Prescription Acne Treatment Options

Topical prescriptions and oral antibiotics

Finding the right prescription acne treatment can take a bit of research. Some prescriptions work better than others. Sometimes individuals react badly to more powerful treatments and have to change their prescriptions to gentler, but less effective ones.

Prescriptions will vary depending on your skin type and severity of acne.

Topical Retinoids (Creams, Ointments)

Topical retinoids are prescription acne treatment derived from vitamin A or retinol. They are used to treat a variety of skin disorders and not just acne. Retinoids are great for whiteheads, blackheads, and inflammatory acne, and are highly regarded by dermatologists.

Essentially retinoids work by fixing abnormal skin cells. They work to make sure cells don’t clump together and build up in the follicle.

While using this prescription acne treatment, however, you might feel some irritation and peeling, which are the common side effects. You should avoid all other acne creams while using retinoids and make sure you wear sunscreen. Also be aware that you may experience a breakout in the earlier weeks before your acne starts to improve.

Tretinoin

Tretinoin comes in different forms like creams, gels, or microcapsules. It is also known as retinoic acid. Besides being used to treat acne, it make the complexion more smooth and counters aging effects in the skin.

There are 2 things to watch out for when using this retinoid. The sun and benzoyl peroxide (BP). Exposure to the sun will lessen the effect of tretinoin, and therefore using it in the evenings is best. BP deactivates tretinoin, so don’t use them both at the same time.

Adapalene and Tazarotene

Adapalene and tazarotene are both synthetic retinoids (they behave like retinoids).

Adapalene is a prescription acne treatment that is easy on the skin and comfortably worn under makeup. However, it doesn’t fight the effects of the sun like Tretinoin.

Tazarotene works faster than tretinoin or adapalene, and also fights sun damage. However, it can irritate the skin.

Oral Retinoids

Accutane, also known as isotretinoin or roaccutane, is an oral retinoid – a drug derived from vitamin A as well. It is a very powerful, but controversial drug that has received much attention and discussion for being the biggest breakthrough in prescription acne treatment history.

Click on the Accutane link above if you want to know more about the pros and cons of this drug, and how it works.

Oral Antibiotics

Oral antibiotics are prescription acne treatments that kill acne bacteria (P. acnes) and control inflammation.

Personally, I am not a fan of oral antibiotics because after awhile, the bacteria mutate and become resistant to the current dose. Then you need to increase your dose.

Oral antibiotics can generally be classified into 2 groups: the tetracyclines and macrolides.

Tetracycline

Tetracycline is a prescription acne treatment that is effective and affordable, but inconvenient with side effects.

Some of the limitations of this antibiotic are that it has to be taken many times a day on an empty stomache. Furthermore, it has side effects like making your skin more vulnerable to sunlight, interfering with oral contraceptives, or affecting unborn babies.

Doxycycline

Doxycycline is a second-generation tetracycline that is more expensive, but much more convenient to use than tetracycline. This antibiotic can be taken with food.

Minocycline

Minocycline is also a second-generation tetracycline that is considered the most effective of all the oral antibiotics. It kills bacteria quickly, and they don’t seem to build a resistance to it as much as the other antibiotics.

Erythromycin

Erythromycin is a macrolide antibiotic which is used as an alternative to tetracylines. It isn’t as effective against acne bacteria, but is safer to use during pregnancy or breastfeeding.

Topical Antibiotics

Topical antibiotics are generally less effective than oral antibiotics. Bacteria are even more likely to build resistance against them.

Clindamycin

Clindamycin is prescribed the most and can be worn comfortably under makeup.

Erythromycin

This prescription antibiotic is more affordable than the above, but bacteria adjust to it more quickly.

Tetracycline

This antibiotic in topical form is found ineffective so far.

Prescription Topicals

Benzoyl Peroxide/combos

Benzoyl peroxide is not only available over-the-counter, but is also prescribed in various cleansers, lotions or gel forms through your dermatologist.

BP is effective by itself, but is even more powerful in combination with other antibiotics.

Other Prescription Acne Treatment

Azelaic Acid

This prescription acne treatment is extremely gentle on sensitive skin, but is not nearly as effective as harsher treatments like benzoyl peroxide. It generally slows inflammation and the growth of acne bacteria.

Sodium Sulfecetimide

This prescription is good for those with sensitive skin. It reduces acne by preventing the growth of acne bacteria.

Metronidozole

This prescription fights infections and is supposed to be fairly gentle on the skin.

Nicotinamide

Nicotinamide is derived from vitamin B complex. It is an anti-inflammatory agent and has been proven useful against acne.

Sulfones

These are meant to be used on severe acne conditions. Sulfones (eg. Dapsone) have anti-inflammatory effects and fight acne bacteria. These are quite powerful and can be toxic. Dapsone is a sulfone that is not FDA approved.

Source: Preston, Lydia. Breaking Out. New York: Fireside, 2004.

As you can see, there are several options available to you. At the end of the day, after talking to your dermatologist, you’ll need to choose just 1 prescription acne treatment to start with (if over-the-counter products just aren’t cutting it for you).

It all depends on your type of acne, your body, and your comfort level with various treatments. If you need some help with your decision you may want to look at the acne guide to rid acne on this site which provides a step-by-step plan to choosing the best acne treatment for you.

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