Topical Vs. Oral Treatment For Acne

Acne can be a frustrating skin condition, especially for teenagers and young adults. Fortunately, a variety of treatments are available. Consult with your family physician or dermatologist to determine which treatment is best for you. While topical treatments can provide moderate relief for acne, they can cause skin irritation and burning. By contrast, medications taken orally are often more effective at treating the condition, but they can cause side effects that may involve internal organs.

Topical Benzoyl Peroxide

Benzoyl peroxide is the most commonly used treatment for acne, and it is only used topically. Dermatologists recommend starting with lower doses and gradually increasing them to 10-percent strength. Benzoyl peroxide is highly effective and is thought to have an antibacterial action. However, it can cause skin dryness and irritation.

Topical Antibiotics

Antibiotics can be applied to the skin. Physicians believe topical antibiotics act against the bacteria Propionibacterium acnes. Commonly prescribed antibiotics are clindamycin and erythromycin. Antibiotic creams are typically applied twice a day. Patients generally have few side effects with these medications, though clindamycin may cause drying, scaling and peeling of the skin.

Topical Vitamins

Topical vitamins can be used for acne. These are typically synthetic derivatives of Vitamin A, which acts by stimulating the skin's epithelial cells to mature.The most commonly prescribed agents are tretinoin, adapalene and isotretinoin. These treatments can be applied as a lotion, cream or gel. People using these medications may have skin irritation or even a rash following prolonged exposure to sunlight. A small amount of these vitamins can be absorbed through the skin into the body. This fact is especially important to women of reproductive age -- even these small quantities of medicine can cause birth defects.

Oral Antibiotics

Oral antibiotics are prescribed for acne that is widespread, severe, or that does not respond to local treatment. The most commonly prescribed antibiotics are tetracyclines, such as oxytetracycline, minocycline and doxycycline. These medications can cause side effects such as birth defects or a skin rash following exposure to sunlight. These medications should be taken on an empty stomach. Erythromycin can also be taken orally to treat acne, though it is less effective. Though oral antibiotics are more effective against acne, they take a long time to act: people usually need to take treatments for 6 to 8 weeks before they show improvement.

Oral Contraceptive Pills

Oral contraceptive pills, which usually contain a low dose of estrogen and progesterone, can be a valuable aid in treating women with acne. These medications act by lowering the levels of male sex hormones, or androgens, that are implicated in acne. These can be taken in addition to local creams for maximal effect.

Isotretinoin

Isotretinoin, the Vitamin A analogue discussed above, can also be taken orally. This is probably the single most effective medication for treating acne. According to "American Family Physician," it is the only medication which can can prevent acne long after the drug is taken. Importantly, isotretinoin is very toxic to a fetus and is associated with birth defects. Dermatologists typically require women taking it to use two types of contraception to avoid pregnancy. Isotretinoin can also cause hepatitis, a raised lipid profile, joint and muscle pain, and night blindness. Because of these complications, isotretinoin is reserved for only the most severe cases of acne.