Navigating Acne Treatments: Over-the-Counter vs. Prescription Medications

An example of hormonal acne

Hormonal acne is often inflammatory and can cause painful nodules that take weeks to resolve and leave hyperpigmentation.

Introduction

Acne is a common skin condition that can range from occasional “pimples” to persistent, severe outbreaks or even cystic features. Understanding the differences between over-the-counter (OTC) options and prescription medications can help you make informed decisions about your skin health.

Over-the-counter (OTC) Treatments: A First Step

Many people begin their acne treatment journey with Over-the Counter (OTC) products, which can often be a helpful starting point.

• Salicylic Acid: Beneficial for treating many types of acne, particularly non-inflammatory comedones like “blackheads” and “”whiteheads".

• Benzoyl Peroxide: Recommended for its antibacterial properties, reducing acne-causing bacteria and serving as a foundation for acne treatment (1,2).

• Adapalene 0.1% cream: This is a topical retinoid, or vitamin A derivative that helps reduce the amount of oil that your oil glands make and unclog your pores. Look for brands like Differin or Effaclar by La Roche Posay.

Prescription Options: When OTC Isn't Enough

Topical Antibiotics

For more persistent acne, topical antibiotics are often prescribed. Medications such as clindamycin and erythromycin target acne-causing bacteria, reducing infection and inflammation. These are frequently used alongside other treatments to enhance effectiveness and minimize antibiotic resistance (2).

Topical Retinoids

Prescription-strength retinoids like tretinoin and adapalene 0.3% are powerful tools against stubborn acne. They help to:

• Promote rapid skin cell turnover

• Prevent clogged pores

• Manage severe and cystic acne

Retinoids are particularly useful for adult acne due to their effectiveness in managing persistent breakouts (2,3).

Other Topicals

In addition to retinoids and antibiotics, other topical agents such as azelaic acid can be effective, particularly for patients with sensitive skin or for whom other treatments may not be suitable. Azelaic acid works by reducing inflammation and killing acne-causing bacteria (1).

Oral Antibiotics

For moderate to severe acne, especially types that are prone to cause acne scarring, oral antibiotics are a common prescription. These can help reduce the presence of acne-causing bacteria and lessen inflammation. Doxycycline and minocycline are examples of oral antibiotics that might be prescribed as part of an acne treatment regimen (2).

Oral Hormonal Therapy

Medications like oral birth control pills or spironolactone, which helps to block androgens from binding to the oil gland, can also be helpful for female patients, especially if you have other symptoms like irregular menstrual cycles or hair loss.

Oral Isotretinoin

Isotretinoin is a potent medication used for treating severe, persistent acne that hasn't responded to other treatments. It targets multiple causes of acne by:

• Shrinking oil glands

• Reducing bacteria

• Unclogging pores

• Decreasing inflammation

Due to its powerful effects, isotretinoin is prescribed carefully and under close medical supervision (3).

Conclusion: Personalized Acne Treatment at Rixis Dermatology

At Rixis Dermatology, we are passionate about treating acne and understand that acne is unique to each individual. Our approach combines the latest research with clinical expertise to provide effective, personalized treatment plans. Whether you're dealing with occasional blemishes or more severe acne, we're here to help you achieve clearer, healthier skin.

If you're seeking solutions for acne or looking for the best treatment or medication that suits your skin type, we're here to guide you. To explore your treatment options contact Rixis Dermatology to book your visit.

References

1. DermNet NZ. Acne Treatment: https://dermnetnz.org/topics/acne-treatment.

2. Cleveland Clinic. Acne: https://my.clevelandclinic.org/health/diseases/12233-acne.

3. National Center for Biotechnology Information. Treatment of Acne Vulgaris: https://www.ncbi.nlm.nih.gov/books/NBK459173/.