Prescription for Acne
The American Academy of Dermatology (AAD) identifies four factors that cause acne: excess production of sebum, or oil; sebum-clogged pores; overgrowth of bacteria commonly found on the skin and inflammation, or irritation, of the skin and underlying tissues. The U.S. Food and Drug Administration (FDA) has approved a variety of topical medications, oral drugs and treatments for people with acne.
Before prescribing anything for acne, the doctor will identify the specific skin lesions on a person's body. Many forms of acne begin in adolescence when hormone surges trigger the production of extra sebum that blocks the pores leading to the surface of the skin. Bacteria grow in accumulated sebum and irritate the surrounding tissues. Inflammation close to the surface causes whiteheads or blackheads. Deeper blockages cause pimples, and infected sebum in deeper skin tissues can cause pus-filled cysts. Prescriptions address one or more components of this acne cycle.
According to the AAD, it's best to treat the whiteheads, blackheads and pimples seen in mild inflammatory acne by applying topical products that come in gels, creams, solutions and lotions. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), these products include antibiotics to fight bacterial infections that cause acne, as well as stronger versions of over-the-counter medications such as benzoyl peroxide, azelaic acid and sodium sulfacetamide/sulfur to dry up excess oil and help remove dead skin cells. Topical vitamin A derivatives, also known as retinoids, help unplug blocked pores so that other topical medicines can enter the hair follicles.
NIAMS expert outline several prescription drugs that are effective for both males and females with moderate to severe inflammatory acne that causes an abundance of pimples or cysts. Doctors may order antibiotics such as doxycycline, tetracycline or minocycline to prevent or slow bacterial growth and reduce inflammation. Isotretinoin, or Accutane, is the only FDA-approved medication for the most severe form of acne that causes pus-filled cysts. Because this drug causes severe birth defects if a woman takes it during pregnancy, patients must register with the FDA's iPLEDGE monitoring program before a doctor can prescribe the drug.
According to NIAMS, there are three types of drugs prescribed for women whose acne is caused by an excess of the male hormone androgen. Selected specific oral contraceptives, or birth control pills, may be ordered to suppress androgen production in the ovaries, while low-dose corticosteroids such as prednisone or dexamethasone can be prescribed to reduce the amount of androgen created by the adrenal glands. Spironolactone, an anti-androgen drug also used as a diuretic or water pill, reduces the amount of sebum produced by the body.
According to the Mayo Clinic, physicians can also prescribe treatments with lasers to damage the oil-producing glands, light-based therapies that kill bacteria or chemical peels and microdermabrasion that remove acne lesions.
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