Prescription Medications for Acne

If over-the-counter acne treatments are not clearing up your acne, you may want to consult a healthcare provider about stronger prescription medications for acne. These prescription acne medications can include retinoids, benzoyl peroxide products and antibiotics.

Topical Acne Medication

In some cases, prescription acne medication is applied to the skin. These medications include:

• Antibiotics. Antibiotic ointments kill bacteria and reduce inflammation. Usually used for mild to moderate acne, topical antibiotics include clindamycin, erythromycin, and sodium sulfacetamide.
• Benzoyl peroxide products. Benzoyl peroxide is common in over-the-counter acne medication but is also available in stronger, prescription benzoyl peroxide products. Benzoyl peroxide products kill acne-causing bacteria and remove dead cells from the skin.
• Retinoids. Topical retinoid medications are vitamin A derivatives that work by unclogging pores and reducing inflammation. These products include tretinoin (Avita®, Retin-A Micro®, Renova®), adapalene (Differin®) and tazarotene (Tazorac®). They do have potential side effects, including redness, peeling and increased sensitivity to the sun. Pregnant women should avoid topical retinoids.

Oral Antibiotics

For moderate to severe acne, your healthcare provider may prescribe oral antibiotics. Erythromycin and tetracycline may be prescribed. Children under the age of eight and women who are pregnant or breastfeeding should not take tetracycline.

Accutane® for Severe Acne

Another prescription drug, which is reserved for severe, inflammatory acne, is the oral retinoid isotretinoin (Accutane®). According to the American Academy of Dermatology (2010b), Accutane® treats the four major causes of acne:

• Clogged pores
• Excessive production of oil
• Inflammation
• "P. acnes" bacteria.

However, Accutane® has potentially serious side effects, including serious birth defects if a woman becomes pregnant while taking the drug. The U.S. Food and Drug Administration (FDA) requires that women taking the drug have regular pregnancy tests and take prescription birth control.

Accutane® has also been linked to reports of suicidal thoughts and actions. The FDA (2010) issues the following warning: "Isotretinoin is a potentially dangerous prescription medicine that should only be taken under the close supervision of your healthcare professional and pharmacist."

Because of these serious side effects, the FDA approved it for marketing only under a special restricted distribution program. Therefore, it should not be purchased on the internet. Generic versions of Accutane (Amnesteem®, Claravis™, and Sotret) are included in the warning and restricted marketing program.

Birth Control Pills

Oral contraceptives can improve acne in women, especially women who develop acne mainly around their menstrual period. Birth control pills seem to slow down overactive oil glands in the skin. However, birth control pills can have other side effects, and women who are older than 35, smoke or have a history of blood clots or migraine headaches shouldn't take birth control pills.

Discuss all the options with your healthcare provider to choose the best acne medication for you.

Resources

American Academy of Dermatology. (2010a). Prescription medications for treating acne. Retrieved November 29, 2010, from http://www.skincarephysicians.com/acnenet/prescriptmeds.html

American Academy of Dermatology. (2010b). Treating severe acne. Retrieved November 29, 2010, from http://www.skincarephysicians.com/acnenet/treatsevereacne.html#3

University of Maryland Medical Center. (2008). Acne. Retrieved November 29, 2010, from http://www.umm.edu/altmed/articles/acne-000001.htm

U.S. Food and Drug Administration. (2010). Isotretinoin (marketed as Accutane) capsule information. Retrieved November 29, 2010, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm094305.htm

Office on Women's Health. (2009). Acne. Retrieved November 29, 2010, from http://www.womenshealth.gov/faq/acne.cfm