There are many prescription medicines to control moderate to serious acne. Some are topical (applied to the skin surface); others are taken orally, as pills, or subcutaneously (under the skin), as shots. All necessitate at least one visit to a dermatologist, a physician who specializes in skin problems. While your general physician can and may prescribe these medications and treatments, it is recommended that you see a specialist. Fortunately, the majority of these treatments have pros and cons that are comparatively simple to delineate.

Isotretinoin (Accutane)

Accutane is an oral medication that has been on the market for many years, so its effects are well known. It has been found to be one of the most effective, prescription medications for the treatment of moderate to severe acne. It's been utilized for cystic and other advanced forms of acne, and has been used safely by millions for that purpose. However, it does have a few potential side effects and risks. Isotretinoin is a synthetic molecule, a retinoid similar to Vitamin A, available in pill form. Normal dosage is once or twice per day for four to five months.

Pregnant women and women who may become pregnant are generally advised not to take isotretinoin. Several studies have indicated that it can result in birth defects. Women of childbearing age who are not using a reliable method of birth control may be told they are not eligible to take this drug, due to the risks of pregnancy during treatment.

Accutane has also been associated with depression and possible suicidal thoughts or plans in teenagers. Because teenagers are the largest population of potential users, there have been concerns regarding the extensive use of Accutane, given this potential side effect. Patients using Accutane should be aware of this risk. Family members should monitor mood and behavior, being aware of the signs of depression and suicidal ideas. The prescribing physician should be notified immediately if it is felt these are present and will most likely advise discontinuing use of the medication. This is felt to be a small risk, however.

Accutane functions to cut back oil production, unclog pores and kill the bacteria that contribute to acne. Typical side effects may include headache, excessive skin dryness, diarrhea and other minor problems. As with all side effects, everyone has a different reaction and some people experience no side effects whatsoever. Side effects, however, are a major reason for seeing a physician regularly during the course of treatment.

Oral Antibiotics

Acne is caused, in part, by a bacteria (Propionibacterium acnes). As a result, the disease can frequently be successfully overcome simply by taking antibiotics. As is the case with all potent antibiotics, some care is necessary when using these. Patients should be aware of the potential side effects and long-term implications.

Tetracycline (or its derivatives, doxycycline and minocycline) is one of the most commonly used antibiotics in the treatment of acne. Both forms have been in use for numerous years and can considerably alleviate inflammatory acne. Normal dosage is 5 to 10 grams per day at first, although it is cut back as treatment advances. Overall, the treatment may take several months. As with any medical treatment, tetracycline (or its derivates) carries some risk. Some patients' skin becomes sensitive to the sun during treatment. One instruction patients are given at the onset of treatment is to avoid excessive sunlight. You will be instructed not to tan, and to wear a strong sunscreen when you have to be out in the sun.

Erythromycin is another basic antibiotic treatment for acne. It is a broad-spectrum antibiotic and works effectively against Propionibacterium acnes. Like any powerful antibiotic, it can sometimes cause gastrointestinal irritation, which is one reason why it's a prescription drug.

Topical Treatments

A few topical antibiotics can attack the Propionibacterium acnes bacteria directly through the surface of the skin. They are typically employed to address less serious cases of acne. They may even be utilized in cases of acne vulgaris, a mild form of acne.

A number of retinoids are occasionally prescribed. They may be a compound equivalent to those used in over-the-counter medications, but in dosages high enough to warrant or necessitate a prescription and medical supervision. Adapalene is a gel or cream that is usually efficacious within two or three months. It can cause minor skin dryness and discomfort. It aids in unclogging pores to help treat acne. Tretinoin is a natural retinoid that has similar effects.

Anyone who has attempted over-the-counter medications or treatments and not experienced acceptable results has numerous additional alternatives. Almost all acne can be treated medically with success. Medical advances have made suffering from the many forms of acne a thing of the past. Consult with a medical specialist to research your alternatives for treatment.

When I was a teenager and well into my young adult years, I suffered from horrible acne. I spent a lot of time (and money) at the dermatologist's office, undergoing a variety of treatments, and he used to joke with me that it was taking longer for me to grow out of acne than most of his patients. No matter what I did, the treatment would only alleviate the acne somewhat, or for a short time, then it would be back with a vengeance.

Now, there are many more effective treatment options available. Understanding acne and how it can be treated is the first step in having the kind of skin you want - free of blemish.

What is acne?

Acne is a common skin disease that results when pores get blocked and bacteria form inside them. It comes in a variety of familiar forms and affects nearly everyone at some stage, particularly in their teen years. The inflamed, red bumps that sometimes form can be painful, and even painless white pimples are unsightly.

In the surface of the skin are pores, tiny openings called a hair follicle. Deeper inside the pore, near the base of the follicle, there are sebaceous glands that produce sebum, a natural type of oil. That oil helps keep the skin flexible and protected.

Hair continues to grow through the surface, while oil or sebum oozes out the side and is spread around the area. Skin cells grow and die and are sloughed off through washing, rubbing or spontaneously. But that process can be interrupted when the pores close and when bacteria form inside them. The result is acne.

The white pimples that sometimes form are usually a combination of dead skin cells, white blood cells and bacteria. The trapped pus often creates an inflamed, red area around it. The term 'pus' is an adaptation of 'pustule', a type of acne that results when the follicle wall bursts and the white blood cells rush into the area as part of a healing process.

When the tiny bumps or spots appear black they're called blackheads, naturally enough. They're a non-inflamed form of acne that come from the material having poked through the surface. Their dark color isn't the result of contact with dirt on the skin. It's a combination of dead skin cells and sebum that have oxidized. Oxygen in the air causes a chemical reaction that turns them black.

Often, however, the material doesn't break the skin, but simply pushes it up, forming a small, white bump called whiteheads. One form are known as 'milia'. Normally dead skin cells will get washed off or simply fall off the surface. But they can get trapped underneath the surface. This type of acne is common among infants, but can affect people at any age.

All these variations go by a general medical term called 'comedones', and whether that formation is open or closed is part of the clinical difference between them.

As the acne develops it can variously form what are called papules, nodules or cysts. A papule forms when the walls holding the hair follicle burst near the surface. They're small and don't contain pus. A nodule is a hardened lump under the skin, resulting from a break at the base of the follicle. A cyst is a larger, reddened bump. They're soft, but can be very painful.

Naturally, while it's helpful to know what acne is, the most important thing is to be able to treat it. In order to do that, it's necessary to know what type we have. We hope you find the information you need here to help you determine the type of acne you have and the best treatment options.