Table of ContentsView AllTable of ContentsWhen to UseOral AntibioticsOral ContraceptivesIsotretinoinAnti-Androgens
Table of ContentsView All
View All
Table of Contents
When to Use
Oral Antibiotics
Oral Contraceptives
Isotretinoin
Anti-Androgens
Oral acne medicationsare typically prescribed when topical medications fail to clear or control acne. These drugs may be used on their own but are more commonly used in combination with topical treatments.
Prescription oral acne medications include certain antibiotics,hormonal contraceptives, isotretinoin, and Aldactone (spironolactone). They’re typically used for moderate to severeacne vulgaris(the most common form of acne)
This article describes the various oral acne treatment options, including the possible side effects and risks.
Kamonchai Mattakulphon / Getty Images
When Oral Acne Drugs Are Needed
Not all acne responds to topical medications likebenzoyl peroxideorsalicylic acid. When acne resists topical treatment, oral drugs may be prescribed to treat the underlying causes of outbreaks. Some of these drugs are taken daily, while others require several doses a day.
Oral acne medications are typically recommended for moderate to severe refractory acne (treatment-resistant acne). This includessevere types of acnesuch ascystic acneornodular acne.
Oral drugs may also be used if your acne is widespread (such as on the back where it can be hard to apply topical creams or lotions). At the same time, applying topical medications to large areas of the skin can cause widespread side effects like redness, irritation, dryness, or peeling.
Even if your acne isn’t particularly severe, it can be stubborn and benefit from oral treatment. Speak with yourdermatologistabout the benefits and risks to make an informed choice. In most cases, the lowest effective dose is prescribed to reduce the risk of side effects.
The most common oral antibiotics prescribed for acne include:
Common side effects include dizziness, nausea, diarrhea, and yeast infections. A severe and potentially dangerous allergic reaction, calledanaphylaxis, can also sometimes occur.
Antibiotic ResistanceDue to the rise in antibiotic-resistant bacteria, oral antibiotics for acne should only be used in combination with topical antibiotics. The dual approach greatly reduces the risk of drug resistance. Moreover, antibiotics for acne should be used for no longer than three to six months.
Antibiotic Resistance
Due to the rise in antibiotic-resistant bacteria, oral antibiotics for acne should only be used in combination with topical antibiotics. The dual approach greatly reduces the risk of drug resistance. Moreover, antibiotics for acne should be used for no longer than three to six months.
It is not uncommon for dermatologists to prescribetopical retinoids, benzoyl peroxide, or other topical treatments to support oral antibiotic therapy.
Possible side effects of oral contraceptives include nausea, vomiting, headache, stomach cramps, bloating, breast tenderness, swelling of the ankles and feet, and weight changes.
Most dermatologists will prescribe topical acne medication to use alongside oral contraceptives.
Common side effects of isotretinoin include headache, back pain, muscle or joint pain, sore throat, dry mouth, dry eyes, rash, and mild itching. Anaphylaxis is rare but can occur.
How to Tell If Skin Purging Worked
Pregnancy RisksIsotretinoin is not used duringpregnancydue to the high risk of birth defects. If you become pregnant while taking isotretinoin, stop taking the drug immediately. Use condoms and other methods of birth control while taking isotretinoin to avoid pregnancy. Do not breastfeed while taking isotretinoin.
Pregnancy Risks
Isotretinoin is not used duringpregnancydue to the high risk of birth defects. If you become pregnant while taking isotretinoin, stop taking the drug immediately. Use condoms and other methods of birth control while taking isotretinoin to avoid pregnancy. Do not breastfeed while taking isotretinoin.
If prescribed isotretinoin, you will be enrolled in theiPledge program, an FDA initiative designed to manage the risks of isotretinoin.
Aldactone isn’t commonly used and is not a first-line acne treatment choice. However, it may be appropriate for some who cannot tolerate or take oral contraceptives. It can also do double duty as a prescribed treatment for high blood pressure and heart failure.
Aldactone should not be used if you are pregnant or trying to get pregnant. Since this medication blocks androgens, it can cause defects in thegenitals and reproductive systemof male babies.
Summary
If you have moderate to severe acne that does not respond to topical treatment, oral acne medications may be prescribed. These are commonly used with topical acne creams and ointments to treat acne directly and from within.
These include oral antibiotics, oral contraceptives, isotretinoin, and Aldactone (spironolactone). Oral contraceptives and Aldactone are used for acne related to the menstrual cycle.
Speak with your dermatologist to understand the benefits, risks, and proper use of any oral acne medication. Some like isotretinoin and Aldactone can be hazardous if you become pregnant.
Prescription Topical Acne Treatments
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tan AU, Schlosser BJ, Paller AS.A review of diagnosis and treatment of acne in adult female patients.Int J Womens Dermatol. 2018;4(2):56-71. doi:10.1016/j.ijwd.2017.10.006American Academy of Dermatology.Acne clinical guideline.Zaenglein AL, Pathy AL, Schlosser BJ, et al.Guidelines of care for the management of acne vulgaris.J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018Zouboulis CC, Bettoli V.Management of severe acne.Br J Dermatol. 2015;172 Suppl 1:27-36. doi:10.1111/bjd.13639American Osteopathic College of Dermatology.Accutane.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tan AU, Schlosser BJ, Paller AS.A review of diagnosis and treatment of acne in adult female patients.Int J Womens Dermatol. 2018;4(2):56-71. doi:10.1016/j.ijwd.2017.10.006American Academy of Dermatology.Acne clinical guideline.Zaenglein AL, Pathy AL, Schlosser BJ, et al.Guidelines of care for the management of acne vulgaris.J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018Zouboulis CC, Bettoli V.Management of severe acne.Br J Dermatol. 2015;172 Suppl 1:27-36. doi:10.1111/bjd.13639American Osteopathic College of Dermatology.Accutane.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tan AU, Schlosser BJ, Paller AS.A review of diagnosis and treatment of acne in adult female patients.Int J Womens Dermatol. 2018;4(2):56-71. doi:10.1016/j.ijwd.2017.10.006American Academy of Dermatology.Acne clinical guideline.Zaenglein AL, Pathy AL, Schlosser BJ, et al.Guidelines of care for the management of acne vulgaris.J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018Zouboulis CC, Bettoli V.Management of severe acne.Br J Dermatol. 2015;172 Suppl 1:27-36. doi:10.1111/bjd.13639American Osteopathic College of Dermatology.Accutane.
Tan AU, Schlosser BJ, Paller AS.A review of diagnosis and treatment of acne in adult female patients.Int J Womens Dermatol. 2018;4(2):56-71. doi:10.1016/j.ijwd.2017.10.006
American Academy of Dermatology.Acne clinical guideline.
Zaenglein AL, Pathy AL, Schlosser BJ, et al.Guidelines of care for the management of acne vulgaris.J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037
Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018
Zouboulis CC, Bettoli V.Management of severe acne.Br J Dermatol. 2015;172 Suppl 1:27-36. doi:10.1111/bjd.13639
American Osteopathic College of Dermatology.Accutane.
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