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Drugs Used to Treat
Acne and its side affects |
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Drug
|
Description |
Side
Effects |
Comments
|
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Topical Acne Products - Antibacterial |
|
Clindamycin |
This antibiotics is available in lotions,
solutions, gels, and disposable pads, and is typically applied twice
daily. |
Diarrhea (rarely) |
— |
|
Erythromycin |
This antibiotics is available in lotions,
solutions, gels, and disposable pads |
— |
Well tolerated |
|
Benzoyl peroxide |
Benzoyl peroxide if often used to treat mild to moderate acne, and can produce a
response in as few as five days. It is available in several strengths, some of
which are only available by prescription. Benzoyl peroxide is available in
soaps, lotions, washes, gels, and creams. Gel formulations are typically the
most potent. Care should be taken when applying products containing benzoyl
peroxide to avoid bleaching hair, sheets, towels and clothing. A common side
effect of benzoyl peroxide is dryness and irritation of the skin. To help avoid
this side effect, start with a lower potency formulation (2.5%) and
increase the strength (5% to 10%) as needed for acne control.
|
- Dry skin
- Possible bleaching of clothing and hair
|
Especially effective when combined with
erythromycin or clindamycin |
|
Unclogs pores - Topically
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Tretinoin |
Tretinoin is a topical retinoid available in various strengths and forms
(creams, gels, solutions, a microsphere gel, and liquid polymer). It works by
preventing the formation of microcomedones and has anti- inflammatory actions.
For mild acne, weaker strengths are typically used first and increased as needed
for moderately severe forms of acne. A "flare" of acne may occur after starting
tretinoin, but clears after about 8 to 12 weeks of therapy. Tretinoin works well
for moderate to severe acne when combined with benzoyl peroxide, topical
antibiotics, and oral antibiotics. Tretinoin can cause skin irritation, redness,
and peeling which are usually noticed within the first week of use but can be
minimized by slowly increasing application frequency. The doctor may recommend
you use it every other day and, over a period of time, increase to a maximum of
twice daily. Tretinoin can also increase sensitivity to sun, wind and cold. |
- Irritated skin
- Sensitization of skin to sunlight
|
Apparent worsening of acne when
tretinoin is started, sometimes requiring 3 to 4 weeks before any
improvement occurs
Requires
use of protective clothing and sunscreen during sun exposure |
|
Tazarotene |
Tazarotene is a topical retinoid, available as a gel or cream, and used to treat
mild to moderate acne. Although it is effective for acne, it can cause skin
irritation, itching, burning, and redness (similar to tretinoin). It is
recommended that patients avoid other medications or cosmetic products that have
strong drying effects as these could further irritate the skin. |
- Irritated skin
- Sensitization of skin to sunlight
|
Apparent worsening of acne when
tazarotene is started, sometimes requiring 3 to 4 weeks before any
improvement occurs
Requires
use of protective clothing and sunscreen should be worn during sun
exposure |
|
Adapalene |
Adapalene is a topical retinoid available as a gel, cream or solution and is
used to treat mild to moderate acne. Adapalene is typically used as an
alternative to tretinoin in patients who cannot tolerate tretinoin. It can also
be used in combination with topical and oral antibiotics. Improvement is
generally seen by 12 weeks of therapy. Some patients may notice redness of the
skin and peeling. It is recommended that patients avoid contact with mucus
membranes, including the eyes, mouth, and nostrils. Patients should also try to
avoid UV ray exposure through sunlight and tanning because drying of skin,
scaling, redness, burning, and itching may occur after exposure. |
Some redness, burning, and increased
sun sensitivity |
As effective as tretinoin but less
irritating
Requires use of
protective clothing and sunscreen during sun exposure |
|
Azelaic acid |
Azelaic Acid is a cream used in the treatment of mild to moderate acne. It has
antibacterial effects and may help with skin inflammation. Azelaic acid is
generally well tolerated with a low incidence of temporary side effects such as
skin redness, itching, and burning. Darker complexions may develop
hypopigmentation during treatment. Azelaic acid should be applied to clean, dry
skin. |
May lighten skin |
Minimally irritating.
May be used by itself or with tretinoin .Should be used cautiously in people
with darker skin because of skin-lightening effects |
|
Anti
bacteria - Oral |
|
Tetracycline |
Tetracycline is the
most commonly prescribed antibiotic for treating acne. |
It may cause sun
sensitivity
and predispose a woman to vaginal yeast infections. |
Inexpensive and safe, but must be taken
on an empty stomach
Should
wear protective clothing and sunscreen during sun exposure |
|
Doxycycline |
Doxycycline is commonly used in
people whose acne does not respond to tetracycline. |
Possible sensitization of skin to
sunlight |
Should wear protective clothing and
sunscreen during sun exposure |
|
Minocycline |
Minocycline is commonly used in
people whose acne does not respond to tetracycline. |
- Headache
- Dizziness
- Skin discoloration
|
Most effective antibiotic |
|
Erythromycin |
Erythromycin is most
effective when combined with other acne medications (such as benzoyl
peroxide). The combination also helps decrease the risk of the bacteria
becoming resistant to the antibiotic. |
- Stomach upset
- Can cause occasional skin irritation and stinging
|
Frequently, development of bacterial
resistance to erythromycin |
|
Unclogs pores - Oral |
|
Spironolactone |
Spironolactone also decreases androgen hormone levels and thus decreases
production of sebum. If oral contraceptive therapy is not effective,
spironolactone can be added for additional benefit. |
Some side effects
associated with spironolactone include: dizziness, breast tenderness, and
painful menstruation in women. |
It is recommended to get blood pressure and potassium
levels checked periodically while on this medication. |
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Isotretinoin
|
Isotretinoin (Accutane) is used to treat severe, cystic acne that has not
improved with other therapies. Some dermatologists use isotretinoin in mild to
moderate acne that has not responded well to 6 months of standard therapies.
Treatment with this drug usually continues until there is a 70% reduction in the
number of cysts, and usually this can be seen in 15 to 20 weeks. A 6-month
course of isotretinoin is sufficient for most patients. While extremely
effective for treating acne, isotretinoin is associated with some potentially
bothersome side effects including extreme drying of the mouth, nose, and eyes
(approximately 90% of patients taking isotretinoin experience these side
effects); inflammation and peeling of facial skin, joint aches, muscle
stiffness, and sun sensitivity. Isotretinoin can also cause birth defects if
used during pregnancy, so contraception (some type of effective birth control)
is required in females taking isotretinoin. Contraception should begin one month
before starting isotretinoin and continued for three months after stopping
isotretinoin. Isotretinoin now has a mandatory registry that was put in place by
the FDA, which is known as IPLEDGE. IPLEDGE was primarily put in place to
prevent unwanted or potentially dangerous adverse effects.
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- Possible harm to a developing fetus
- Possible effect on blood cells, the
liver, and fat (triglyceride and cholesterol) levels
- Dry eyes, chapped lips, and drying
of the mucous membranes
- Pain or stiffness of large joints
and lower back with high dosages
- Associated with depression, suicidal
thoughts, attempted suicide, and (rarely) completed suicide
|
For sexually active women, requires a
pregnancy test before they start isotretinoin and at monthly intervals
while they are taking the drug plus use of two forms of contraception or
sexual abstinence, beginning 1 month before they start the drug and
continuing while they take it and for 1 month after they stop taking it
Requires blood tests to check whether
the drug is affecting blood cells, the liver, or fat levels |
