Topical Prescription Acne Treatments

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It would be great if acne could always be taken care of with over-the-counter products. But, as you may well have experienced, that's not always the case.

More than likely, to get some real results you'll need to turn to your physician for a prescription acne treatment. The good news is, there are plenty of topical medications that are super effective in treating acne.

So, if OTC acne products just aren't helping, it's time to move on to the prescription options.

Azelaic Acid

Azelaic acid is a prescription cream or gel for mild to moderate acne.

It is believed that azelaic acid works by reducing propionibacteria acnes, the bacteria responsible for acne breakouts. It also helps normalize the shedding of dead skin cells and decreases inflammation. Azelaic acid has the added benefit of improving post-inflammatory hyperpigmentation, the discoloration left after an acne lesion has healed.

Azelaic acid is also sold under the brand names Azelex and Finacea. According to published studies, azelaic acid should be used with caution in patients with sensitive skin due to side effects that include redness, burning, and irritation. It should also be used with caution in patients with with Fitzpatrick skin types IV or greaterAlso, the safety of this medicine during pregnancy is not known.

Topical Retinoids

Topical retinoids are extremely popular and effective acne treatments. Topical retinoids are a group of medications derived from synthetic vitamin A. 

The topical retinoids that are used to treat acne include tretinoin and tazarotene. Adapalene is more accurately described as a retinoid-like compound, but because it works in just the same way it's often included in the topical retinoid group. 

Topical retinoids rapidly exfoliate the skin, keeping your pores unclogged and preventing comedones. They're used to treat mild to moderate breakouts, as well as severe acne.

Topical retinoids, especially the topical retinoid tretinoin, have other advantages — they're effective anti-aging treatments. They are often used to reduce the look of fine lines and wrinkles, making retinoids a popular treatment choice for adult onset acne sufferers.

A common side effect during the first few weeks of topical retinoid treatment is a flare up of acne. This should, however, clear as the patient continues with the treatment.

The most common topical retinoids used to treat acne are:

Topical Antibiotics

Topical antibiotics improve acne by stopping the growth of acne-causing bacteria, propioni acnes. They can also help reduce inflammation and might decrease the amount of blocked pores.

Topical antibiotics aren't used as often today as they were in years past because they can contribute to antibiotic-resistant bacteria and some users may experience side effects. To counteract this problem, topical antibiotics should be used along with another acne treatment medication, like a topical retinoid or benzoyl peroxide. Monotherapy with topical antibiotics are used for only a short time period (12 weeks). 

Topical antibiotics are generally prescribed for moderate to severe acne. The most common topical antibiotics used to treat acne are clindamycin and erythromycin.

The use of oral and topical antibiotics in combination to treat acne should be avoided.

Topical Combination Medications

Topical combination medications, as the name suggests, include medications that contain two acne-fighting ingredients. You get the benefits of both medications with just one application.

These medications can kill acne-causing bacteria, normalize the shedding of dead skin cells, keep pores clear, and reduce the number of comedones, depending on the combination acne medication that your dermatologist prescribes.

An important feature of topical combination therapy is the fact that less antibiotic is often needed to kill bacteria compared to using topical antibiotics alone. Additionally, studies have shown that using a combination therapy increases adherence to treatment and may therefore increase effectiveness.

There are plenty of topical combination medication options, including:

  • Acanya (clindamycin and benzoyl peroxide)
  • Benzamycin (benzoyl peroxide and erythromycin)
  • BenzaClin (benzoyl peroxide and clindamycin)
  • Duac (benzoyl peroxide and clindamycin)
  • Epiduo (adapalene and benzoyl peroxide)
  • Onexton (clindamycin and benzoyl peroxide)
  • Ziana (clindamycin and tretinoin)

Your Dermatologist Can Prescribe the Right Medication for You

There are so many prescription medication options available to treat acne. Luckily, your dermatologist will know which will work the best for your breakouts.

Prescription medications can work quickly. Within just a few weeks, you can start noticing the improvement of your skin. So, don't wait any longer. Give your dermatologist a call.

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Article 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.
  1. Tan AU, Schlosser BJ, Paller AS. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol. 2017;4(2):56–71. Published 2017 Dec 23. doi:10.1016/j.ijwd.2017.10.006

  2. Fox L, Csongradi C, Aucamp M, du Plessis J, Gerber M. Treatment Modalities for Acne. Molecules. 2016;21(8):1063. Published 2016 Aug 13. doi:10.3390/molecules21081063

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