Acne is a condition involving the formation of blemishes on the skin. It can range in severity from mild to disfiguring and may be caused by a variety of factors such as bacteria, buildup of dead skin cells and excessive oil on the skin. Prescription acne medications include topical and systemic drugs such as oral contraceptives, antibiotics and isotretinoin.
Isotretinoin
Isotretinoin (Accutane/Roaccutane) is a prescription acne medication derived from vitamin A. It is used to treat severe nodular acne and is effective in clearing or reducing acne in 95 percent of patients, according to Acne.org.
Side effects of isotretinoin can be severe, making it a poor first-line treatment for mild-to-moderate acne. According to Drug Information Online, isotretinoin may cause psychological side effects including depression, unprovoked crying and suicidal ideation. Because it is harmful to fetuses, isotretinoin is available only through the iPledge program, which requires patients who take the drug to use birth control to prevent pregnancy.
Tetracyclines
Tetracycline is an oral antibiotic used to treat inflammatory acne. Tetracycline derivatives such as minocycline and doxycycline are effective in treating inflammatory papules and pustules. They work by killing P. acnes bacteria, which leads to reduced inflammation of the skin.
According to the American Academy of Dermatology, minocycline is helpful for treating acne that responds poorly to other antibiotics and may be less likely to cause to bacterial resistance over time. Side effects of tetracycline derivatives include skeletal birth defects, sun sensitivity and staining of teeth in children under 8.
Erythromycin
Erythromycin is a broad-spectrum antibiotic that can be used both orally and topically to treat acne. Erythromycin works by killing P. acnes and other skin bacteria that contribute to the formation of inflammatory acne. It may be especially effective when combined with the over-the-counter medicine benzoyl peroxide, which also has anti-microbial properties.
Taken orally, erythromycin can cause gastrointestinal irritation in the form of nausea and diarrhea, while topical use may lead to skin dryness, irritation and itching.
Sodium Sulfacetamide
Sodium sulfacetamide is a sulfa drug prescribed to treat inflammatory acne. It works by killing P. acnes bacteria and unclogging pores, resulting in less debris and buildup on the skin's surface. Sodium sulfacetamide is a topical medication with side effects including skin irritation in the form of stinging, redness or a burning sensation.
Oral Contraceptives
In some instances, oral contraceptives can help treat acne caused by hormonal triggers in women. Oral contraceptives inhibit hormones that lead to excess oil production by the sebaceous glands, which is a causative factor in many types of acne.
According to the Mayo Clinic, oral contraceptives can increase the risk for stroke and other cardiovascular problems. Women with a history of blood clotting disorders, cardiovascular disease or other serious health conditions should consult a gynecologist before taking oral contraceptives to treat acne.
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