Medications Used to Treat Acne
Medication | Some Side Effects | Comments |
|---|---|---|
Kills bacteria (applied to the skin) | ||
Clindamycin | Diarrhea (rarely) | Should be avoided in people with inflammatory bowel disease |
Dapsone | Temporary skin yellowing when used with another product that contains benzoyl peroxide | Very rarely causes methemoglobinemia (a disorder that impairs the ability of the blood to carry oxygen) |
Erythromycin | Rarely irritated skin | Well-tolerated Frequent development of bacterial resistance |
Minocycline | Irritation, dry skin, redness | Foam propellant is flammable. Fire, flame, and smoking should be avoided immediately after application. |
Benzoyl peroxide | Dry skin Possible bleaching of clothing and hair Allergic reactions (rarely) | Especially effective when combined with erythromycin or clindamycin Benzoyl peroxide combined with erythromycin: Refrigeration sometimes required |
Unclogs pores (applied to the skin) | ||
Tretinoin | Irritated skin (with dryness, redness, and scaling) Sensitization of skin to sunlight | Apparent worsening of acne when tretinoin is started, sometimes requiring 3 to 4 weeks before any improvement occurs Requires use of protective clothing and sunscreen during sun exposure Should be avoided during pregnancy |
Tazarotene | Irritated skin Sensitization of skin to sunlight | Apparent worsening of acne when tazarotene is started, sometimes requiring 3 to 4 weeks before any improvement occurs Requires use of protective clothing and sunscreen during sun exposure Should be avoided during pregnancy |
Adapalene | Some redness, burning Increased sun sensitivity | As effective as tretinoin but less irritating Requires use of protective clothing and sunscreen during sun exposure |
Azelaic acid | May lighten skin | Minimally irritating May be used by itself or with tretinoin Should be used cautiously in people with darker skin because of skin-lightening effects but can help lighten areas that darken skin after healing |
Glycolic acid | Stinging Mild irritation | Over-the-counter product in form of a cream, lotion, or solution used in addition to prescription products but no longer commonly used |
Salicylic acid | Stinging Mild irritation | Over-the-counter product in form of a wash, peel, mask, or lotion used in addition to prescription products |
Trifarotene | Dryness, redness, and scaling of the skin Increased sun sensitivity | Requires use of protective clothing and sunscreen during sun exposure |
Kills bacteria (taken by mouth) | ||
Tetracycline | Sensitization of skin to sunlight | Inexpensive and safe, but must be taken on an empty stomach Requires use of protective clothing and sunscreen during sun exposure |
Doxycycline | Sensitization of skin to sunlight | Requires use of protective clothing and sunscreen during sun exposure |
Minocycline | Headache Dizziness Skin discoloration | Most effective antibiotic according to some experts but is expensive |
Erythromycin | Stomach upset | Frequently, development of bacterial resistance to erythromycin |
Azithromycin | Stomach upset | Fewer side effects than erythromycin Frequently, development of bacterial resistance to azithromycin |
Sarecycline | Sensitization of skin to sunlight Stomach upset Light-headedness, dizziness, or vertigo | Requires use of protective clothing and sunscreen during sun exposure |
Sulfamethoxazole, Trimethoprim | Stomach upset Rash | Development of bacterial resistance to sulfamethoxazole, trimethoprim |
Unclogs pores (taken by mouth) | ||
Isotretinoin | Possible harm to a developing fetus Possible effect on blood cells, the liver, and fat (triglyceride and cholesterol) levels Dry eyes, chapped lips, and drying of the mucous membranes Pain or stiffness of large joints and lower back with high dosages Associated with depression, suicidal thoughts, attempted suicide, and (rarely) completed suicide, but whether isotretinoin is the actual cause is unknown Unclear whether associated with new or worsened inflammatory bowel disease (Crohn disease and ulcerative colitis) | For sexually active women, requires a pregnancy test before they start isotretinoin and at monthly intervals while they are taking the medication, plus use of 2 forms of contraception or sexual abstinence, beginning 1 month before they start the medication and continuing while they take it and for 1 month after they stop taking it Requires blood tests to check whether the medication is affecting blood cells, the liver, or fat levels |
Blocks action of hormones | ||
Clascoterone cream (applied to the skin) | Redness, scaling or dryness, and itching | For treatment of acne in people 12 years of age and older |
Combined (estrogen and progestin) contraceptives (taken by mouth) | High blood pressure (hypertension), blood clots, breakthrough vaginal bleeding (for example, between menstrual periods) Weight gain Stomach upset Headaches | For treatment of acne in females |
Spironolactone (taken by mouth) | Light-headedness Increased urination Breast tenderness Stomach upset | For treatment of acne in females |