How Effective Are Different Acne Medications?
If you have acne prone skin, then you’re probably wondering how to clear acne, especially if it’s making you feel frustrated and sometimes embarrassed. But the good news is, there are many different types of treatments available to you.
How to treat acne will depend on how severe your breakouts are, what treatments you may have tried before, your gender, your age and whether or not you're pregnant and/or breastfeeding.
From topical gels and hormonal treatments to oral acne medications, your doctor will be able to discuss how to clear acne in the best way for you.
We recommend a holistic approach to acne management such as looking at your diet, lifestyle and skincare before going down the acne medication route.
The Sönd Skin Blog is full of useful advice on managing acne prone skin.
If nothing seems to make much difference, speak to your GP or dermatologist for advice on acne medicine.
Here's our guide to everything from oxy acne medications to antibiotics and beyond.
How Does Acne Medication Work?
There are many options available to you if you’re trying to manage your acne prone skin. Each product works in a different way, and some may be more beneficial to you than others, depending on your causes, circumstances and preferences.
What works for a friend may not work for you, so it can be a case of trial and error to find the best acne medication for you. It’s best to stick to one type of acne medication for a while, as it can be several weeks before you start to notice a difference. It may then take further months or even years before your skin completely settles down.
So, how does acne medication work and what would a dermatologist prescribe for acne?
Some acne medications work by reducing the amount of sebum, the natural, wax-like oil produced by the skin. Lower levels of sebum can help to prevent blocked pores causing spots and acne breakouts.
Blocked pores are a common cause of acne, and some acne medications work by unblocking the pores, so that they don't become clogged up.
Others work by reducing skin inflammation that can lead to angry, red spots whilst some work by killing the bacteria that lives naturally on the skin but can build-up and cause acne.
Does Benzoyl Peroxide Help With Acne?
Perhaps one of the most well-known acne medications, benzoyl peroxide is the main active ingredient in Oxy 5 and Oxy 10 products. Containing benzoyl peroxide 5% and 10% respectively, oxy acne medicated gels, wipes, cleansers and creams work by reducing the bacteria that causes acne. They also help the skin to feel less oily.
Benzoyl peroxide products are a good choice as a first line of treatment against acne. They can also be used alongside other acne treatments.
When you first start to use benzoyl peroxide, the skin can peel or become itchy or irritated. This is quite normal, but if it becomes severe or unbearable, speak to your doctor or pharmacist.
Does Salicylic Acid Help Acne?
Salicylic acid is a type of fruit acid that’s safe to use on the skin. It’s found in products such as creams and serums, or as standalone products that are designed to be applied directly to the skin to help treat acne.
Skincare products containing salicylic acid are available from beauty products aisles as well as over the counter. However, stronger versions containing a higher concentration of salicylic acid are available on prescription from your GP or dermatologist.
It works as an exfoliant, clearing away debris from the pores helping to prevent them from becoming blocked and also helps to reduce sebum levels.
Salicylic acid can cause the skin to become dry, red or irritated, so it’s best to start with a low concentration product and to always follow the instructions. Speak to your GP if you’re taking other medications, and it may cause some interactions.
Are Antibiotics for Acne Effective?
Antibiotics for acne can be prescribed by your GP or skin specialist, usually alongside other topical treatments. They're usually used to help treat more severe cases of acne.
Such acne pills usually contain the antibiotic, tetracycline. They effectively kill the Propionibacterium acnes bacteria that causes the spots and inflamed skin that characterises acne by having an anti-inflammatory effect.
You should begin to notice a difference in your skin after around six weeks of taking antibiotics for acne. Your doctor will usually suggest that you continue treatment for around four to six months.
They may make your skin more sensitive to sunlight, so it's recommended that you use sunscreen. Antibiotics can also reduce the effectiveness of the contraceptive pill in preventing pregnancy during the first few weeks, so use further precautions such as condoms if necessary.
Tetracyclines are not suitable for women who are pregnant (or trying to get pregnant) or breastfeeding. In these cases, doctors may prescribe an antibiotic called erythromycin.
Prescription Acne Medication - Aczone (Dapsone - Gel Acne Treatment)
Aczone is the brand name for the drug dapsone and is a topical medicine for acne gel that you apply directly to your skin. It's an effective treatment for non-severe acne and is particularly useful for inflammatory acne on both the face and the body. Aczone is a prescription acne medication used primarily to treat red, angry, inflamed cases of acne.
It works by effectively killing the bacteria called Propionibacterium acnes that colonises the skin, causing acne. Aczone works in a similar way to antibiotic medicine for acne.
This kind of prescription acne medication can cause the skin to become dry and red, or to peel. It can also make the skin appear oilier. If you're using Aczone alongside acne creams that contain benzoyl peroxide, then beware that using the two together can cause the skin to become temporarily stained a yellow, orange or brown colour.
It will wash off, but if you're going out, then you can avoid this by applying one cream in the morning, and the other at night.
Aczone is unsafe for use in pregnancy and whilst breastfeeding, so always let your doctor know if you're planning to become or you are pregnant.
How Do Birth Control Pills Work for Acne?
Sometimes, taking birth control pills, or “being on the pill” can make acne worse or even cause it to develop. This is especially the case with the progesterone only, or ‘mini' pill, or contraceptive implants.
But in other cases, taking the combined oral contraceptive pill will help to clear the skin. It can be especially helpful if you're female and your acne tends to flare up around the time of your period or you have polycystic ovary syndrome.
Acne is often linked to hormone levels, as male hormones called androgens can stimulate the production of excess sebum. Skin that produces excess sebum can be more prone to acne as sebum can clog the pores which leads to acne spots and pustules. Taking birth control pills lowers the level of androgens in the blood, and therefore the amount of sebum produced by the skin.
Your doctor may recommend the oral contraceptive pill to help your acne if other treatments haven't worked, even if you're not sexually active.
As with any other hormonal drug, the contraceptive pill does have side effects. These include mood changes and weight gain. More severely, but less commonly, the pill can lead to a slightly higher risk of developing blood clots, high blood pressure, heart attacks, strokes, depression and migraines.
Aldactone (Spironolactone) Acne Treatment
Another treatment for acne that's linked to hormones in women is Aldactone. Aldactone is the brand name for the drug spironolactone and is another type of drug that reduces the activity of the male hormones called androgens in women.
Although primarily male hormones, androgens are present in women, but in a lower concentration. Some women have higher levels, which can lead to acne, particularly around the time of their period.
Spironolactone blocks the androgen receptors in the body, meaning that the action of these androgens cannot be switched on. This reduces the amount of sebum produced, meaning that it cannot block the pores and acne spots and redness are reduced.
If your acne is hormonally linked, you may benefit greatly from taking Aldactone. It's an oral acne medication that is usually prescribed alongside the oral contraceptive pill, when other acne treatments haven't worked.
Aldactone can lead to disruptions to your menstrual cycle and breast soreness. It can also cause sickness and diarrhoea. Spironolactone is a diuretic, which means it can make you go to the toilet to pass urine more often. If this is the case, you may feel thirsty and your blood pressure may drop, causing you to feel dizzy or have a headache.
Becoming dehydrated may cause your potassium levels to reduce too, and you may be required to have blood tests to check your potassium levels throughout your treatment.
Spironolactone isn't suitable for pregnant women and care should be taken not to get pregnant whilst taking it.
Acne Medication - Co-Cyprindiol for Severe Acne
Some forms of acne, particularly severe acne, don't respond to so-called ‘first line' acne medicine such as antibiotics. In these cases, sometimes a drug called Co-cyprindiol is prescribed as medication for severe acne.
Sebum is an oily substance that is naturally produced by the skin to help keep it supple and hydrated. In acne prone skin, this sebum can be produced excessively. Co-cyprindiol is a hormonal drug that works by controlling the amount of sebum the skin produces.
It's an effective treatment but does require up to six months of use before any improvement is seen in the skin. There are also some side effects to be aware of.
Co-cyprindiol can increase the risk that a woman who takes the drug in her early 20s will develop breast cancer later in life. Co-cyprindiol can also increase the risk of developing a blood clot. The risk of both are very small.
Co-cyprindiol isn't safe for use in pregnant or breastfeeding women. It can also lead to bleeding or spotting between periods and sore breasts. Other side effects include headaches, mood changes, loss of libido and changes in weight.
Azelaic Acid Acne Treatment
If using benzoyl peroxide or topical retinoid treatments have caused you to suffer painful or upsetting side effects, then your doctor may discuss azelaic acid with you. Azelaic acid is an acne medication that has a twofold action against acne. It's an exfoliant that removes dead skin cells and kills bacteria in the skin that are the cause of acne.
Azelaic acid is available as a cream or a gel that you apply to your skin twice a day. If you have very sensitive skin, your doctor may advise you to apply it only once a day. You can buy azelaic acid without a prescription.
An effective anti-inflammatory agent for the skin, this acne treatment is particularly effective for acne rosacea. It helps to reduce an excess of melanin in the skin that can lead to hyperpigmentation issues. You should notice an improvement in your acne after around four weeks of treatment with azelaic acid.
The exfoliating nature of azelaic acid means that it could make your skin more sensitive to the sun so make sure you use sunscreen too. This cream can also lead to a mild burning sensation, itching, dryness and redness of the skin.
Does Cortisone Help Acne?
If you have severe acne, with large, inflamed acne cysts, then your skin specialist may suggest cortisone injections. Known as intralesional corticosteroid injections, often shortened to cortisone shots, these injections are given by a specialised doctor directly into acne cysts.
Cortisone has an anti-inflammatory action and helps reduce the swelling of acne cysts. Your doctor will use a very fine needle, much finer than a needle to give an injection into your arm. Within 24 hours, you'll notice your acne cysts reducing in size and beginning to flatten out. Within a week, most cysts will be significantly smaller and less angry.
The downside of this effective treatment is pitting of the skin. It's usually caused by using too much cortisone, but your doctor will discuss the best course of action in your case to avoid the risk of pitting as much as possible. If you do experience pitting, it will normally subside after six months.
Does Accutane (Isotretinoin) Cure Acne?
Accutane is the brand name for the drug isotretinoin. Isotretinoin is an effective prescription only acne medication that reduces sebum production, kills the bacteria that can lead to acne, reduces swelling and redness and prevents clogged pores. It's derived from vitamin A and supports the skin to renew itself more quickly.
It usually takes four to six months for Isotretinoin to work but the results are usually significant.
Whilst this sounds like a wonder drug, there are some side effects that mean that Accutane is only ever prescribed for severe acne when other treatments haven't worked. It's never prescribed in the first instance of acne.
The side effects of Isotretinoin include skin inflammation and dryness around the eyelids, lips and nostrils, and conjunctivitis. It can also cause blood in the urine and changes in the level of sugar in the blood.
In rarer cases, some people taking Accutane can develop problems with their liver, kidneys or pancreas. For this reason, you'll need blood tests to check for the health of these organs throughout your treatment. This acne treatment can also lead to depression and anxiety and it's important that you mention it to your doctor if you begin to experience mood changes.
Isotretinoin isn't suitable for pregnant women or women who are trying to become pregnant. It can lead to severe birth defects, so you'll be encouraged to take regular pregnancy tests.
Acne Medication Side Effects
Many acne medications cause some side effects, and it's important to be aware of the possible effects of the medications that you're using. If side effects are severe then it's important to stop taking or using your medication and seek medical attention straight away.
If they're not severe, then carry on using your acne medication and either make an appointment to see your GP or talk to your specialist at your next appointment.
If any of the possible side effects mentioned in connection with any of the acne medications mentioned here concern you, speak to your GP to help put your mind at risk.
Alternative Therapies for Acne
If you’d rather take a holistic approach to managing your acne, than taking acne medications, there are several alternative treatments you can try.
Alternative topical treatments for acne that can be applied directly to the skin include ozonated olive oil from Sönd and tea tree oil to help manage bacteria levels on the skin. Oral alternative treatments include probiotics and a type of yeast called Brewer’s yeast that support good gut health and immunity that can positively impact the skin.
There are also alternative physical treatments that can help, such as acupuncture to help relieve stress and light therapy using different wavelengths of light to target acne causing skin bacteria. Oxygen therapy is known to accelerate wound healing and also helps kill some bacteria, especially Propionibacterium acne bacteria which is responsible for certain types of acne.
Speak to your GP before embarking on any natural treatment avenues if you’re concerned or taking other medications.
Acne Medicine and Pregnancy
If you're pregnant, planning to become pregnant or you're breastfeeding, then some acne medicines won't be suitable for you. Always discuss your options with your doctor or pharmacist. If you become pregnant whilst using prescription acne medications, speak to your doctor as soon as you can.
Lifestyle Changes to Support Acne Treatments
Whether you choose or require natural acne treatments or acne medication to manage your acne prone skin, there are other, lifestyle based, things you can do to help. These include:
- Using a mild cream cleanser to cleanse your face of makeup, dirt, oil, sweat, dead skin cells and pollution, twice a day.
- Perfecting a gentle skincare regime that involves moisturising after each cleanse and non-pore blocking, oil free makeup.
- Exfoliating your skin once or twice a week to prevent your pores from becoming blocked.
- Staying well hydrated by drinking plenty of water each day.
- Keeping your hair clean and away from your face, especially if you have greasy hair.
- Avoiding touching your face as much as possible to prevent transferring dirt, oil and bacteria.
At Sönd We Want to Help you Feel Good About Your Skin!
Some acne medications take time to begin to work whilst your body may take time to get used to them. Each one needs a period of two to three months to see if they're going to work for you and if any side effects will settle down. If they don't, then your doctor can usually try a different type of acne medication.
Treating acne isn't a one size fits all approach. Your skin is unique to you, and what works for someone else may not work for you. But don't lose hope – we know first-hand how seemingly untreatable acne can be brought under control.
Discover how we can help with our alkalising skincare that's been specifically developed to help acne prone skin . Like so many others, it could be the answer you're looking for!
This article is not meant to treat or diagnose. Please visit your doctor for advice about any health concerns you may have.