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Acne Treatments: Topical and Oral Medication

Updated: Mar 11


Over-The-Counter Medications For Acne

Acne occurs when oil, dirt, and dead skin cells on the skin clog the pores. To treat acne, you need to remove the bacteria and excessive oil. There are several subtypes of acne including close and open comedones, colloquially known blackhead and white heads. These can be managed via over-the-counter medications.

Effective over-the-counter topical medications include:

  • Salicylic acid

  • Benzoyl-peroxide

  • Tea tree oil

  • Zinc

  • Sulfur

  • Resorcinol

These ingredients reduce the amount of sebum produced by the body and reduce inflammation, aiding in acne recovery and prevention of new acne formation.

When you use a lotion, gel, or cream containing these ingredients, apply the products as instructed on the packaging. It is generally encouraged to include moisturiser in your skincare routine to strengthen your skin barrier.

Read the directions carefully and avoid overuse, as some products can cause side effects such as dryness, irritation, burning sensation, and skin peeling. If you have sensitive skin, attempt to use only one product at a time.

Topical Medications for Acne (Prescription)

If over-the-counter topical medications do not improve the condition, consult a dermatologist. They might prescribe topical medications.

The following topical medications are available:

  • Topical Clindamycin (antibiotic)

  • Topical Retinoids: promote skin turnover and improve acne and acne scars. Large doses can be harmful to a developing fetus. Skin redness and peeling may occur at the beginning of use but will subside as the skin becomes accustomed to the medication. Always wear sunscreen when using retinoids.

Oral Medications for Acne (Prescription)

Woman consuming a oral medication

Your doctor may prescribe oral medications for severe acne that does not improve with topical treatments. Here is the list of them:

  • Antibiotics: Tetracycline and others. They are only recommended for short-term use due to concerns about rising bacterial resistance.

  • Birth control pills: regulate hormone levels to improve acne.

  • Isotretinoin: It (a retinoid derived from vitamin A) is considered the most effective treatment for cystic acne. It reduces the size of the sebaceous glands and the production of oil and fat. It also regulates skin cell turnover. It is effective for severe acne but has its side effects including common side effects such as dry eyes, dry mouth, headache, intestinal disturbances, mood disorders. Mood disorders, headaches, nosebleeds, intestinal disorders, and hematuria.It is teratogenic and not safe during pregnancy.

  • Spironolactone: Effective for severe acne and cystic acne. Originally used as a diuretic to reduce swelling and high blood pressure. It improves acne with its anti-androgen effects. It is only effective in women especially for acne around the chin and on the lower half of the face.

Side Effects of Acne Treatment

Common side effects of acne medications:

  • Topical medications: dryness, itch, peeling, teratogenicity.

  • Oral medications: dizziness, lightheadedness, decreased effectiveness of birth control pills, effects on the fetus, depression, suicide attempts, effects on cholesterol levels, effects on liver function

  • Antibiotics: stomachache, diarrhea, nausea, photosensitivity

It is important to discuss which treatment you should practice with the dermatologist and use as medically directed.

In addition, take extra precaution if you are of child-bearing years or are currently pregnant. Best to consult your doctor for a comprehensive list of side effects and contraindications!

Consider surgical, laser , or chemical peels if you have more severe acne and scarring.

Achieving Acne-Free Skin

Happy woman kicking her feet in the ocean water at the beach

If you suffer from severe acne or acne scars that show no improvement with medications or lifestyle changes, you may want to consider cosmetic dermatology procedures such as:

  • Laser: the light from the laser reduces bacteria load that causes acne. They are also effective in treating Acne Scars.

  • Chemical peel: removes the top layer of skin for skin rejuvenation, comedones, superficial scarring.

  • Intralesional steroid injections: effective for cystic acne and severe acne scars.

  • Phototherapy

  • Microdermabrasion

  • Microneedling

  • Drainage

  • Ultrasound technology

  • Extraction

  • Laser resurfacing

  • Surgical procedure: the dermatologist may propose this for deep ice-pick scars.

Click here for more information on acne and acne scar treatment.

And, along with treatment, try to improve your lifestyle. Lifestyle modifications that can help improve acne include the following:

  • Use oil-free and alcohol-free cosmetics.

  • Frequent change of pillowcases, as sebum from the scalp can affect acne.

  • Wash your face with a mild cleanser that does not contain exfoliants. Wash your face no more than twice a day (Scrubs may aggravate inflammatory acne).

  • Avoid the use of lotions containing fragrance or oil.

  • Use cosmetics labeled as non-comedogenic.

  • Remove makeup before you go to sleep.

  • Apply oil-free sunscreen daily.

  • Wash your face and body after exercises to remove the excessive sebum, sweat, and bacteria.

  • Avoid eating too much food with high glycemic index including white bread, pasta, and sweets.

  • Avoid stress (take deep breaths, get a good night's sleep, exercise, do yoga, meditate, talk to friends or a counselor to reduce stress)

  • Do not touch, pick, pop, or scratch the pimples.


Acne is a condition you can treat with improvements in lifestyle and proper medication and procedure. Some people may suffer from chronic severe acne due to genetic factors. Also, some over-the-counter topical products can cause side effects, so if you have any concerns or are pregnant, feel free to consult a dermatologist. Never blame yourself and give up your treatment!

Schedule a consultation today and start your acne recovery journey today.

This blog post was medically reviewed by Dr Summer Zhang.


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