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Prescription Medications for Treating Acne

A variety of prescription medications are used today to clear acne. Topical (applied to the skin) medications may be prescribed for mild to severe acne. Systemic (works internally) therapy is needed to treat severe acne and may be used for moderate cases. These medications, which play an important role in acne treatment, attack the different factors that lead to acne. To achieve long-term control and resolution, dermatologists may combine therapies. The following prescription medications to treat acne:-

Benzoyl Peroxide

Benzoyl peroxide (BEN-zoe-ill per-OX-ide) is used to treat acne. Benzoyl Peroxide can be very effective in treating mild cases of non-inflammatory acne. It's safe for children as well as adults, and may combined with other topical or oral treatments. 

Benzoyl peroxide works by destroying P. acnes, the bacteria that causes the condition acne. It acts as an antiseptic and oxidizing agent, reducing the number of comedones, or blocked pores. It may be 2-3 weeks before you begin to see improvement.

Benzoyl peroxide comes in cleansing liquid or bar, lotion, cream, and gel for use on the skin. Benzoyl peroxide usually is used one or two times daily. Start with once daily to see how your skin reacts to this medication. Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use benzoyl peroxide exactly as directed. Do not use more or less of it or use it more often than directed by your doctor.

Retinoids

Retinoids work by unclogging pores and reducing inflammation. These medications come in prescription form only. Commonly prescribed retinoids include tretinoin, adapalene, and tazarotene. They are intended for individuals with significant numbers of both open and closed comedones as well as papules and pustules. Side effects may include redness, peeling, and photosensitivity (high risk of sunburn). Most retinoids are applied at night and should not be applied at the same time as benzoyl peroxide (with the exception of adapalene). Topical retinoids should not be used during pregnancy as they may cause harm to the fetus.

Azelaic acid

Naturally occurring in the skin, azelaic acid is used to treat mild to moderate inflammatory and non-inflammatory acne. It is believed that azelaic acid clears acne by reducing the populations of P. acnes , decreasing the abnormal shedding of skin cells and reducing inflammation. This medication has also proven effective in treating the dark spots that develop in some acne patients with skin of color. Azaleic acid is well tolerated by most people and can be safely used for years. Side effects may include skin dryness and lightening of the skin where applied.

Antibiotics

Antibiotics work by several mechanisms. The most important is the decrease in the number of bacteria in and around the follicle. Antibiotics also work by reducing the irritating chemicals produced by white blood cells. Finally, antibiotics reduce the concentration of free fatty acids in the sebum, also reducing the inflammatory response. The most frequently used antibiotics for acne are :-

  • Tetracycline
  • Erythromycin
  • Minocycline
  • Doxycycline
  • Clindamycin

Oral tetracycline

Oral tetracycline has a long history in the treatment of acne, and remains one of the most widely used. A typical tetracycline regimen for treating moderate to severe acne is a starting dose of 500 to 1000 milligrams a day, decreased as improvement is noted. Long-term, low-dose tetracycline therapy may be continued for many months to maintain suppression of acne. Higher doses may be prescribed for very severe acne, with regular monitoring for systemic side effects. Tetracycline may cause staining of teeth in children, and should generally not be taken by children younger than 8 years of age. Oral tetracycline may cause permanent teeth staining or skeletal defects in a fetus and therefore should not be taken by a woman who is pregnant.

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