There are many treatment options available for the treatment of acne. Moderate-to-severe or treatment-resistant acne can often be treated with prescription medications. Some medications come in the form of oral pills versus topical products. Treatments reduce oil production, speed up skin cell turnover, kill bacteria or fight inflammation. Treatment can often be a combination of oral and topical medications for maximum efficiency.
Antibiotics
Oral antibiotics target P. acnes---which is one cause of acne---and work to reduce associated inflammation. Erythromycin, amoxicillin, sulfa, cefadroxil and the "cyclines"---tetracycline, doxycycline and minocycline---are the antibiotics that are generally prescribed. Mayo Clinic states that antibiotic resistance has increased significantly as antibiotics were first used to treat acne. Antibiotics are generally given for six months or less or as soon as symptoms begin to improve. Antibiotics are often used in conjunction with a topical medication. Side effects include upset stomach, dizziness, skin discoloration and increased sun sensitivity. Antibiotics may reduce the effectiveness of birth control pills as well.
Accutane
Accutane---or isotretinoin---is prescribed for severe cystic acne that has not responded to previous treatments. Due to the risk of serious side effects, patients who take Accutane need to be closely monitored. The FDA has implemented a monitoring program for women of child-bearing age to participate in, due to the risk of severe birth defects. Women should not get pregnant while on Accutane. Side effects of Accutane include dry eyes, mouth, lips, nose and skin, itching, nosebleeds, muscle aches, sun sensitivity and poor night vision. Accutane also may increase risk of depression and suicide.
Birth Control
Birth control pills are an option for women to consider. Birth control pills containing norgestimate and ethinyl estradiol are often prescribed. The American Academy of Dermatology states that oral contraceptives can effectively clear acne in women by suppressing the overactive sebaceous glands. This is a long-term treatment option. Women who smoke, have a blood-clotting disorder, are over the age of 35 or suffer from migraines should seek the advice of a medical professional before considering this option. Side effects include headaches, breast tenderness, nausea and depression. Mayo Clinic also states there is a slightly increased risk of heart disease, high blood pressure and blood clots.
Spironolactone
Spironolactone is a prescription medication that blocks the androgen---male hormone---receptors. Women who suffer from hormonal imbalance can consider this treatment option. Side effects include breast tenderness, menstrual irregularities and increased potassium levels.
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