Prescription medicines : Acne Treatment Guide

If over the counter acne products fail to work then your next course of action is a prescription medicine. This is only available via your GP.

Visit your GP if there is no improvement in your acne after a couple of months or if you have a severe outbreak.

Your GP may prescribe a product which contains benzoyl peroxide, or he/she may suggest an anti-microbial lotion or an antibiotic cream.

Treatment options include gels, lotions and creams; tablets and oral contraceptives (women only).

Gels/lotions/creams

These are rubbed into your skin (known as topical) and include:

• Retinoids: Topical, vitamin A based products which are applied on a daily basis to your acne outbreak. They enable dead skin cells to slough off as well as reducing any inflammation. They help to prevent new acne spots from developing. Azelaic acid: an alternative to products which contain benzoyl peroxide. A good choice if this chemical causes your skin to feel sore or peel.
• Antibiotics: there are lotions or creams which contain antibiotics such as erythromycin or clindamycin. These work by controlling the ‘P acnes’ bacterium.
• Antimicrobial lotions and creams: these contain an antimicrobial with other ingredients and are designed to prevent the growth of new bacteria.

Tablets

These are another option. There is a range of tablets available which include:

• Antibiotics: these are usually prescribed for cases of severe acne although their use is limited. The main reason for this is that bacteria become immune or resistant to the effects of bacteria which are a common feature of all types of antibiotics. They are effective although they do not prevent pores from clogging up which is why benzoyl peroxide is prescribed at the same time. An example of this is tetracycline.
• An oral retinoid such as Isotretinoin (brand name Roaccutane) which is also available as a lotion or cream. This is usually prescribed for cases of severe acne and works by drying up any excess oil from the sebaceous glands. However, isotretinoin has several side effects which include depression, liver problems, eye irritation, headaches and back pain. These are the most common side effects. Isotretinoin is not prescribed to pregnant women as it can cause birth defects such as hearing/visual impairment and retardation. For these reasons alone, it is only prescribed by a dermatologist.
• Oral contraceptives: there are some types of oral contraceptives which aggravate acne but conversely, there are others which may actually improve it. A combination pill is given which works by suppressing testosterone levels which can cause acne. Testosterone is present albeit in very tiny amounts in women but any slight increase can cause excess sebum production and acne. An oral contraceptive works by reducing this amount.

There are other options which include laser treatment and light therapy but they are not usually available via the NHS.

These treatments are available via private cosmetic clinics.