Types of Medication for Acne

Acne refers to a common skin condition when the hair follicles get plugged with oil and dead skin cells. These blockages can lead to whiteheads, blackheads, nodules, and other types of pimples. It mostly affects the face, back, and chest. Approximately 80 percent of people aged between 11 and 30 years will have a mild form of acne. 

Acne can be caused by increased production of the androgen hormone. Acne is a combination of these factors:

• Sensitivity to androgen hormones
• Surface bacteria on the skin
• Fatty acids within oil glands

Topical and oral medications are commonly used to treat acne. Some of the commonly used topical medications include:

• Retinoids and retinoid-like drugs: These drugs are useful for clogged pores and blackheads. Some examples include:
  • Tretinoin
  • Adapalene
  • Tazarotene
• Antibiotics: These drugs work by killing excess skin bacteria and reducing redness and inflammation. These antibiotics are usually combined with benzoyl peroxide to prevent antibiotic resistance. Some antibiotics commonly used in combination with benzoyl peroxide include:
  • Clindamycin
  • Erythromycin
• Azelaic acid and salicylic acid: Azelaic acid is a naturally occurring acid produced by yeast. It can also remove blemishes associated with acne. Salicylic acid may be beneficial against plugged hair follicles. Salicylic acid may prevent plugged hair follicles. 
• Dapsone: It is recommended for inflammatory acne in women.
• Clascoterone

Some of the commonly used oral medications for acne treatment include:

• Antibiotics: Oral antibiotics may be recommended for moderate to severe acne for a short time. Tetracyclines or macrolides are commonly given as oral antibiotics. Some examples include:
  • Minocycline
  • Doxycycline
  • Erythromycin
  • Azithromycin
• Combined oral contraceptives: These drugs consist of estrogen and progestin. Some examples include:
  • Ortho Tri-Cyclen 21
  • Yaz
• Spironolactone: It blocks the effect of androgen hormones on the oil-producing glands. This drug is considered for women and adolescent girls if oral antibiotics aren’t working.
• Isotretinoin: It is a derivative of vitamin A and may be prescribed when other treatments have failed to treat acne.

Topical medicines that contain benzoyl peroxide are usually recommended for mild to moderate acne. For moderate to severe acne, it is best to consult your dermatologist for the best medication. Your dermatologist would prescribe the best possible medication based on the severity of the acne.

Common side effects of topical acne drugs include:

• Sensitivity to the sun
• Irritation
• Dry skin
• Redness

Common side effects of oral antibiotics include:

• Upset stomach
• Dizziness
• Light-headedness

Common side effects of combined oral contraceptives include:

• Weight gain
• Breast tenderness
• Nausea

Common side effects of spironolactone include:

• Breast tenderness
• Painful periods

Common side effects of isotretinoin include:

• Inflammatory bowel disease
• Depression
• Severe birth defects

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to the FDA at 1-800-FDA-1088.

Topical medications that are safe during pregnancy include medications that consist of the following:

• Erythromycin
• Clindamycin
• Benzoyl peroxide
• Azelaic acid

Other topical medications may get absorbed into the skin even if it’s small. Hence, consult your doctor before applying any medicine to the skin for acne.

Oral isotretinoin is known to cause birth defects and must be avoided during pregnancy.

Alcohol consumption should be avoided while taking oral medications such as isotretinoin and spironolactone. Isotretinoin when combined with alcohol can lead to the following side effects:

• Fast heart rate
• Flushing
• A tingly feeling
• Nausea
• Vomiting

Combining spironolactone and alcohol can cause these side effects:

• Declined blood pressure
• Headache
• Dizziness
• Fainting
• Light-headedness

Oral antibiotics when combined with alcohol do not cause any significant side effects. However, heavy drinking can lower the effectiveness of doxycycline.