Best oral medication for acne Types and more
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Several oral medications are available through prescription to help treat acne. The most effective depends on a person’s circumstances, such as age, health, and severity of the condition. Globally, acne affects more than 8 in 10 people aged 12–25 years. People may develop acne during hormonal fluctuation, including puberty, pregnancy, or menopause. In addition, factors such as stress, diet, and certain cosmetics can contribute to the development of acne. Many different oral medications are available to treat acne, including antibiotics, anti-androgens, birth control pills, or a vitamin A drug called isotretinoin. A dermatologist can assess a person’s skin and inform them about the best medication on an individual basis. This article explores the best oral medications for acne, including the risks and benefits of each drug type. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. What is acne Share on PinterestNSimages/Getty ImagesAcne is a skin condition that occurs when the hair follicles become plugged with oil and dead skin cells. Each hair follicle connects to a sebaceous gland, which produces an oily substance called sebum. Sebum helps to keep the skin lubricated and soft. However, when there is excess sebum, it can mix with dead skin cells and form a plug in the follicle. This plug then traps bacteria under the skin, leading to inflammation and forming pimples, blackheads, or whiteheads. Acne can occur on the face, neck, chest, back, or shoulders. It most often affects teenagers and young adults, but it can happen at any age. Many oral medications are available should a person wish to treat acne. However, a doctor’s recommendations may depend on the severity of acne and any other health conditions a person has. Learn more about acne here. Antibiotics Oral antibiotics are a mainstay for treating moderate to severe inflammatory acne. They work by killing bacteria, such as Cutibacterium acnes, that contribute to acne formation. Antibiotics may also ease inflammation. Some examples of antibiotics that may help to treat acne include:doxycyclineminocyclinetrimethoprim-sulfamethoxazoleerythromycinamoxicillin Doctors may recommend antibiotics when people have tried topical agents and other alternatives that have not helped ease symptoms. Some examples of topical agents for acne might include benzoyl peroxide or adapalene. Due to the potential for antibiotic resistance, doctors may only prescribe oral antibiotics for a limited course — for example, 3–4 months. They should then reevaluate the person. Long-term oral antibiotics have various associated risks, including:nauseavomitingdiarrheadizzinessheadachesphotosensitivityhypersensitivity reactionsincreased intracranial pressureliver damageheart issues Additionally, minocycline may increase the risk of developing systemic lupus erythematosus (SLE) and autoimmune hepatitis generally after 1 year of use. Once oral antibiotics ease symptoms, dermatologists may recommend that the person continues using topical agents, such as clindamycin, sodium sulfacetamide, or azelaic acid, to maintain their results. Oral contraceptives Oral birth control can treat acne by regulating androgen levels and suppressing overactive sebaceous glands. Androgens are a group of hormones, including testosterone, that stimulate the skin to produce sebum. Usually, the ovaries and female adrenal glands produce low levels of androgens. But if levels are higher, it can lead to excess sebum that triggers acne. Females with acne along their jawline and lower face often have good results using oral contraceptives. Three oral birth control pills for acne have Food and Drug Administration (FDA) approval:Ortho Tri-Cyclen, a combination of norgestimate and ethinyl estradiolEstrostep, a combination of norethindrone acetate and ethinyl estradiolYaz, a combination of drospirenone and ethinyl estradiol The side effects of oral contraceptives are usually mild and disappear with continued use. However, they can cause:nauseaheadachesabdominal crampingbreast tendernessdecreased libido In a small number of cases, they can also cause more serious side effects, including:high blood pressureblood clotsstrokeheart attack Anti-androgens Anti-androgens are another class of hormone medications. They block androgen receptors, preventing androgens from stimulating the sebaceous glands. The group includes spironolactone (Aldactone), which doctors also use to treat high blood pressure and fluid retention. In addition, dermatologists use it to treat acne and excess hair growth in females. If other acne treatments do not work, it is an option for deep-seated acne on the lower face, jawline, or neck. Anti-androgens cause few issues in females but they may be more likely to experience menstrual irregularities and breast tenderness. In males, anti-androgens can cause: decreased libidoimpotencegynecomastia, or swelling of the breast Isotretinoin Isotretinoin (Amnesteem, Claravis, Absorica, Zenatane) is a vitamin A derivative. This medication is sometimes called Accutane. Doctors may prescribe it for people with severe cystic acne, severe acne, or stubborn acne that does not respond well to other treatments. A course can last 4 or 5 months. It often results in prolonged acne clearance, which can be permanent for some people. It is not an option for pregnant people as it can cause serious birth abnormalities and pregnancy loss. Isotretinoin can also cause serious side effects, including:dry skindry eyesnosebleedssun sensitivitythinning hairdifficulty seeing at nightrashesstomach issues Due to the potential for serious side effects, dermatologists inform people about the benefits and risks associated with this drug. They may provide educational leaflets to help people decide if they would like to undergo isotretinoin therapy. People on the drug should expect close medical supervision while taking isotretinoin and frequent visits to their dermatologist. This may require taking extra precautions — for example, blood tests and pregnancy tests, where relevant. Most effective oral medication for acne The best or most effective medication for acne may depend on the person’s circumstances. There is no one specific treatment that is the most effective overall. Factors that can influence the decision include:severity of acneany other health conditionsagesexpregnancy statusother medications a person is takingpotential side effects of the medication Doctors may consider the following oral medications for specific types of acne:Hormonal acne: Doctors may recommend treatment with antibiotics or oral contraceptives, depending on the person’s gender.Cystic acne: Severe acne that does not ease with antibiotics may require isotretinoin.Fungal acne: Also known as pityrosporum folliculitis, this condition develops when fungus on the skin grows out of control. Antifungals, such as itraconazole and fluconazole, are the treatments of choice for this acne type. Acne in different populations Acne can develop in people of any age but is common in teenagers and pregnant individuals. These populations may require different treatment regimes. Dermatologists may recommend topical treatments such as benzoyl peroxide and retinoids for teenagers before suggesting oral medications. Oral medications, such as isotretinoin, are not always an option in pregnant people due to the potential risk to fetuses. Oral birth control and anti-androgens are also not an option during pregnancy. Some antibiotics may be suitable, or a doctor may recommend topical treatments only. Summary Doctors may recommend various oral medications to help treat acne. Usually, they reserve these options for when topical treatments are ineffective. Oral medications include antibiotics, oral contraceptives, isotretinoin, and anti-androgens. The best oral medication for acne depends on the type of acne someone has, their age, pregnancy status, overall health, and other factors. There is no one oral medication that works best for everyone. Oral medications carry the risk of side effects which can range from nausea to serious birth abnormalities. For this reason, anyone considering oral medications for acne must discuss their situation with a doctor or dermatologist. Last medically reviewed on August 24, 2022Dermatology 10 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Cooper, D. B., et al. (2022). Oral contraceptive pills.http://www.ncbi.nlm.nih.gov/books/NBK430882Dao, M., et al. (2020). Potential harms of long-term acne treatment with oral antibiotics.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491659Isotretinoin: Overview. (2021).http://www.aad.org/public/diseases/acne/derm-treat/isotretinoinIsotretinoin: The truth about side effects. (2021).http://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effectsPatel, D. J., et al. (2021). Oral antibiotics for acne [Abstract].https://link.springer.com/article/10.1007/s40257-020-00560-wSłopień, R., et al. (2018). Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925193Stubborn acne? Hormonal therapy may help. (n.d.).http://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapySutaria, A. H., et al. (2022). Acne vulgaris.http://www.ncbi.nlm.nih.gov/books/NBK459173Trivedi, M. K., et al. (2017). A Review of hormone-based therapies to treat adult acne vulgaris in women.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419026Winters, R. D., et al. (2022). Folliculitis.http://www.ncbi.nlm.nih.gov/books/NBK547754FEEDBACK:Medically reviewed by Jennie Olopaade, PharmD, RPH — By Zia Sherrell, MPH on August 24, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageAcne Treatment Guide Acne is one of the most common skin disorders in both males and females, occurring on the chest, face, shoulders and back.READ MOREThe best treatments for acneMedically reviewed by Daniel Murrell, MD Acne forms pimples, also known as zits or spots, and can be persistent and difficult to control. 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