Overview
Acne is one of the most common skin problems that people of all ages face. Though acne may be more prevalent during the transitory teen years, it can also strike adults. Treatment options vary depending on the severity of the acne, and you should discuss them with a dermatologist before making a choice.
Oral Antibiotics and Retinoids
There are two categories of acne treatment medicines: prescription and over-the-counter. Oral antibiotics fall into the former category, and are prescribed for people suffering from moderate to severe acne. These antibiotics work from within the body to target the P. acnes bacteria that is the main cause of inflammatory acne. The most potent oral antibiotics are erythromycin, tetracycline, doxycycline and minocycline.
If antibiotics don’t work, which usually happens when the bacteria become resistant to the medicine, your dermatologist may prescribe oral retinoids. Isotretinoin, better known as Accutane, is a very powerful oral retinoid that treats large, painful cysts. You must use isotretinoin with caution, and preferably under the supervision of a dermatologist.
Topical Antimicrobials
Topical antimicrobials also work by reducing the P. acnes bacteria population in the skin, thereby relieving inflammation and redness. Depending on your needs, you may use them alone or in conjunction with another type of medication. These topical medications are very effective if you have mild to moderate acne. Azelaic acid, benzoyl peroxide, clindamycin, topical erythromycin and sodium sulfacetamide all fall under the category of topical antimicrobials.
Topical Retinoids and Corticosteroid Injections
Retinoids are derived from vitamin A and used to treat mild to moderate acne. They work by unclogging pores and preventing clogged pores from becoming infected and inflamed. They also treat and prevent comedogenic acne such as blackheads and whiteheads. Topical retinoids that dermatologists most often prescribe are adapalene, tretinoin and tazarotene.
Corticosteroid injections are used to treat highly inflamed cystic acne nodules. These injections work by healing the lesion and reducing inflammation in about 3 to 5 days. Dermatologists may recommend corticosteroid injections if the cysts are very large, painful or in danger of bursting. Very large and painful cysts may also lead to scarring if not dealt with effectively.
Over-The-Counter Acne Medicine
Acne medicine available without a prescription usually contains small percentages of acne-fighting ingredients such as benzoyl peroxide, salicylic acid, sulfur, lactic acid and resorcinol. You apply these over-the-counter medications topically, and they are best for the treatment of mild acne. The amount of the acne-fighting ingredient in most over-the-counter acne lotions and gels is too small to have any significant effect on more severe types of acne.
Considerations
Erythromycin may cause irritation of the gastrointestinal tract. Tetracycline and isotretinoin have been known to cause birth defects in unborn babies, and should not be used by pregnant women. Isotretinoin may also cause muscle aches, sun sensitivity, poor night vision and itching.
Side effects for topical antimicrobials include skin irritation, dryness, peeling and redness.
For topical retinoids, side effects include skin irritation, sun sensitivity and redness. Tazarotene, in particular, has been known to produce birth defects, and should not be used by pregnant women or women who plan on becoming pregnant.
If increased irritation or complications develop, discontinue use of these medications and contact your dermatologist immediately.
