Oral Acne Medication Options

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There is no doubt that acne can be tough to treat. If you've tried several topical medications without success, or you have a severe case, oral acne medications are generally the next step in the treatment process. There are several options available. Each of them carries its own risks and benefits.

This article discusses the various types of oral acne medications you can use to help improve the appearance and health of your skin.

Doctor writing prescription for medication with pill bottle in hand

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Oral Medications for Severe Acne

Not all acne clears up with topical medications (i.e., creams, lotions, or gels).

Oral medications, or those taken by mouth, work systemically (body-wide) to improve the skin from the inside out.

Some oral medications are taken once a day, while others are take more often. Regardless, you should take your dose(s) at the same time(s) every day.

Persistent or severe cases of acne are difficult to control. In the majority of cases, these types of acne require oral medications. Severe acne is sometimes called cystic acne or nodular acne. When you have severe acne:

  • It creates large, deep, inflamed breakouts.
  • Topical medications can't get deep enough to effectively treat these types of blemishes.

Acne often occurs on other areas of the body, like your back or shoulders. It can be tough to reach those areas to effectively apply topical treatments. Oral acne medications, on the other hand, can work on deeply inflamed blemishes no matter their location.

Even if your acne isn't necessarily severe, it might simply be stubborn. Sometimes you may try topical treatments and your skin still isn't clearing up. If this describes your situation, oral medications can give your treatment the boost it needs so you can see actual results.

In any case, if you're having trouble getting your acne under control, see a dermatologist. All oral acne medications are prescription only. There are no over-the-counter alternatives. 

Oral Antibiotics

Oral antibiotics have been used to treat acne for many years. Like topical antibiotics, oral antibiotics work by reducing Propionibacteria acnes. This is the bacteria responsible for acne breakouts. Oral antibiotics also help decrease inflammation of the skin.

Dermatologists usually start people on a high dosage. Then they move them to lower dosages as acne improves. Oral antibiotics are used to treat moderate, severe, or persistent acne.

The most common oral antibiotics prescribed for acne treatments include:

Due to the rise in antibiotic-resistant bacteria, oral antibiotics should only be used to treat acne when combined with topical therapy. And they should be prescribed for no longer than three to six months, according to the American Academy of Dermatology. Dermatologists should avoid using just one type of therapy.

Oral antibiotics work best when paired with topical acne treatments. Expect your doctor to prescribe topical retinoids, benzoyl peroxide, or another topical treatment to use as well.

Oral Contraceptives for Acne in Women

Oral contraceptives, also known as birth control pills, are frequently used to treat acne in women. The drugs are able to reduce oil gland secretions by suppressing androgen hormones.

Oral contraceptives may be an ideal choice for women with acne that comes and goes with their menstrual cycle. It may also be a good choice for those who want to use a form of birth control anyway.

Some birth control pills have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne in women. This includes the medicines Ortho Tri-Cyclen and Beyaz.

But you don't necessarily need these specific brands. Birth control pills have been prescribed to treat acne for many years. Most doctors agree nearly any formulation will give the same effect.

You'll also likely need a topical acne medication to use alongside oral contraceptives.

Other Common Oral Acne Medications

Aside from the above, the following are commonly prescribed oral acne meds.

Aldactone

Aldactone (spironolactone) is another medication that is for adult women only. It's not specifically an acne treatment but can be used in certain circumstances to treat hormonal fluctuations that contribute to breakouts.

Aldactone isn't very commonly used, and it's not a first-line acne treatment choice. But for some women, it's helpful in treating acne that isn't getting better with more conventional treatments.

Accutane

Accutane (isotretinoin) is a super-powerful acne medication. It works when all other acne treatments have failed. And it's considered the best treatment for severe acne.

Accutane works by shrinking the sebaceous glands, which are small glands near hair follicles that produce oil. This reduces the amount of oil found on the skin. As a result, it also makes the skin produce fewer comedones, or pore blockages. When your pores aren't blocked, you experience fewer or no pimples.

Accutane is not used during pregnancy due to the extremely high risk of birth defects. It should also not be used if you are breastfeeding. In case you become pregnant while taking Accutane, you should immediately stop taking the drug.

If your doctor gives you a prescription for Accutane, you will be enrolled in the iPledge program. This is an FDA-approved initiative designed to reduce the number of birth defects caused by Accutane. Everyone has to enroll, even men. The requirements for men and women who can't get pregnant are different than those for women who can get pregnant, however.

You'll also be monitored for side effects during the course of your treatment. The good news is most people only need one or two courses of the treatment before acne is gone for good.

Your dermatologist can help you decide if this is the right option for you.

Summary

If you have severe, moderate, or persistent acne, topical medications may not always work. In that case, your dermatologist may prescribe oral medications.

Oral medications work alongside topical medications to treat your acne. Each medicine comes with its own risks and benefits. It's important to follow your dermatologist's directions to make sure you treat your acne safely and effectively.

A Word From Verywell

Acne, no matter how severe, can be frustrating. If topical treatments alone aren't improving your acne, or if your acne is quite severe or widespread, oral medication is the best option.

In some cases, you'll only need to take oral medications for a short period of time. These medications help you get acne under control. Then you maintain your skin with topical medications. Other times, though, you may need to take them for longer periods of time.

If you're at all worried about taking an oral acne medication, or if you have questions or concerns about your treatment, talk to your dermatologist.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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