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Commonly Prescribed Acne Medications

For many suffering from acne, over-the-counter creams, washes and spot treatments are often the best and most effective form of treatment. For moderate to severe cases of acne, dermatologists may prescribe medications or drugs in topical or oral form to reduce oil secretions, infection or hormonal changes that spawn and encourage blemishes and pimples. Though not exhaustive, below are the most commonly prescribed acne medications for review.

Acne is a skin condition where patches become inflamed and are marked by pimples in the form of blackheads, whiteheads and even cysts. The pimples are also called zits and are caused by pores on the skin becoming clogged. Greasy, oily skin and hormonal changes are some of the most common causes of acne. If youíve been struggling with this skin condition and are looking for prescription relief youíll want to read further for some of the most important information on commonly prescribed drugs.

Note: Though this list of acne medicines and drugs is fairly thorough, it is not intended to be all-inclusive but as a general guide to prescriptions you may encounter from a dermatologist or physician - nor is meant to the "final word" on side effects, availability or efficacy of medications.

Adapalene>

This is generally prescribed under the brand name Differin and is manufactured by Gladerma Laboratories out of France.

It was first approved by the FDA in 1996. You can get it in .1% strength as a lotion or .3% as a gel. It is applied once a day, generally at night after washing and before bed. It is prescribed to slow skin cell accumulation that is responsible for plugging pores from within the follicles. In addition it has properties that reduce inflammation. It has been reported to take up to twelve weeks or more before improvements are seen.
  • Side Effects: Some side-effects you can expect to see are itching, dry or red skin, burning and scaly skin. These occur in as many as 10-40% of patients. It is also recommended that you are very careful with time in the sun as extreme sunburn and irritation can happen quickly. If you have swelling of the tongue, throat, lips or face, breathing problems or hives you need to go to the emergency room right away.
  • Ingredients: The active ingredient in Differin is Adapalene and the inactive ingredients are: methylparaben, edetate disodium, carbomer 940, purified water, proplene glycol, poloxamer 182, sodium hydroxide and it may also have hydrochloric acid for stability.

Azelaic Acid

Azelex is the brand name of this cream that is prescribed for application twice daily. The drug is made by Allergan, Inc. and was FDA approved in 1995.

It takes eight to ten weeks for results to show. It is prescribed to help prevent the buildup of skin cells that cause pores to plug, help skin cells renew more quickly and kill acne causing bacteria. Finally, it has anti-inflammatory properties and can be used with a face wash for oily skin to further reduce oil secretions and clogged pores without irritating sensitive facial skin.
  • Side Effects: Some patients have (hypopigmentation) patches of skin that become lighter, often permanently. In 1-5% of patients surveyed tingling, stinging, burning and itching are reported.
  • Ingredients: It has a 20% strength of Azelaic acid along with other inactive ingredients: cetyl palmitate, cetearyl alcohol, octanoate, cetearyl, PEG-5 glyceryl tearate and propylene glycol, coglycerides, propylene glycol, glyceryl stearate, glycerin; purified water and Benzoic acid is often used as a preservative.

Clindamycin

Clindamycin is the active ingredient in the brand Cleocin produced by Pharmacia and Upjohn, it got FDA approval in 1987. Other brands that use Clindamycin as an active ingredient are: Clida-derm, Clindets and Benzaclin. It is an antibiotic taken orally twice a day to kill the bacteria generally responsible for acne (P. acnes) and it takes about eight weeks before youíll see a marked difference in your acne.
  • Side-effects: Some side effects include severe diarrhea with blood, infrequency of urination, flu symptoms, bruising, unusual itching and bleeding of the mucus membranes, inflammation of the colon, joint pain, nausea and stomach problems, rashes, throat irritation, and jaundice.
  • Ingredients: Inactive ingredients are: yellow and blue dyes, corn starch, gelatin, talc, magnesium stearate, lactose and titanium dioxide. These are combined with Clindamycin in the strength of 5%.

Dapsone

Dapsone is the active ingredient used in Aczone, made by Allergen, Inc. and approved by the FDA in 2005. It is prescribed because it is shown to slow inflammation, has antioxidant and a small amount of antibacterial properties. It is a gel that is applied twice a day topically and results are generally seen after 8 weeks.
  • Side Effects: Some side-effects you can expect to see are burning skin, rashes and dry patches on your skin. In a small percentage of patients involved with clinical trials severe reactions such as tonic colonic movements, suicide attempts, pancreatitis, severe vomiting, sever pharyngitis, and abdominal pain have been reported as well as erythema.
  • Ingredients: A strength of 5%dapsone along with the following inactive ingredients: methylparaben, carbomer homopolymer tye C, diethylene glycol monoethyl ether (DGME), sodium hydroxide and purified water.

Erythromycin

Erythromycin is the active ingredient in Benzamycin and in several other medications including: Erydeerm, Akne-Mycin, Emgel, Erycette, Erymax, Erygel, Erythra-Derm, Ery-Sol, ETS, Staticin, T-Stat, Theramycin Z.

Benzamycin is a topical solution prescribed to use twice a day in the effort to kill acne causing bacteria or P. Acnes. It is made by Dermik Laboratories and was FDA approved in 2000. It takes roughly three months before you will see results.
  • Side Effects: Colitis has been reported as well as, skin problems including peeling, burning, itching, redness, dryness and excessive oiliness as well as inflammation of the nose, eyes and the face. We recommend use of an acne face wash for sensitive skin in conjunction with these type acne drugs and medicines.
  • Ingredients: Inactive ingredients the drug contains are: docusate sodium, alcohol, water, carbomer homopolymer type C and docusate sodium.

Isotretinoin

This drug was approved in 1982 for the treatment of acne under the brand name of Accutane (as well as Roaccutane and Accutane Roche) and is manufactured by Roche U.S. The drug is prescribed because of its effectiveness reducing oil secretions from oil glands - one of several prescription products for oily skin.

Accutane is a prescription for an oral medication thatís taken orally for 15-20 weeks under close doctor supervision. Depending on doasage, moderate to severe drying of skin can occur. We recommend an acne moisturizer like Acnetene ClearCream to keep skin hydrated and to further treat acne.
  • Side Effects: Some side-effects are checked for with frequent blood tests. It has been shown to effect serum cholesterol, blood sugar levels, as well as reduce night vision in some who take it.It is critical that women do not take this drug while pregnant or if they expect to get pregnant and they must be off the drug for over a month before attempting to get pregnant. If pregnancy occurs while on the prescription the doctor should be notified right away. Serious birth defects, miscarriage or infant death have been shown to occur. The prescription may cause mental health issues, dangerously increased pressure on the brain, serious stomach issues, bone, muscle and joint trouble, dry skin and rashes, hearing and vision problems that can be permanent, increased cholesterol, problems with blood sugar, serious allergic reactions as well as lowered red and white blood cell count. Though Accutane has been taken off the U.S. market for indications of causing inflammatory bowel disease as well as being shown to stop long bone growth in teens that are growing, people can still get Claravis, a generic form of the drug.
  • Ingredients: Inactive ingredients used in the drug are: red, blue and yellow dyes, iron oxide, titanium dioxide, parabens, glycerin, butylated hydroxyanisole, edetate disodium, beeswax, hydrogenated soybean oil flakes, soybean oil, and hydrogenated vegetable oil.

Oral Antibiotics

There are a few different antibiotics used and Minocin is commonly prescribed to treat acne, it is manufactured by Patheon Pharmaceuticals, Inc. It is taken orally one time a day and used to reduce inflammation as well as to stop the growth of P. Acnes, the bacteria responsible for causing acne.
  • Side Effects: Issues with sunlight causing rashes, itchiness, redness or burning of the skin as well upset stomach, diarrhea, nausea, headache, vomiting, dizziness, or light headedness, sores in the mouth, and skin discoloration after prolonged use may occur. Some reports have shown discoloration of teeth and gums. Some serious though less frequently reported side effects are: jaundice, mental problems, vision issues, throat pain, and fever. Very rarely it is associated with auto-immune problems like drug related lupus and hepatitis, which more commonly happens with women.
  • Ingredients: The active ingredient, Minocycline was approved in 1971 for a variety of health uses. Other common antibiotics prescribed for acne are Septra (sulfamethoxazole-trimethoprim), Bactrim and Vibramycin (doxycycline).

Oral Contraceptives

A popular oral contraceptive prescribed is Ortho Tri-Cyclen which is manufactured by Ortho-McNeil Pharmaceutical, Inc.

The combination of hormones used in it has been used for the past 25 years although itís only been recently that studies have shown its usefulness in the treatment of acne. This can take 4 to 6 months or more to see results. It is taken once a day that distributes doses of Progestrone and or estrogen. It is used to lower the testosterone which also lowers the incidence of acne producing a 30-60% reduction of lesions. It is also helpful to use acne scar removal products such as Acnetene PimplePaste as a light exfoliant to help remove acne scarring.
  • Side Effects: Headaches and elevated blood pressure is often seen in users of oral contraceptives as well as weight gain, irregular bleeding, ectopic pregnancies, gall bladder and vision problems and carcinomas in the breast and reproductive tissues. Smoking while on birth control increases risk of heart disease.
  • Ingredients: Inactive ingredients generally found are; purified water, titanium dioxide, lactose, magnesium stearate, carnauba wax, polyethylene glycol, microcrystalline cellulose, croscarmellose sodium, hypromellose, polysorbate 80, ferrixoxide and corn starch.

Sodium Sulfacetamide

Sodium Sulfacetamide goes by the brand names; Karon, Novace and Sulfacet-R which is made by Dermick Laboratories. It is prescribed as a cream for topical use. It slows the growth of acne and has anti-inflammation properties.

Because it is an antibiotic you can expect at least eight weeks of use before youíll see results. Sulfacet-R is used for its antibacterial properties. It helps with inflammation and reduces growth of bacteria that causes acne.
  • Side Effects: Two % of patients will experience skin irritation, burning and itching. Other side effects include: rashes on the skin, pain in the joints, mouth sores and fever. Sun and harsh weather conditions should be avoided while using this medication as they can further irritate the skin. You should also be very careful about using any other medications before speaking to your doctor.
  • Ingredients: It is made with a 10% Sulfacetamide and 5% Sulfur solution, propylene glycol, polyethylene glycol 400 monolaurate, purified water, simethicone emulsion, sodium polynaphthalenesulfonate, zanthan gum, talc, sodium metabisulfite, 2-bromo-2-nitropropane-1, butylaraben, 3-diol, colloidal activated attapulgite, iron oxides, butylparaben, zinc oxide and lauramide DEA.

Spirono Lactone

Also known as Spironolactone and sold under the brand name, Aldactone. It is taken orally and only by prescription tablet. It is often used as a treatment for hyperaldosteronism (which is when the hormone aldosterone is produced in abundance) and used to treat low potassium as well as for the retention of fluid as with edema.

It is a diuretic and blocks androgen-receptors reducing acne. Some doctors prescribe it when women have excess hair that is unwanted or hirsutism. This drug has been in use since 1959 and is made by Pfizer. Some results will be seen after twelve weeks with better results after six months taking Aldactone.
  • Side Effects: Side-effects reported for this prescription are muscle weakness, lack of energy, pain and cramps. Some patients have reported unusual bruising and bleeding as well as a decreased appetite. There are reports of vomiting, nausea, diarrhea, cramping, gastritis, bleeding and ulceration. For men it can cause the inability to get an erection and in women irregular menstruation. In addition it can cause headaches, lethargy, drowsiness, ataxia, confusion and renal dysfunction can happen.
  • Ingredients: Inactive ingredients you can expect to see are: Triacetin, titanium dioxide, calcium sulfate dehydrate, colloidal silicon dioxide, sodium lauryl sulfate, pregelatinized (corn starch), croscarmellose sodium, crospovidone, providone, polyethylene glycol, polydextrose, hypromellose, lactose monohydrate, peppermint flavor, magnesium stearate.

Tazarotene

The brand name Tazorac is used for prescriptions for acne with Tazarotene as the active ingredient. It is a topical solution applied once a day in strengths of .05 or .1. It is prescribed for both acne and plaque psoriasis. It works to both unclog pores and reduce inflammation. In trial studies 50% of patients saw improvements of their lesions within 12 weeks of using Tazorac. This drug is produced by Allergen and approved in 1997. It generally takes between four to six weeks after taking it to see results.
  • Side Effects: The largest side effect is with women who are pregnant or become pregnant while using this drug- serious birth defects and/or death in the fetus will occur. In addition, exposure to sun, cold or wind should be minimized as it will irritate the skin further. Other side effects are: stinging, dry or red skin, peeling skin, burning and itching occur in 10-30% of users.
  • Ingredients: Inactive ingredients for this drug are: butylated hydroxyanisole, carbomer homopolymer type B, Ascorbic acid, butylated hydroxytoluene, edetate disodium, purified water, polysorbate 40, tromethamine, hexylene glycol, poloxamer 407, and polyethylene glycol 400.

Tretinoin

Tretinoin is used in the brand Retin-A which is manufactured by Ortho Dermatologics and has been used for just over twenty years.

Other brands that use Tretinoin are Retin-A Micro, Avita and Renova. Itís used topically as an acne skin cream, gel or liquid and is prescribed because it increases the speed of replacement of skin cells, helps keep follicles unplugged and pores cleared as well as reduces inflammation. In studies patients showed 32-45% reduction in lesions.
  • Side Effects: Patients may see an initial increase in the flare of acne, severe skin damage when time is spent in the sun, other skin meds can be bad to mix while using this, soaps and cleansers can also cause irritations, skin swelling, irritation, lightening/darkening of skin, increase in sores, increase in redness and more blisters or crusted skin. It is not recommended for use if you plan on getting or are pregnant or nursing.
  • Ingredients: Inactive ingredients are butylated hydroxytoluene, benzyl alcohol, trolamine, sorbic acid, dimethicone copolyol, glycerin, carbomer 934p, methyl methacrylate, water, glycol dimethacrylate, disodium EDTA, and propylene glycol.
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