Prescription Acne Treatment

Medicine for Clear Skin

A prescription acne treatment can come 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. Systemic medications (work internally) - usually needed for severe acne cases and may be used for moderate acne or acne that has been resistant to other treatments

  2. Topical medications (applied to the skin) - used for mild to severe acne

These 2 prescription acne treatment options attack the different factors that contribute to acne.

SYSTEMIC MEDICATIONS (work internally)

Oral antibiotics

Oral antibiotics are a prescription acne treatment that 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. For more information, check out the top oral acne medication options.

Hormonal Treatments

Hormonal treatments such as spironolactone or birth control pills attempt to adjust the hormone fluctuations which can cause acne. They particularly have an "anti-androgen" affect, which can help reduce sebum production/sensitivity which reduces the chances for acne.

These treatments are really only available to women

Learn more about birth control for acne.

Accutane (Isotretinoin)

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. So, how does Accutane work?

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 potentially risky Accutane side effects. These can include 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 acneincluding 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.

TOPICAL MEDICATIONS (applied to skin)

Topical Antimicrobials :

Topical antimicrobials are a prescription acne treatment that works 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 prescription acne treatment 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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