For many people, acne can be treated by leaving the area alone or using over-the-counter remedies, such as salicylic acid. When acne grows in severity and becomes inflamed or infected, prescription medications may be required for adequate treatment. When this is the case, there are five main prescriptions that doctors most commonly prescribe.
Prescription retinoids are derived from vitamin A and are one of the most common prescription medicines for acne treatment. According to the American Academy of Dermatology, the retinoid tretinoin is the most effective acne treatment available due to its abilities to treat all four of the main contributing factors of acne development. These factors are irregular skin shedding, inflammation, bacteria and sebum oil production.
Antimicrobials are also a common prescription for the treatment of acne. Antimicrobials, such as azelaic acid and benzoyl peroxide, work by targeting and killing one bacteria that is commonly associated with severe acne breakouts called Propionibacterium acnes, or P. acnes. Azelaic acid has the added benefit of also helping relieve inflammation in more severe inflammatory acne such as cysts or nodules.
Antibiotics are also prescribed for acne treatment. Antibiotics may be used orally or topically, and commonly include erythromycin and tetracycline. Antibiotics work by also targeting and killing the P. acnes bacteria in inflammatory acne. According to the American Academy of Dermatology, antibiotics are often combined with other antimicrobials to help prevent antibiotic resistance of the bacteria to the medication.
Contraceptives are also commonly prescribed for the treatment of acne, more specifically for women. Although contraceptives are marketed for birth control, the same medications help control the overproduction of sebum oil in the skin. Excess sebum combines with dead skin cells to form plugs in the pores of the skin, resulting in acne.
Corticosteroids are a common prescription for acne that has progressed to seriously inflamed acne nodules or cysts. As the inflammation builds, so does the pressure behind the acne nodule or cyst, which eventually can cause them to burst. This leads to acne scarring. Corticosteroids are injected directly into the acne lesion to reduce the inflammation and pressure to prevent this from occurring.