a topical antibiotic that curbs the growth of P. Acnes, the bacteria that causes acne, and opens up clogged pores. It is effective in treating inflammatory acne. Many products containing sodium sulfacetamide also include sulfur.


Topical Retinoids :

Topical retinoids are a derivative of vitamin A and considered a cornerstone in acne prescription medicine options. Retinoids work to unclog pores and prevent whiteheads and blackheads from forming. An added benefit in using topical retinoids is that they may help diminish the signs of aging, such as fine lines and wrinkles.

Topical retinoids can irritate the skin and increase sun sensitivity so it is important to use sun protection and follow the dermatologist’s directions if using any of the following products.

~ Adapalene
Made under the brand name "Differin", this is a gel which is applied once a day. Acne occurs when the skin cells inside the hair follicle shed too fast and clog the pores. Differin gel works by slowing down the accumulation of skin cells inside the follicle that plug the pores. Differin also possesses moderate to potent anti-inflammatory abilities

~ Tazarotene
Made under the brand name "Tazorac". It is generally available as either a gel or cream in 0.05% or 0.1% concentrations. Tazorotene works to keep the skin’s pores clear and has proven effective in treating acne; however, exactly how it works is not yet understood by dermatologists.

~ Tretinoin
Tretinoin is contained in popular acne prescription medicine products such as Retin-A and Retin-A Micro (also often used to treat wrinkles). Tretinoin is retinoic acid and vitamin A acid combined, and it comes in various strengths in creams, gels, and liquids for use on the skin. It is used to treat acne and also to treat sun damaged skin or wrinkles.

Tretinoin works to gradually unclog pores and keep them unplugged. It also increases the speed at which surface skin cells are replaced.

It's important to be aware that tretinoin actually brings pimples to the surface in the beginning, so your skin may get worse before it gets better. Also, exposure to sunlight should be minimized as you may be more sensitive to its rays.



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