What acne medication can a doctor prescribe?

What medications are prescribed for acne?

Some ingredients, including adapalene and benzoyl peroxide, are also available without a prescription; the ingredient name alone does not tell you whether a prescription is needed.3

Which treatment fits which breakouts?

Blackheads and whiteheads need treatment that unclogs pores. Adapalene can do that and help prevent new blackheads. Deep, painful acne needs a broader approach that addresses clogged pores, bacteria, inflammation and excess oil. A dermatologist can identify the types of breakouts you have and choose treatment for them.2

For women whose acne is caused or worsened by hormones, spironolactone or birth control pills can help. Birth control pills can also worsen acne in some women, so they are not an automatic choice. Cystic acne with scarring is another reason a doctor might consider isotretinoin, with close monitoring.3

How to use your prescribed acne treatment

1. 1Follow your prescription's directions consistently. Use the stated amount and schedule rather than choosing a frequency yourself.
2. 2For medication applied to the skin, apply a thin layer across the whole acne prone area rather than only the spots you can see. This treats existing acne and helps prevent the next breakout.
3. 3Give treatment time to work. Do not keep adding products or abandoning a treatment after a few applications.
4. 4Keep cleansing gentle. Scrubbing and picking irritate skin and can make breakouts worse.

Wash with a gentle cleanser twice a day. Remove makeup at the end of the day, even when the packaging has made it sound like skincare with better public relations. Choose oil free skincare, sunscreen and makeup labelled 'noncomedogenic' or 'won't clog pores', because decorative packaging is not a pore policy.12

Acne products can cause redness, dryness or excessive peeling. Benzoyl peroxide can also bleach towels and clothing. Follow the product directions carefully and apply it sparingly rather than assuming a larger amount will help.3

How long does acne medication take to work?

If the medication works for you, fewer breakouts can appear within 4 to 8 weeks, with clearing around 16 weeks after starting. Consistent use matters. A treatment that reduces redness or swelling can make pimples look less noticeable overnight, but getting rid of blemishes and preventing new ones takes longer.24

Arrange a review if treatment is not giving the improvement you want after several weeks, or your skin is not clearing within a few months. Dark spots left after breakouts also deserve attention: they can reflect significant inflammation, and a dermatologist can plan treatment to reduce further acne and dark spots.4

When should you see a doctor?

See a doctor for lots of spots, deep or painful lumps, scarring, or acne that affects your mental health. Hot, swollen or red skin can indicate infection and also needs medical attention; redness can be harder to see on brown and black skin. You do not have to exhaust shop bought treatments before seeking help.14

What if you are pregnant or trying to conceive?

Tell your doctor before starting acne treatment if you are pregnant or trying to conceive. Some treatments available without a prescription are unsuitable during pregnancy too. In the US, isotretinoin treatment requires iPledge enrollment; women taking it must use two forms of birth control before starting.34

What changes if you are prescribed isotretinoin?

Isotretinoin is usually prescribed by a skin specialist. Swallow capsules whole with food at the prescribed times. Dose and course length depend on symptoms. Regular appointments and blood tests check treatment and side effects.5

• Do not take isotretinoin during pregnancy, while trying to conceive or while breastfeeding. If pregnancy is possible, use contraception from at least one month before treatment until at least one month after stopping.
• Tell your doctor about all medicines, supplements and medical conditions, including past mental health problems. Doxycycline, vitamin A supplements and other acne treatments can interact.
• Avoid salicylic acid, benzoyl peroxide, chemical peels, microdermabrasion, waxing and laser hair removal during treatment.
• Limit sun exposure, avoid sunbeds and use SPF 30 or higher sunscreen outdoors, reapplying regularly. Avoid excessive intense exercise and alcohol.

Side effects include dry or itchy skin, headaches, muscle or joint pain and sexual problems. Contact your doctor or pharmacist for troublesome or persistent effects; keep taking the medicine unless advised to stop. Seek urgent medical help for suspected serious effects, including severe abdominal pain, seizures, breathing difficulty, hallucinations or thoughts of harming yourself. In the UK, call NHS 111. If you take more than prescribed, seek urgent advice too.5