Acne is a condition in which pimples form on the skin, generally on the face, back or shoulders. There are a number of internal treatments for acne, some of which include antibiotics and retinoids, like isotretinoin.
Types
Internal acne medications are categorized as either antibiotic or non-antibiotic. Antibiotics commonly used for acne include tetracycline derivatives, erythromycin and sodium sulfacetamide, although amoxicillin and clindamycin are also used. Some of these medications, such as erythromycin and tetracycline, may be taken internally as well as applied topically for their healing effects.
Non-antibiotic medications include isotretinoin (Accutane), oral contraceptives and the mineral zinc.
Uses and Indications
Antibiotics, like tetracycline and erythromycin, are generally prescribed for inflammatory acne caused by P. acnes bacteria, while isotretinoin is reserved for severe acne types like acne vulgaris, acne conglobata and acne fulminans. Isotretinoin is a retinoid (derivative of vitamin A) that is extremely effective for treating nodular acne. According to Acne.org, it has a 95 percent efficacy rate for patients who complete at least one cycle of the medication. For acne caused by oily skin in women, oral contraceptives may be prescribed to correct hormonal factors that trigger excess oil production.
The tetracycline derivatives doxycycline and minocycline are among common antibiotics for inflammatory acne. When these are ineffective, erythromycin may be prescribed. Isotretinoin is effective for both inflammatory and non-inflammatory types of acne, but is generally reserved as a last line of treatment due to the associated risk of severe side effects.
Function
Isotretinoin is unique in that it alters DNA transcription and prevents stickiness of dead skin cells, resulting in decreased acne formation and prevention of reformation. Antibiotics kill or reduce P. acnes bacteria in the skin, thereby easing inflammation. Oral contraceptives work by suppressing overactive sebaceous glands responsible for oil production, while the mineral zinc can help aid in skin healing, according to Mayo Clinic.
Side Effects
All acne treatments can cause side effects, although not all patients will experience them. Common side effects of antibiotics include diarrhea, nausea and dizziness, while oral contraceptives can cause weight gain, nausea and vaginal discharge, according to Medline Plus. Isotretinoin has the most extensive side effect profile, with adverse effects including depression, hallucinations and suicidal thoughts, according to Drugs.com.
Warning
If you experience thoughts of suicide or self harm while taking isotretinoin, seek immediate medical attention. Isotretinoin is a Category X drug that is available only through the iPledge program, which requires patients to use birth control to prevent pregnancy. Even one dose of isotretinoin can cause fatal birth defects in the developing fetus, according to Drugs.com.
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