When you feel as though you have tried every over-the-counter skin care product there is, it may be time to talk with your dermatologist about receiving a prescribed medication for your acne. Although prescriptions are often thought to be for those who suffer from severe acne cases those who have mild to moderate acne may also benefit.

These prescriptions are designed to fight off all forms of acne, from blackheads, whiteheads, pimples, nodules, and cysts. It is best to talk with your doctor to know which prescribed drug will work best for your skin type and acne type.

  • Benzoyl Peroxide (BP)

You will find this prescription to be one of the most popular ones on the market. It comes in a variety of forms, from cream, washes, and gels; you may also find it under other names such as Benzaclin, Breyoxyl, or Benzac AC.

Bacteria don’t like oxygen, the two cannot coexist, so this treatment brings oxygen into the skin and ultimately the bacteria die. If there are no bacteria beneath the skin there is less of a chance of acne developing. Your dermatologist will determine the appropriate amount needed for your skin, often at 10%.
Your doctor may advise you to you spot treatments as often prescribed BP cannot be used directly on the whole face due to its intense strength. You can expect to feel a tingling sensation, possible burning, drying of the skin and even peeling.

These side effects are described as a hardening effect and are to be expected. That said, there are those who are allergic to the agent and so you must use caution if you notice crusting of the skin and severe inflammation be sure to talk with your doctor. You may be switched to a lower dose below 5%.
Some choose to use the lower dose for all over their face and the higher intensity treatment as a spot treatment on severe areas. You may experience worsening of the acne before it gets better.
Also, be aware that when the skin heals some discoloration can occur if your skin is susceptible to this sort of discoloration be sure to use vitamin E in combination with the prescribed drug. This product is also known to bleach hair and clothing, so use caution when applying it to your skin.

  • Azelaic Acid

This acid is also found under the brand name of Azelex, the cream contains 20% of the acid and can be used on your skin twice a day. Derived from animal products and whole grains it is a natural acid. It is a powerful agent that stimulates the renewal of skin cells.

When the cells are stimulated there is less build-up of dead cells and residue clogging the pores and hair ducts, thus the development of acne is considerably less. Included in this treatment is the anti-inflammatory properties it produces as well as the ability to diminish bacteria under the skin.

Although found in over-the-counter products, the dosage will be low and therefore it won’t be able to kill the bacteria in the same way as a concentration of 20% that is prescribed by your doctor. By using a stronger concentration, you will likely feel a tingling and burning sensation on the skin. Those with darker colored skin may experience a lighter pigmentation when the skin heals.

Sufferers of rosacea have also shown signs of improvement by trying this prescribed medication.

  • Antibiotics

Depending on where you live will determine if you are old enough to receive tetracycline antibiotic Minocycline. In Canada and Europe, the patient must be older than 22 to receive this form of treatment. There is a condition known as “blue smile” where this antibiotic actually stains teeth that are still growing.
The safer antibiotic is known as clindamycin which can be given as an ointment, which is usually the case in Europe, or as a pill, as Canada often prescribes. Tetracycline drugs can cause upset stomach and should not be prescribed to those who have kidney issues.

  • Erythromycin

This macrolide antibiotic can treat cystic acne and is often combined with the use of Benzoyl Peroxide. The dermatologist will advise against using it with other products to avoid any possible irritation, peeling, itchiness, redness, or even a burning sensation.

When taken as a pill, the antibiotic will need to be taken once per day and for no longer than six months. In the more recent studies 50 percent of those who were prescribed this oral treatment recorded some improvement. Other side effects not directly related to the skin may include dizziness or vomiting, diarrhea, sensitivity to light, rashes, redness of the skin, and vaginal yeast infections.

Since the purpose of antibiotics is to remove the bacteria from the skin you will find that it also removes good bacteria in the body, hence why women will find that they may get recurring yeast infections. For some, they may prefer to take the antibiotic at a lower dose to reduce the side effects.

It is extremely important to talk with your doctor before you try any form of antibiotics. Fluoroquinolone antibiotics, for example, cannot be used if you also consume citrus fruits. Your doctor will also know best the proper dosage your body can handle.

  • Dapsone

This product helps to treat inflammation and is also an anti-bacterial fighting agent. It also is full of antioxidants which help to prevent acne from developing and comes in the form of a gel that is to be applied topically to the skin. It is often sold under the brand name Aczone.

The gel is to be spread on the target area twice a day and has shown great results, specifically in females. They report that their acne is reduced anywhere from 30-45 %. With continued treatment, more than three months, the improvement of their skin is that much better.

Most dermatologists prefer to try other medicated treatments before they prescribe Dapsone, such as Salicylic acid, retinoids, or even Benzyl Peroxide. They may even prescribe Dapsone along with the use of retinoid Tazorac as the results have been better.

Beware of some side effects such as dryness, which could lead to dryness, and a burning sensation.

  • Tretinoin

This prescribed medication can be taken orally as a pill or used in the form of a gel that is applied topically to the skin; It is a chemically activated variation of vitamin A and is also called Retin-A. Researchers believe that the best way to use this medication is through the gel-form which is put directly onto the skin.
Tretinoin locks onto the keratinocytes on the skin, the cells that bring new cells to the surface of the skin and increases the production of these cells. The skin stretches and grows, helping to improve the surface of the skin.

This derived variation of vitamin A is also an anti-inflammatory and helps to trigger more growth of white blood cells, which in turn help to fight off infection. They also help to shrink the sebaceous glands that produce sebum, the oily substance that clogs pores.

If you suffer from liver problems you will not be able to take this medication due to the fact that it can cause problems with the liver as well as the central nervous system. If you are pregnant you will also not be able to take this drug as it can cause birth defects.

Although it is wise to talk with your dermatologist first, you may find that you can purchase this gel without a prescription which is usually cheaper. By going outside of your doctor, you can choose the amount of topical tretinoin you apply and for how long. You may also want to consider combining it with benzoyl peroxide to help fight off any infections.

  • Birth Control

Obviously, the use of oral contraceptives is restricted to females, but the results are quite positive. Birth control lowers the levels of testosterone in the woman’s body due to the progesterone and estrogen it contains.

For women who suffer from severe acne, the reduction can be quite significant. Reports indication that acne was reduced anywhere from 30-60 %. It is advisable to not smoke while taking oral contraceptives as the combination of the two can increase the risk of heart disease.

The Food and Drug Administration (FDA) has approved the use of birth control in order to treat women who suffer from acne.

  • Sodium Sulfacetamide

This prescribed medication has anti-inflammatory properties and can also help decrease the growth of bacteria under the skin. It is a topical application and has minimal side effects, such as burning or irritation in the skin. Severe effects have led to death.

  • Spironolactone

Another treatment specific to women, this is an oral medication and is a potassium-sparing diuretic, that is it does not promote potassium to be secreted in the urine. Women who choose to take this form of acne typically do not suffer from the hormonal kind.

It can be combined with other treatments and aids in reducing the production of oil, or sebum, in the skin. Some women experience weakness, cramping or bleeding, and possibly a loss of appetite.

  • Accutane

Also known as isotretinoin, this medication stimulates skin growth but has many side effects. It takes approximately 5 hours before it is absorbed into the bloodstream and lasts in the body for a whole day. Due to the drastic side effects, mainly those that affect babies, women who are on this medication are required to also be on two forms of birth control.

This strong medication, which works in the same way as Retin-A, is typically prescribed to those who have severe acne, nodular acne, for example, and have yet to respond to other forms of treatment. The entire cycle of treatment takes four to five months to complete and doesn’t show any sign of remission.

  • Differin (Adapalene)

Also similar to Retin-A, this can be applied topically to the skin in the form of a gel, lotion, or even as a cream. It has anti-inflammatory properties and is best used as a gel. It can be combined with benzoyl peroxide to help reduce infections when the nodules or cysts are open and vulnerable.

This agent helps to keep the pores covered with new skin and is prescribed mainly to those who suffer from cyst acne.

  • Tazorac (Avage)

Another derivative of vitamin A, this treatment can come in the form of a gel, cream, or a lotion and is applied topically to the skin. In the same manner as Differin, a gel is the best application and often comes in concentrated forms of 0.05 to 0.1%.
Application of this medication is to be applied once each day and has quick results. The medication will stay effective on the skin for about 36 hours. Those who suffer from eczema or have recently suffered a sunburn should avoid its use. It is also not to be used for more than 10 days, consecutively.

Side effects that should be noted are that those who use the medication become more susceptible to sunburn after they eat celery or celery root or if they choose to take St. John’s wort. Reports of dry skin, redness and peeling should be monitored.