Before we begin, a note that this article is not intended to guide choice of medication. Always see a licenced medical professional for any recommendations on medication.
What medication exists for acne-prone skin?
Let’s start with clarifying two acronyms. OTC stands for over the counter, meaning you can buy the product at a pharmacy without the need for a prescription. The same active ingredients can be found in both OTC and RX options. The OTC versions typically come in milder dosage than those that you might be prescribed. RX (which applies to oral medications as well as topical creams) refers to prescription only medicine and it will generally be a higher dose, given under the supervision of your doctor. Of course certain medication can only be obtained with a prescription.
What are the common drugs and medication types for acne?
There are several issues that need to be addressed when it comes to acne medication: reducing sebum production, repairing the skin barrier, fighting infection and reducing inflammation.
The treatment your doctor prescribes will depend on your age, the severity of your acne, and your individual circumstances. For example, a pregnant woman might not be given oral prescription medication.
Don’t expect to see instant results. With most prescription acne medication your skin may get worse before it improves and it may take several weeks before you see any results. Even then it can take months or even years to clear up completely.
Let’s begin with RX topical medications – those that you apply directly to your skin. Adapalene and Benzoyl peroxide are among the most effective treatments prescribed by doctors, although other products exist.
Topical retinoids – derived from vitamin A:
Tretinoin
Purpose: This retinoid is more powerful than adapalene. It’s often prescribed for clogged pores and blackheads. It removes dead skin cells so they don’t stick together and clog your pore openings. Brand names: Avita, Retin-A, others
Adapalene
Purpose: Removes dead skin cells from the surface of the skin. Brand name: Differin.
Tazarotene
Purpose: Removes dead skin cells to prevent pore blocking. Brand names: Avage, Fabior, Tazorac
Benzoyl peroxide
Purpose: Works as an antiseptic to reduce the number of germs (bacteria) on the surface of your skin.
Topical antibiotics
Purpose: Kill excess skin bacteria and reduce redness. Usually prescribed in combination with a retinoid or benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. Brand names: Clindamycin with benzoyl peroxide (Benzaclin, Duac, Acanya) and erythromycin with benzoyl peroxide (Benzamycin).
Salicylic acid and azelaic acid
Purpose: Azelaic acid is a naturally occurring acid with antibacterial properties. Often used as an alternative acne treatment. Gets rid of dead skin and kills bacteria. Even more effective when used in combination with erythromycin.
Brand names: Azelex, Finacea
Dapsone
Purpose: Often recommended for inflammatory acne
Brand name: Dapsone (Aczone)
Now, we’ll look at RX oral medication:
Antibiotics
Purpose: Kill bacteria on your skin and reduce on inflammation. Particularly good for inflammatory acne i.e. tender red bumps and pus-filled whiteheads.
Brand names: Doxycycline, Clindamycin and erythromycin.
Oral contraceptives
Purpose: Birth control pills have been used by women to clear up problem skin. Pills that contain both estrogen and progestin are often prescribed.
Brand names: Ortho Tri-Cyclen and Yaz.
Spironolactone
Purpose: This anti-androgen medication is another hormonal option for women. Created as a blood pressure pill, it stops your hormones from making too much oil.
Isotretinoin
Purpose: This powerful medication is used for cystic acne or acne that scars. However, it needs careful supervision due to its numerous side effects.
Brand names: Amnesteem, Claravis, Sotret
What alternative therapies exist?
Lasers and photodynamic therapy: Light is applied to the skin to try to improve the symptoms of acne. Further research is needed to determine the ideal method, light source, and dose.
Chemical peel: A chemical solution (such as salicylic acid, glycolic acid or retinoic acid) is applied to the face to peel off top layers of skin and encourage regrowth. This is a short term solution so repeat treatments are usually needed.
Comedone extraction: Your doctor may use special tools to gently remove whiteheads and blackheads that haven’t cleared up with topical medications.
Steroid injection: Nodular and cystic lesions can be treated by injecting a steroid drug directly into them. This therapy has resulted in rapid improvement and decreased pain. Side effects may include thinning in the treated area.
