Prescription medications

What is it:

Made under the brand name "Differin," it is a topical retinoid gel which is applied once a day.^1-2 It comes in .1% and .3% strength.

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Exposure to sunlight should be minimized.^1-2

About 10-40% of patients experience redness, dryness, scaling, burning, or itchiness. Other adverse reactions were also reported.^1-2,4

Brand names:

What is it:

Made under the brand name "Azelex." Azelex is a cream containing 20% azelaic acid, a naturally occuring acid found in whole grain cereals and animal products. It is normally applied twice daily.⁵

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people.

There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.⁵

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What it is:

Benzoyl peroxide is available in prescription and over-the-counter medications, in cream, gel, and wash form. It is an anti-bacterial agent.^7-8,10-11

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Some dryness, redness, and itchiness is to be expected in the first few weeks of use.¹² Scientists calls this initial period the "hardening effect" of benzoyl peroxide.

About 1-3% of people are allergic to benzoyl peroxide and experience an inflammation of the skin or severe crusting.⁹ This should not be confused with the "hardening effect" of benzoyl peroxide.

Benzoyl peroxide, like any other peroxide, can bleach hair and fabric.⁷

Prescription names:

What it is:

Clindamycin is a topical antibiotic which usually comes in a solution, gel, foam, or lotion, and is normally applied twice daily.^17-18

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Burning, itching, peeling, redness, and dryness are the most reported side effects, particularly at the onset of treatment.^17,19

Diarrhea, bloody diarrhea, and inflammation of the colon have been reported.^17,19

Brand names:

What it is:

Made under the brand name "Aczone." Aczone is a 5% topical gel which is normally applied twice daily.

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Brand names:

What it is:

Erythromycin is a topical antibiotic packaged in gel, ointment, pledgets (little take-along packets), and solutions, and is usually applied twice a day.⁸ It is often combined with benzoyl peroxide.

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Ask your doctor before using any other products on your skin while using erythromycin, as it may be too irritating. This includes other prescriptions, over-the-counter medicines (including those listed on this site), and harsh or abrasive cleansers, perfumes, or make-up.²³

People report burning as the most frequent side effect, and also peeling, dryness, itching, redness, and oiliness, among others.²³

Brand names:

What it is:

Originally under the brand name "Accutane" but now available only in generic form, isotretinoin is a derivative of vitamin A taken in pill form for 15-20 weeks. Doctors normally prescribe it for people with "severe nodular acne" that does not respond to other treatments. Nodules are inflammatory lesions with a diameter of 5mm or more. A single course of 15-20 weeks has been shown to result in complete clearing and long-term remission of acne in many people.^24-25

(Learn more on the accutane page of acne.org)

What it does:

Reduces the amount of oil produced by the oil glands.²⁴

Considerations:

THERE IS AN EXTREMELY HIGH RISK THAT A DEFORMED INFANT CAN RESULT IF PREGNANCY OCCURS WHILE TAKING ACCUTANE IN ANY AMOUNT AND EVEN FOR SHORT PERIODS OF TIME. FEMALES WHO ARE PREGNANT OR WHO MAY BECOME PREGNANT WHILE UNDERGOING TREATMENT SHOULD NOT TAKE ACCUTANE. There are many other warnings as well.^24-26

Side effects of Accutane are many, some of which include dry and cracked lips, dry skin, dry nose and mouth, mild to moderate muscle or joint aches.^24-25,27-30

Brand names:

What it is:

Oral antibiotics are taken in pill form usually once per day.

What it does:

Considerations:

Some antibiotics cause increased sensitivity to sunlight. Exposure to the sun could cause a rash, itchiness, or redness, and you may be burnt more easily, so you'll want to wear protective clothing and sunscreen.³²

Side effects may include upset stomach, diarrhea, nausea, headache, vomiting, dizziness, or light-headedness as your body becomes accustomed to it.³²

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What it is:

Birth control pills contains progesterone and estrogen.^33-34

(Learn more)

What it does:

Considerations:

Cigarette smoking with oral contraceptive use increases the risk of serious heart disease.³³

There are many negative side effects and poistive side effects to taking birth control pills for acne. Talk to your doctor to decide if it is right for you.^8,33-34

While it is a widely held belief, evidence does not show a correlation between pregnancy rates and concurrent administration of birth control pills and oral antibiotics. [With the exception of anti-tuberculosis drugs like rifampin.]

Brand names:

What it is:

Sodium Sulfacetamide is a "sulfonamide," which was a wonder drug before other antibiotics and penicillin came into existence. It is still used for its antibacterial activity. It is used topically on the skin.^34,36

(Learn more from Wikipedia)

What it does:

Considerations:

People have died due to severe reactions to sulfonamides, although rarely.³⁷

Side effects in clinical trials were experienced by less than 2% of patients, and include irritation, stinging and burning.³⁷

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What it is:

Spironolactone is a prescription medication in tablet form used to treat certain patients with hyperaldosteronism (the body produces too much aldosterone, a naturally occurring hormone), low potassium levels, and in patients with edema (fluid retention) caused by various conditions.³⁸

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Brand names:

What it is:

Made under the brand name "Tazorac." Tazorac is a retinoid gel that contains tazarotene, a vitamin A derivative, in 0.05% or 0.1% concentration and is usually applied to the skin once per day. It is used for both psoriasis and acne.⁴⁰

(Learn more from Wikipedia)

What it does:

Considerations:

Because tazarotene is a retinoid (vitamin A derivative), like Accutane, it should not be used by women who are pregnant because of potential harm to the fetus.

Exposure to sunlight should be avoided. Wind or cold may be more irritating when taking tazarotene.

Side effects occured in 10-30% of patients and included dry peeling skin, burning, stinging, dry skin, redness, and itchiness.

Brand names:

What it is:

You may have heard of tretinoin in reference to "Retin-A" wrinkle treatments. Tretinoin is retinoic acid and vitamin A acid combined, and comes in various strengths in creams, gels, and liquids for topical use on the skin. It is used to treat acne and also to treat sun damaged skin or wrinkles and is usually applied once per day.⁴⁶

(Learn more from the U.S. National Library of Medicine)

What it does:

Considerations:

Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no science evidence to back this up. You should not expect an initial worsening of acne.⁴⁸

Exposure to sunlight should be minimized as you may be more sensitive to its rays.

Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason.

Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.

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