Prescription Medication for Moderate Acne Treatment
Drug treatment is aimed at reducing several problems that play a part in causing acne: abnormal clumping of cells in the follicles, increased oil production, bacteria, and inflammation. Depending on the extent of the person's acne, the doctor will recommend one of several over-the-counter (OTC) medicines or prescription medicines that are topical (applied to the skin) or systemic (taken by mouth).
The doctor may suggest using more than one topical medicine or combining oral and topical medicines. The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease.
Prescription Medications. When acne becomes especially troublesome in moderate to severe cases, physicians can prescribe stronger medications. These medications may be used alone or in conjunction with OTCs.
Antibiotics. There are many different types of antibiotics in various classes. The goal of the acne treatment using antibiotics is to kill relevant bacteria and help with inflammation.
- Antibiotics can be topical (applied as gels, lotions or creams) or systemic (taken in pill form). Your physician should recommend what is appropriate for you.
- Be sure to ask about side-effects and precautions associated with prescribed antibiotics as some acne antibiotics are contraindicated in people with liver disease, people that are anemic, people that have proven hypersensitivities and people who are pregnant.
- Some examples of commonly used antibiotics prescribed for severe cases of acne vulgaris include: Tetracycline (Sumycin), Doxycycline (Doryx, Vibramycin, Bio-Tab), Minocycline (Dynacin, Minocin), Trimethoprim/sulfamethoxazole (Bactrim, Septra), Azithromycin (Zithromax), Clindamycin (Cleomycin) and Erythromycin (E-mycin, Ery-Tab, Eryc, Ilosone).
- Azelaic Acid (Azelex, Finevin) and Sodium Sulfacetamide (Klaron, Novacet, Sulfacet) are topical creams used for mild to moderate acne.
- Typical side effects of oral antibiotics include increased tendency to sunburn, upset stomach, dizziness or lightheadedness, and changes in skin color. Tetracycline is not given to pregnant women, nor is it given to children under 8 years of age because it might discolor developing teeth. Tetracycline and minocycline may also decrease the effectiveness of birth control pills. Therefore, a backup or another form of birth control may be needed. Prolonged treatment with oral antibiotics may be necessary to achieve the desired results.
Topical Retinoids. These medications are derived from Vitamin A. Topical forms are applied directly to the skin via cream, gel or lotion. They work by preventing hyperkeratinization of epithelial skin cells and normalizing the lifecycle of the pilosebaceous unit. This effectively helps to open clogged pores as well as exfoliates.
- Recommended due to its anti-inflammatory and comedolytic effects (useful against blackheads and whiteheads).
- Side effects are usually mild but include skin dryness, irritation, redness and peeling. For these reasons, protection against the sun is also recommend. Ask your physician about other side effects and cautions.
- Examples of common prescribed topical retinoids include: Tretinoin (Retin-A, Avita), Adapalene (Differin) and Tazarotene (Avage, Tazorac).
Some people develop side effects from using prescription topical medicines. Initially, the skin may look worse before improving. Common side effects include stinging, burning, redness, peeling, scaling, or discoloration of the skin. With some medicines, like retinoids, these side effects usually decrease or go away after the medicine is used for a period of time. Patients should report prolonged or severe side effects to their doctor. Between 4 and 8 weeks will most likely pass before patients see their skin improve.