This article will review the prescription acne medications from low-potency to high-potency, with suggestions on how to make each medication work optimally well.
Summary:
- Always discuss options when you are offered prescription acne medication.
- Over-the-counter benzoyl peroxide may be easier to use and produce far fewer side effects that prescription benzoyl peroxide.
- In the United States, minocycline is the preferred antibiotic for acne. In Canada, clindamycin is offered to children, teens, and young adults to prevent staining of their teeth.
- Never pick out your own antibiotic for acne, even if antibiotics are available without a prescription in the country where you live. It is important to avoid getting a secondary infection that can be much worse than acne.
- Topical tretinoin can treat both acne and wrinkles.
Benzoyl Peroxide
Benzoyl peroxide, also known as BP, is the world’s most frequently prescribed acne treatment. The problem with prescription benzoyl peroxide usually is that it is too strong to use over the whole face. Most people experience stinging, burning, itching, flaking, peeling, and redness when they use benzoyl peroxide gels that contain more than 5% benzoyl peroxide, and doctors often start off their patients at 10% or more.
Ask your doctor about starting with a milder formula of benzoyl peroxide, as low as 2 to 2.5%. These products are much less likely to cause side effects that make you want to stop treatment. Save stronger benzoyl peroxide products for spot treatments—but be forewarned that a stronger produce may make the pimple even redder before it heals.
If you have Asian skin, use a vitamin E product in addition to benzoyl peroxide. The vitamin E will reduce the production of pigment that can discolor the skin even after acne heals.
Antibiotics
In the United States, dermatologists usually treat acne with minocycline. In Canada and Europe, dermatologists usually reserve minocycline for patients who are past the age of 22.
The reason to be careful with minocycline is that it can stain growing teeth, causing a condition known as “blue smile.” American dermatologists insist that if your teeth turn black or blue after you use their prescription, something else must be the problem, but European doctors—who in most cases can’t be sued—take the safer and more conservative route and treat acne with clindamycin ointments instead of minocycline. In Canada, doctors may also offer a clindamycin pill, but in Europe, doctors will offer clindamycin ointments because of a strain of bacteria known as Clostridium difficile in Europe that is more severe after treatment with oral clindamycin.
Tetracycline drugs are still use to treat acne, but they can cause stomach upset, and they are not safe for people who have kidney problems. Other antibiotics are used to treat acne and other infections occurring simultaneously, but the fluoroquinolone antibiotics used for combination treatment, such as Cipro, can’t be used if you eat certain citrus fruits.
Don’t choose antibiotics on your own, even if you live in a country where antibiotics are available without a prescription. Using the right antibiotic for the right period is essential for killing acne bacteria without increasing the risk of another infection.
Tretinoin
Tretinoin, also known as Retin-A, is a chemically activated form of vitamin A. It is available as a pill and in the form of gels that can be applied directly to acne-prone skill.
The way tretinoin works is by locking into receptors on the surface of a special class of skin cells known as keratinocytes. These are the cells that create baby skin cells that mature as they travel from the basal layers of skin to the surface. Increasing the production of these cells causes the skin to stretch and grow around pores, opening them without any need of deep-cleaning cleansers or, in the case of nodules and cysts, lancing or surgery. Retin-A is also anti-inflammatory and encourages the growth of white blood cells that fight infection, while it shrinks the glands that make sebum.
The problem with oral Retin-A is that it can cause problems in the liver and central nervous system. It can also overstimulate growth in the human embryo, and cause birth defects if taken during the first month or pregnancy. And a significant problem with Retin-A is that it can stimulate so much growth in the skin that new skin blemishes occur.
The best way to use Retin-A is as a gel applied directly to the skin. Products for this purpose are labeled as “topic tretinoin.” You don’t have to get a prescription, and the product is much less expensive over-the-counter than from the pharmacy. Results can be very fast, and you can control the amount of tretinoin you apply to your skin to limit irritation. Using both benzoyl peroxide and topical tretinoin, at different times of day, can prevent new infections as the skin opens up around pores.
Accutane, Tazorac, and Differin
Accutane, Tazorac, and Differin are medications that work in much the same way as Retin-A, but they have very different side effects.
- Accutane (isotretinoin) takes about 5 hours to enter the bloodstream and lasts about 24 hours. It is a strong stimulant to skin growth that can cause significant side effects. In the United States, doctors will require all women of reproductive age to use not just one but two forms of birth control to prevent genetic damage to unborn babies.
- Tazorac (tazarotene, also sold under the trade name Avage) is used as a cream, gel, or lotion applied to the skin. The gel form is best for acne. It begins working immediately and lasts about 36 hours, with very little absorption into the bloodstream. Creams and lotions can clog pores and cause whiteheads and blackheads, however. It cannot be used by people who have eczema, it should not be used after a sunburn, and it should not be used for more than 10 days at a time. Some people who take this drug are more sensitive to sun after they eat celery or celeriac or after they take St. John’s wort.
- Differin (adapalene) is also used as a cream, gel, or lotion applied to the skin. As with Tazorac, the gel form is best for acne. Sometimes Differin is combined with benzoyl peroxide to prevent infection of surrounding skin as cysts and nodules open. The product works by keeping pores from being covered with new skin, and is best for people who need to keep cyst-prone skin clear.
There are many other medical treatments for acne—most of which have severe side effects or very specialized applications. For the best non-prescription clear skin maintenance system, consider Exposed Skin Care.
Source: http://www.facingacne.com/top-prescription-acne-treatments-reviewed/
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