Most cases of acne respond to an over-the-counter product, such as salicylic acid; however, more chronic or inflamed cases of acne may require prescription medications. These medications are especially important for acne breakouts that have become infected with bacteria, such as with Propionibacterium acnes (P. acnes). Acne prescriptions may vary, or may even be combined, depending on what type of acne your are currently facing.
Salicylic Acid
Topical medications with salicylic acid are the first line of treatment when an acne outbreak occurs. Designed more for non-inflammatory acne (such as blackheads) salicylic acid works as a beta hydroxy acid, which breaks down acne comedones and softens keratin proteins that make up the skin. It also helps prevent acne by correcting irregular skin cell shedding.
Erythromycin
Erythromycin is an antibiotic that is commonly used both topically and orally to treat acne breakouts. Erythromycin specifically targets and kills colonies of the Propionibacterium acnes bacteria, which are believed to contribute to the formation of infected and inflammatory acne (such as acne nodules and cysts). According to the New Zealand Dermatological Society, erythromycin is typically combined with antimicrobials, such as benzoyl peroxide, to both increase the effectiveness of the antibiotic, as well as help prevent resistance of the bacteria to the antibiotic.
Benzoyl Peroxide
Benzoyl peroxide is an antimicrobial medication also used to treat acne. The Propionibacterium acnes associated with acne is unable to survive in oxygen-rich environments. Benzoyl peroxide penetrates clogged pores and introduces oxygen into the pores, which kills off the acne bacteria.
Isotretinoin
Isotretinoin is a key medication for the treatment of acne. Derived from vitamin A, this retinoid is believed to be the most effective treatment for acne, as it addresses all four main contributing factors to acne development, according to the New Zealand Dermatological Society. These factors are sebum oil production, irregular skin cell shedding, inflammation and the bacteria P. acnes. This treatment also comes with some of the most serious side effects. In fact, the Food and Drug Administration (FDA) has developed the iPLEDGE monitoring program specifically for isotretinoin to prevent the serious birth defects that can occur if used by pregnant women.
Corticosteroids
Corticosteroids are medications that can be used to treat the inflammation associated with severe acne outbreaks (such as acne cysts or nodules). Corticosteroids are directly injected into inflamed acne lesions, which relieve the inflammation and pressure building beneath. If pressure continues to build up in acne cysts or nodules, the lesion can burst, resulting in tissue damage and acne scarring.
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