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Treatment for Moderate to Severe Inflammatory Acne

People with moderate to severe inflammatory acne may be treated with prescription topical (applied to the skin) or oral (taken by mouth) medicines, alone or in combination.


Prescription Topical Medicines
Several types of prescription topical medicines are used to treat acne. They include:

  • Antibiotics - Help stop or slow the growth of bacteria and reduce inflammation
  • Vitamin A derivatives (retinoids) - Unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are:
  • Others - May destroy P. acnes (the bacteria that causes acne), and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are:
    • Prescription strength Benzoyl peroxide
    • Sodium sulfacetamide/sulfur-containing products
    • Azelaic acid (Azelex)

Like OTC (over-the-counter) topical medicines, prescription topical medicines come as:

  • Creams
  • Lotions
  • Solutions
  • Gels
  • Pads

Your doctor will consider your skin type when prescribing a product. Creams and lotions provide moisture and tend to be good choices for people with sensitive skin. If you have very oily skin or live in a hot, humid climate, you may prefer an alcohol-based gel or solution, which tends to dry the skin. Your doctor will tell you how to apply the medicine and how often to use it.

Side Effects
For some people, prescription topical medicines cause minor side effects, including:

  • Stinging
  • Bburning
  • Redness
  • Peeling
  • Scaling
  • Discoloration of the skin

With some medicines, such as tretinoin, these side effects usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don't go away, notify your doctor.

As with OTC medicines, the benefits of prescription topical medicines are not immediate. Your skin may seem worse before it gets better. It may take from 4 to 8 weeks to notice improvement.



Prescription Oral Medicines
For people with moderate to severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Common antibiotics used to treat acne are:

Other oral medicines less commonly used are:

Some people taking these antibiotics have side effects, such as:

  • Upset stomach
  • Dizziness or lightheadedness
  • Changes in skin color
  • Increased tendency to sunburn

IMPORTANT WARNING:
Because tetracyclines may affect tooth and bone formation in fetuses and young children, these drugs are not given to pregnant women or children under age 14. There is some concern, although it has not been proven, that tetracycline and minocycline may decrease the effectiveness of birth control pills. A backup or another form of birth control may be needed.

Prolonged treatment with oral antibiotics may be necessary to achieve the desired results.


References:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
www.niams.nih.gov/
U.S. Department of Health and Human Services
www.4woman.gov/
January 2005 - 2006

This summary does not include everything there is to know about the medicine mentioned above. Do not use this medicine without first talking to your doctor. Other brand names or generic forms of this medicine may also be available. Side effects other than those listed above may occur. This medicine may be prescribed for other uses. If you have questions or concerns, or want more information, your doctor or pharmacist has the complete prescribing information about this medicine and possible drug interactions.