Dermatologists can be able to help control acne, avoid scarring and skin damage, or make scars less noticeable. Usually the first line for acne treatment includes good hygiene and over the counter medications. If after a couple weeks or months these methods do not work for you, then your dermatologist may have to prescribe stronger medications.
Acne medications work by reducing oil production and swelling or treating bacterial infection. The type of treatment and medication your dermatologist prescribes will depend on the severity and type of acne that affects your skin. Sometimes these prescription treatments can take weeks to months to have a beneficial effect. Additionally, you will need to have follow up appointments every three to six months with your doctor to assess your skin condition.
The most common topical prescription drugs include retinoids, antibiotics, azelaic and salicylic acid, and Dapsone. Retinoids are used for moderate acne and can be applied initially three times a week in the evening. These drugs do increase your skin’s sensitivity to light and the sun, so it may cause dry skin and redness. Retinoids should not be used in combination with benzoyl peroxide. Antibiotics work by killing bacteria and decreasing redness and inflammation. These drugs may be used in combination with retinoids or benzoyl peroxide to help prevent antibiotic resistance. Topical antibiotics alone are not recommended. Topical azelaic acid may be a god option for patients that are breastfeeding or during pregnancy. Dapsone can be used in inflammatory acne, especially with women.
Oral medications may be beneficial if topical treatments do not improve the condition. Antibiotics can be used in small time periods to decrease inflammation, but tetracyclines should not be used in women or children under 8 years old. In these patients, a macrolide would be more appropriate. Combined oral contraceptives may also be used for acne patients, however the effects of the medication for acne may not be seen for several months. Anti-androgen agents like spironolactone can be used in women and adolescent girls if oral antibiotics are not working. Isotretinoin can be used in patients who have tried other treatments, but they have not worked for moderate to severe acne. Isotretinoin may cause serious side effects and patients taking this medication need to be monitored closely by their doctors.
Other treatments that ma be helpful with or without other medications include light therapy, chemical peel, drainage and extraction, or steroid injections. The type of prescription treatment should be determined by you and your doctor, and should be monitored closely as side effects may arise.
This article reviewed by Dr. Jim Liu, MD and Ms. Deb Dooley, APRN.
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