If you’ve ever suffered from acne then you know they are never fun to deal with. In this day and age, it’s surprising how acne isn’t taken as seriously as it should, considering the long-term psychological consequences that it can result in. Being constantly bombarded with new exotic treatment options, the temptation to try all of them is so big that we’re often impatient to stick to one regimen for a long period of time so we can see results.
Not to mention, acne is a very complicated skin condition, and getting to the root cause of it isn’t as straightforward as it might seem at first. Luckily, with the help of a good doctor and lots of patience and persistence, a cure for acne is well within anyone’s reach.
But in order for us to get to the root cause of acne, we should first examine the most common causes.
There are many different factors that contribute to the appearance of acne.
Let’s start by explaining the physical process behind a pimple. Acne happens when pores in the skin become clogged with oil, bacteria or dead skin cells. During puberty, the oil glands attached to the hair follicles are triggered, which is why this condition appears most often in teenagers. The released sebum travels up the hair and onto your skin. A normal amount of sebum is necessary for keeping the skin soft, moisturized and preventing dry patches. But when the skin starts producing excess oil is when trouble begins.
Other factors can also contribute to the overproduction of sebum such as stress, hormonal changes, and comedogenic cosmetics.
Genetics play a very important part in acne production. The chances of you getting acne are bigger if your parents also have acne.
There are several treatment options for acne. Depending on your age and the severity of your acne, you can get prescribed either topical medication or oral medication, or sometimes both, if your case is more acute.
You might be wondering what falls under the category of topical medication. The most common topical prescriptions include antibiotics, retinoids, benzoyl peroxide, and salicylic acid. Typically, they come in the form of creams, cleansers, lotions, and gels. They work by treating the acne topically and by preventing future breakouts from occurring.
Now let’s discuss the most common oral medication options and how exactly they treat acne.
If you’ve suffered from acne for a long period of time and have tried milder treatments which haven’t worked, then you’re eligible for getting prescribed some kind of oral medication. The truth is, not all acne can be cleared up by topical medication only. However, oral medication is often left as a last result for a reason – they come with harsher side-effects and take longer to work.
Not to mention, for many people, the thought of taking pills is horrifying in of itself, which is why so many people are put off by them. But it’s not all doom and gloom.
Anyone who’s made a google search for acne at some point has come across Accutane, and that’s because it’s the single most powerful acne medication that’s currently on the market. For those suffering from severe acne that haven’t seen results from antibiotics and topical medication, it’s the treatment they’ll likely be prescribed.
Isotretinoin belongs to the group of retinoids, which are forms of vitamin A that alter your DNA transcription. This makes the oil glands decrease in size. Since acne is most often the cause of excessive sebum on the skin, when considering acne treatments it’s one of the most crucial factors to take into account.
Accutane both shrinks and reduces the activity of the sebaceous glands, so there’s a reduction of the amount of sebum that the skin produces.
In addition, it also decreases the number of bacteria in the oil glands, which makes the area less susceptible to comedones and breakouts.
Other than having a miraculous effect on acne and acne scarring, isotretinoin can also help with skin conditions such as psoriasis, and others more severe like lupus and lichen planus.
Every case of acne is different, so there isn’t an exact estimate as to how long will it take for you to see results. Typically, you will start to see results around two weeks after your starting point.
It’s important to mention that in many cases, people notice that their acne gets worse before it gets better. This is because the acne is forced to come out because of the medication, but soon afterward you will notice an improvement and it will continue to get better.
The treatment usually lasts from 15 to 20 weeks. During those weeks your dermatologist will probably make a few appointments just to see how your progress is going. Luckily, most patients who undergo an Accutane don’t relapse after the treatment.
Your dosage largely depends on the severity of your acne, your age, your weight, and your family history.
The recommended daily dose is 0.5 to 1.0 mg/kg a day. Your doctor might start you on a small dose and increase your dose to the one that’s optimal for your case in a few weeks.
The pills should be taken with food or on a full stomach, once or twice a day, depending on your doctor’s instructions.
A few less serious side effects can occur during Accutane therapy, such as:
Make sure to moisturize the skin on your face and body to avoid overly dry skin. If your mouth gets dry, you can suck on a piece of candy or chew gum. Make sure you stay hydrated so you can moisturize the skin from inside out.
Even though these are less frequent, there are a few serious side-effects that can come with taking Accutane. You must take these into account before deciding whether or not to get the treatment.
Tell your doctor immediately if you experience any of the following:
According to statistics, around 25.6% of Accutane cases result in neonatal defects.
Some of the defects include intellectual disabilities, eye and ear abnormalities, heart defects, hydrocephaly, microcephaly, and central nervous system malformations.
Women who took Accutane right before their pregnancy should not breastfeed their children.
It’s not recommended to wax during therapy and 6 months after your treatment, because your skin is highly sensitive and the risk of scarring is higher. On top of scarring, you also risk injury and trauma to the skin during the wax hair removal.
It’s recommended that you wait at least 6 months after you’ve finished your treatment to start waxing or doing any treatments to the skin such as dermaplaning, dermabrasions, peels, and lasers. This also includes tattoos, piercings and any surgical procedures. Make sure to speak to your doctor regarding any skin procedure done.
The general answer is that you shouldn’t drink while on Accutane because it can damage the liver and increase liver toxicity, especially if you drink large amounts of alcohol.
In addition, Accutane can alter the lipid levels in your bloodstream, which can be extremely dangerous.
Depending on your doctor, you might be told that small amounts of alcohol like wine are safe. Their suggestions will largely depend on your age, the dosage of Accutane, whether or not you’re taking any additional medication and your medical history.
If you combine alcohol with Accutane, in some extreme cases, if your liver gets damaged, you might experience additional side effects like redness and tingling of the skin, vomiting and nausea and an increased heart rate.
The most important thing, in this case, is being honest with your doctor.
You’re undergoing a serious treatment after all, and you should always be upfront with your doctor about what kind of substances you take, including any food supplements and vitamins.
Make sure to consult your doctor about the possible side-effects of combining alcohol and Accutane.
In addition to the tips your doctor will give you after your decision to go on Accutane, here are a few things that can help you make the experience easier.
After going on a long treatment for acne, the last thing we want is for all of that to go to waste and have some pimples pop up again. Even though post-Accutane acne relapse is relatively rare, recent clinical experience shows that relapse might be more common than it was initially thought.
However, it depends on a few circumstances in particular.
Relapse rates vary from 10% to 60%, depending on the Accutane dose and the treatment duration. There are a few factors that play a role in these percentages.
First, we need to define what exactly counts as relapse. No Accutane patient is immune to getting a few pimples here and there. After all, to some extent, lifestyle and diet play a major role in acne. So if you’ve gone off Accutane and still experience occasional pimples, then it might be something in your control, so don’t panic.
Another factor that influences relapse rates is age. The younger the patient, the higher the chances of relapsing. This is probably due to the fact that younger patients experience greater fluctuations in their hormone levels as opposed to older patients. The upside of taking Accutane while younger is that you minimize the chances of scarring, which can be equally hard to deal with as acne.
Similarly, there is a higher relapse rate in women who initially suffered from hormonal acne. If the root cause isn’t treated, the acne will probably appear again at some time. So female patients that suffer from polycystic ovarian syndrome and similar conditions should treat the cause directly before considering a second dose of Accutane.
Also, no matter how successful your Accutane treatment will be, it’s important to remember that we’re all different and there’s no universal reason why you might suffer from acne. It’s a complicated matter, so there isn’t only one cure for it because there are various factors that contribute to the appearance of acne. Some people never get them, while others have to go through years and years without finding the right cure.
Like with other treatments, there’s no guarantee that the acne won’t come back after you go off the pills. It ’s not all doom and gloom though, since even if a relapse does occur it will be less severe than the initial state.
Even if it doesn’t work for you the first time, there are other options to explore. Don’t let this bring you down and stay positive.
Another commonly used medicine for controlling acne in females is the birth control pill.
Usually, birth control pills contain synthetic forms of estrogen and progesterone – the female hormones. The ratio depends on the type of birth control and varies often.
These hormones work by stopping the ovaries from releasing an egg and changing the lining of the uterus to prevent implantation.
You might be wondering how each of these hormones play a role in regulating acne. The pill has a direct effect on androgens (often called male hormones) and it decreases the production of sebum, which is very beneficial for making the acne go away.
It’s important to note that the pills should contain both estrogen and progestin so they’re considered as an acne medication. The minipill that has only the synthetic form of progesterone isn’t as effective in improving acne.
Studies show that combined birth control pills have the best chance of improving acne. Also, the studies proved that pills that contain drospirenone or synthetic progestogen are more effective than others.
All in all, there is enough evidence to conclude that the pill can potentially improve your skin and reduce acne.
The FDA has officially approved four types of birth control, all of which are a combination of both estrogen and progesterone. The following pills are prescribed most often:
It’s important to note that the FDA has stated that pills that contain drospirenone may increase the risk of blood clots as opposed to pills that contain other progestins.
The birth control has multiple benefits, most of which aren’t directly related to skin issues.
It’s said to improve periods and make them lighter and less painful and minimize cramps. Some scientific claims state that it can reduce the risk of certain cancers, such as ovarian, colon and uterine cancer.
Finally, there is enough anecdotal and scientific evidence to support the claim that it reduces the amount of acne in most individuals.
There are a few side-effects that can appear while you’re on birth control. The less serious side effects are:
Some serious side-effects of birth control include deep vein thrombosis (DVT), stroke and heart attacks. Even though these are rare, your doctor will ask you to provide a detailed family history to see if you qualify for taking birth control pills. Patients who are more susceptible to these serious side-effects are those who smoke, have a history with cardiovascular problems and are older than 35.
Some pills that haven’t been approved by the FDA have shown a positive effect on acne in clinical studies. If you’re taking oral contraceptives that haven’t shown any improvement in terms of acne, you might want to consider switching brands.
Remember, everybody is different and will have a different reaction to birth control. Some people swear by it as an acne treatment, others claim that It has worsened their acne. If you’re new to birth control, the safest way to go is by taking those that are FDA approved for treating acne.
On average, you should start seeing results after a couple of months. Similarly to Accutane, your skin might break out initially before getting better. Be patient and trust the process. If you want to take birth control solely for its effect on acne, then you should also see a dermatologist so that you have an overall varied treatment that contains both topical treatment or antibiotics.
Often prescribed for patients suffering from polycystic ovarian syndrome, spironolactone works by blocking the effects of excess male hormones which can have a negative effect on hormonal acne. When the hormone profile of a female patient is dominated mostly by male hormones, the sebaceous glands can overproduce oil and the dead skin cells can increase, which increases the likelihood of acne breakouts.
It has an effect on testosterone, which can increase sebum production in the body. By blocking the actions of testosterone, it minimizes the chances of excess oil and clogged pores.
Even though it’s not FDA approved for treating acne specifically, dermatologists are allowed to prescribe it for women who are suffering from hormonal acne.
Spironolactone comes as 25 mg, 50 mg or 100 mg oral tablets. Your dosage will depend on your medical history and the reason why you’re taking them. Just like Accutane, it can make your acne worse before they get better. It’s best to be prepared and expect some breakouts when you first start the treatment. Don’t worry, they should be gone in a short time. You should expect to see results after a few months of treatment.
The most common side-effects are:
More severe side-effects include:
It shouldn’t be taken along with potassium-supplementing drugs because it can lead to hyperkalemia and arrhythmia. If you have any history of cardiovascular, kidney and liver problems you must tell your doctor about it.
Typically, spironolactone isn’t recommended for pregnant women or women who are breastfeeding.
You're probably used to taking antibiotics in order to treat bacterial infections, but did you know that they can also help with acne?
Antibiotics work by killing the bacteria on the skin that contributes to acne as well as reducing the redness. In most cases, they’re used to treat inflammatory acne such as pustules.
Even though antibiotics have been used as an acne treatment for decades, there are still concerns within the dermatological community about the possibility of patients developing antibiotic resistance. Which is why they’re often combined with a benzoyl peroxide topical treatment so that the patient doesn’t develop aresistance to antibiotics.
Usually, it takes 6-12 weeks for patients to see a noticeable difference in the appearance of their skin. The dosage is different for every patient and it depends on the type of acne they’re suffering from. Talk to your doctor for precise instructions and whether you should take them with food or not.
This is the most common antibiotic which is prescribed for treating acne. It’s important to remember that it should always be taken on an empty stomach and that children under the age of nine and pregnant women shouldn’t take it.
When it comes to the dosage, usually, the starting dose is 500 mg, twice a day.
Minocycline is the antibiotic that’s been used for the longest time for treating acne. It’s a derivative from tetracycline, but the dosage is smaller – it ranges from 50 to 100 mg, twice a day and you should take it with a meal. This kind of antibiotic is most effective for pustules.
This type has the same dosage as minocycline and you should also take it with food. It’s not usually the first choice but it’s used for patients that don’t respond to other types. With doxycycline, your skin is more likely to be sensitive to the sun and cause sunburns, so you should definitely stay out of the sun if you’re on it.
Arguably the most successful antibiotic for acne, erythromycin, other than its basic function to kill the bacteria on the skin, also has the ability to reduce redness due to the anti-inflammatory properties it contains. The dosage is from 250 to 500 mg a day, taken with food. This one is reported as safe for pregnant women.
There are a few things every patient on antibiotics should remember.
Some types of antibiotics can increase sun sensitivity, which is why it’s advised to wear sunscreen at all times and avoid direct exposure to the sun. Avoid going out in the middle of the day, between 10 AM and 4 PM. You should also wear protective clothing such as hats or shirts if you’re going to the beach.
Patients have reported gut-related issues while they’re on their antibiotics course. This is due to the pills killing even the good, protective bacteria in the gut, which can lead to a few digestive issues. Talk to your doctor about taking oral probiotics that are known to help with digestion in cases like this.
Make sure to speak to your doctor about these potential side-effects.
If you suffer from mild acne, or if you’re under a lower dose of acne medication, your dermatologist might suggest other treatment options in conjunction with the orthodox treatment. These include laser therapies, chemical peels, steroid injections, and dermabrasion.
Acne is an extremely hard and painful skin condition to deal with, both physically and psychologically. Speaking from experience, it can make you feel utterly helpless and it can damage your mental health.
Even though the side-effects of the medication mentioned can seem daunting, these are some of the most successful acne treatment options out there, with millions of testimonies in favor of their effectiveness.
What I wish I knew earlier is that there’s always hope, as long as you don’t give up. The right treatment for you is out there, you just have to be persistent enough to find it. Never stop searching for a solution! The most important thing is to consult with a dermatologist you trust and listen to their instructions.
The days of healthy and clean complexion will come sooner than you think.
All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.