Accutane Isn’t Your Only Option: 8 Prescriptions That Also Treat Acne

Alt: 8 Acne Treatments to Help Clear Your Skin

Whitehead pimples, pustules, nodules, or deep cysts can ruin your day. If you have acne, you’re one of millions of Americans who fight this battle. Many blemishes clear up with over-the-counter face washes or ointments. If yours are stubborn and resist treatment, though, you’re likely headed for a prescription medication.

Accutane (isotretinoin) is the best-known acne medication you can get from your doctor. It’s highly effective, but it can also cause some serious side effects. It dries up acne-causing oil so much you could get chapped lips or nose bleeds (ouch!). You may develop sun sensitivity and lose some hair. The biggest risk is severe birth defects if you get pregnant.

Don’t throw your hands up in frustration just yet. Accutane isn’t your only option. There are plenty of other prescription acne treatments you can try. Talk to your doctor about whether any of these eight medications are right for you.

1. Spironolactone

Treating acne is just one use for this oral medication, also called Aldactone. It takes a hormonal approach to zapping your zits. By blocking the impact of androgen (the male sex hormone) on your oil glands, it dries out your skin.

Most women will see some, if not all, of their acne clear up. In fact, this medication is only for women. It is often prescribed to treat stubborn cystic acne, common in adult women. Because it impacts androgen, men who use it could potentially grow breasts.

Your doctor will probably prescribe birth control pills along with spironolactone. It’s a good combination for two reasons. One, it boosts acne-fighting effectiveness. Two, like Accutane, spironolactone can cause significant birth defects if you get pregnant. If birth control pills aren’t an option for you, be sure to use a barrier method for contraception.

2. Clascoterone

If you want an alternative to spironolactone, ask your doctor about this newly approved acne cream, also called Winlevi. This one is a topical medication. It’s safe to treat moderate-to-severe acne in both males and females over age 12.

Clascoterone also blocks androgen, limiting your skin’s oil production. As a result, you’ll have fewer clogged pores. There’s also an added benefit, too. The medication also reduces acne-related inflammation and redness.

3. Oral Contraceptives

Preventing pimples before they pop up isn’t the priority for oral contraceptives. It can be a happy side effect, however. You’ll need to choose your pill carefully. Currently, only three birth control pills have FDA approval to fight acne: Ortho Tri-Cyclen 21, Yaz, and Estrostep.

These pills work by evening out your estrogen and progesterone levels. Just know it could take a few months to see a change in the mirror. Remember these prescriptions also have other side effects including weight gain, breast tenderness, and nausea. They can also increase your risk for breast and cervical cancer, as well as cardiovascular problems.

4. Oral Antibiotics

There’s a lot of talk about oil being the root of acne evil. Bacteria can also be the culprit. If that’s the case for you, your doctor could prescribe an oral or topical antibiotic. It will likely be paired with benzoyl peroxide to reduce the chance you’ll develop antibiotic resistance.

The four most common antibiotics — erythromycin, tetracycline, minocycline, and doxycycline (get more detailed info on how does doxycycline kill bacteria) — all work by killing bacteria. Over time, you’ll also see less redness and inflammation. Your doctor can help you decide which antibiotic is best for you.

5. Retinoids

Don’t want to take a pill? Retinoid creams, such as Retin-A, are another good topical option to treat your moderate-to-severe acne. Instead of adjusting your hormones, it unclogs your pores. Just rubbing it in can keep dead skin cells from plugging up your pores again, causing another breakout.

These creams can really dry you out, so ease into using them. Apply them in the evening, three times a week. Once your skin is accustomed to it, you can start using the medication daily. You may notice some redness and peeling at first. If so, add in an oil-free moisturizer.

6. Dapsone

If retinoid creams are too harsh, talk with your doctor about dapsone (Aczone) unless you’re pregnant or breastfeeding. It’s a gentler gel that combats your face and back acne without causing as much redness or irritation. Much like an antibiotic, it kills zit-causing bacteria.

It’s easy to use. Just apply the 5% gel to your skin twice daily. Pairing it with another acne medication can lead to even clearer skin. Be careful, however, if you’re also using benzoyl peroxide. Applying them at the same time can temporarily leave you with yellow-orange skin. So let one absorb before using the other. Don’t worry, though, any color change washes away easily.

7. Salicylic Acid

You probably already know about salicylic acid. Look on the back of most over-the-counter acne treatments or face scrubs, and it’s on the ingredient list. What you may not know is it comes in prescription strength, too. Your doctor can decide the concentration that will work best for you.

Basically, salicylic acid works two ways. It exfoliates your skin, encouraging new skin cells to grow. It then works into your pores, dissolving the dead skin cells, stopping pimples and pustules in their tracks.

8. Azelaic Acid

When it comes to azelaic acid, you have lots of options. It’s available as a gel, lotion, or cream, and you can find it over the counter. Most patients see the best results if their medication has around a 15% concentration, though. You’ll need to be patient. It can take a few months to see significant results.

Azelaic acid is like salicylic acid, but it more gently exfoliates your skin and dissolves old skin cells. What makes it different is the extent of its calming effect on the angry skin around your zits. It’s used to treat rosacea, so it can soothe acne-related redness and inflammation. It can also even out your skin tone, helping heal the discolored spots pimples leave behind.

Acne of any kind can be frustrating. When it lingers, finding a medication to clear your skin might always be on your mind. Fortunately, zapping zits isn’t a one-size-fits-all solution. Between oral and topical medications, you have lots of options. Work with your doctor to find the right prescriptions, and you’ll be on your way to a blemish-free complexion.

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