10 Drugs Commonly Prescribed for Acne

Medically Reviewed By William C. Lloyd III, MD, FACS
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Young Hispanic girl applying acne cream to spots on face in mirror
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Acne, acne vulgaris, is the most common skin condition in the United States. Most people will experience a breakout at some point during their lives. Breakouts can range from mild to severe and may or may not require a prescription acne medication.

Acne occurs when skin pores become clogged with oil, dead skin, and debris. The blocked pore can also trap bacteria, which triggers inflammation. Although acne can affect any age group, it is most common in teenagers and young adults. Hormones are the most likely reason for this, but the exact cause remains unclear. Treating acne aims to unclog pores, decrease oil production, reduce bacteria, and bring down inflammation. Medications play a key role in achieving these treatment goals.

Classes of Acne Drugs

Over-the-counter (OTC) acne treatments are often effective for mild to moderate acne. They can help dry up oil, kill bacteria, and unclog pores by increasing skin cell turnover. However, they are not strong enough to treat severe or inflammatory acne. If OTC treatments fail to improve acne within eight weeks, it’s time to see a dermatologist for prescription treatment.

Classes of prescription acne drugs include:

  • Acid keratolytics break down and decrease the production of keratin, a protein whose overproduction can lead to clogged pores. These acids are topical exfoliants to help unclog pores. Side effects include skin redness and irritation.

  • Antibiotics work to kill or reduce bacteria on the skin. They also decrease redness and inflammation. Topical and oral products are available. Doctors prescribe them for short-term use in combination with products from other classes. Side effects are not common, especially with topical antibiotics, but they can make your skin sensitive to the sun.

  • Anti-androgen agents block the effects of androgen hormones on oil production. This treatment is only for females if antibiotics do not work. Side effects include breast tenderness and menstrual problems.

  • Retinoids work by increasing skin cell turnover and promoting peeling, which keeps pores from clogging. They also decrease the size and activity of oil glands. Both topical and oral products are available. Side effects include skin dryness, redness, and sun sensitivity. Oral retinoids can also cause serious birth defects. Anyone taking oral retinoids must participate in a risk management program.

  • Oral contraceptives help modulate hormone levels. This treatment is only for females. Combination oral contraceptives work best, but it can still take a few months to see their effects. Another acne treatment can help while you wait to see the full effects of the contraceptive. Side effects may include nausea, weight gain, breast tenderness, and headache.

Common Acne Drugs

For severe acne, your doctor will likely recommend a combination of topical acne medication and oral acne medication. Once your skin clears, maintenance treatment may be different. Doctors commonly prescribe drugs on the following acne medication list:

  1. Azelaic acid (Azelex, Finacea) is an acid keratolytic. It also has antibacterial properties. It comes as a gel, foam or cream you apply twice a day.

  2. Clindamycin (Cleocin-T, Clindagel, others) is an antibiotic for topical use. It is available as a foam, gel, lotion, solution, and premedicated swab. Depending on the form and the brand, you apply the product either once or twice a day. There is also a combination product that contains benzoyl peroxide.

  3. Dapsone (Aczone) is an antibiotic with anti-inflammatory properties. It is a gel you apply twice a day.

  4. Doxycycline (Doryx, Vibramycin, others) is an oral antibiotic. The dosage may be once or twice a day. Taking it with food or milk can help with stomach upset, but it can also decrease the drug’s absorption. Wear sunscreen with this product.

  5. Isotretinoin (Amnesteem, Claravis, others) is an oral retinoid. You take the capsule twice a day with meals. Treatment usually lasts for 4 to 5 months. The original brand name of this product was Accutane. Wear sunscreen with this product.

  6. Minocycline (Minocin, Solodyn, others) is an oral antibiotic with a regular and extended-release form. You take it once or twice a day, depending on the dosage form. There is also a topical version of this antibiotic. Wear sunscreen with this product.

  7. Progestin/estrogen are the two hormones in combination oral contraceptives. There are four of these products with FDA approval to treat acne, although any combination product will probably help. The four products have different forms of progestin and estrogen. Brand names include Beyaz, Estrostep, Ortho-Tri-Cyclen, and Yaz. Wear sunscreen to avoid spotty skin darkening.

  8. Spironolactone (Aldactone) is an anti-androgen that is also a blood pressure and heart disease medicine. You take it once or twice a day. This product is not a first-line treatment.

  9. Tazarotene (Tazorac) is a topical retinoid that comes as a cream, foam or gel. You apply it at bedtime. Acne can worsen during the first week or so of treatment. With continued use, skin should clear. Wear sunscreen with this product.

  10. Tretinoin (Altreno, Retin-A, others) is a topical retinoid. It comes as a lotion, cream or gel you apply at bedtime. Like tazarotene, acne can worsen before it gets better. Wear sunscreen with this product.

There are other antibiotics not on this list that doctors use less commonly for acne. They include azithromycin (Zithromax), erythromycin, tetracycline, and trimethoprim/sulfamethoxazole (Bactrim, Septra).

Acne treatment varies from one person to the next and it often takes trials of different medicines. But it is possible to get clear skin if you can commit to a treatment regimen. Talk with your doctor about the risks and benefits of your treatment options. If you are experiencing acne medication side effects, ask your doctor about alternatives. You may also be a candidate for other therapies, such as steroid injections, chemical peels, and laser treatments.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 1
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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