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It is easy to get overwhelmed with all of the acne remedies out there. Should you choose one of the many over-the-counter acne treatments or get a prescription acne medication? What would your dermatologist prescribe for acne, and when should you see a specialist? Learn the answers to these questions and more.
When to see a doctor for acne treatment
There are lots of reasons to get a dermatologist’s recommendation on how to get rid of acne:
- You may have severe acne, including nodular acne or cystic acne.
- You have tried several different over-the-counter (OTC) topical acne treatments and are still unhappy with your skin.
- Your acne is getting better but leaving behind scars or dark spots.
- You feel shy, embarrassed, or depressed because of your acne.
This list is by no means exhaustive. In short, if you think you could use a skin expert’s advice on how to treat pimples, that’s reason enough to make an appointment.
5 prescription acne medication options
Fortunately, there are many effective prescription acne treatment options that your dermatologist can recommend, including topical and oral medications.
Tretinoin (brand name Retin-A; see Important Safety Information) is an effective prescription for treating acne that’s been used by dermatologists for years. It works by unclogging pores, decreasing oil production, and reducing inflammation—all of which are causes of acne. Other examples of topical retinoids include adapalene and tazarotene.
Know that these acne creams can make you more prone to sunburns, so you’ll need to use sunscreen and protect yourself from sun exposure (Leyden, 2017).
When it comes to antibiotics for acne breakouts, your dermatologist may recommend either oral antibiotics (pills) or topical (cream) treatments. Both forms work similarly: the antibiotics help kill bacteria and decrease inflammation, leading to clearer skin. If your dermatologist prescribes antibiotics, they will often limit the duration of treatment and combine it with another drug to avoid developing antibiotic resistance.
Examples of topical antibiotics include erythromycin and clindamycin, while doxycycline, minocycline, and sarecycline are the most commonly used oral antibiotics for acne (Zaenglein, 2018; Zaenglein, 2016).
Doxycycline for acne: what is it, how does it work, side effects
Isotretinoin (brand name Accutane) is an oral retinoid that dermatologists often use to treat moderate to severe acne. Like tretinoin, it combats the major causes of acne like clogged pores, oil production, and inflammation.
While it is very effective, isotretinoin can cause serious problems in people who are pregnant (or who become pregnant during therapy). Therefore, you must be on a reliable form of birth control to be on this drug (Fallah, 2021).
4. Combined oral contraceptives
Four birth control pills are currently FDA-approved to treat acne (Zaenglein, 2018):
- Ortho Tri-Cyclen (estrogen and norgestimate)
- Estrostep (estrogen and norethindrone)
- Yaz (estrogen and drospirenone)
- Beyaz (estrogen, drospirenone, and levomefolate)
These acne treatments encourage clear skin by re-establishing a healthy hormone balance of sex hormones, including estrogen, progesterone, and androgens.
5. Other treatments
Your dermatologist may also prescribe other acne treatments, sometimes in combination with several of the medications already mentioned in this article. Other options include (Zaenglein, 2016):
- Azelaic acid (15% or higher)
- Dapsone gel (5% or higher)
Azelaic acid (see Important Safety Information) can help clear your pimples and lighten dark acne scars, called post-inflammatory hyperpigmentation (Zaenglein, 2018; Zaenglein, 2016).
Dapsone works against skin inflammation, and spironolactone blocks androgens in the skin to decrease breakouts and skin oiliness (Zaenglein, 2016).
What’s the best birth control for acne?
Best over-the-counter acne treatments
Your dermatologist may also encourage you to try one of the many available over-the-counter treatments for acne-prone skin, especially if you have mild acne. Some of the most effective ones include (Zaenglein, 2016):
- Benzoyl peroxide
- OTC retinoids, like retinol, adapalene, retinyl acetate, retinyl propionate, etc.
- Azelaic acid (less than 15%)
- Salicylic acid
These topical treatments can also be combined with prescription drugs to treat breakouts and help prevent acne recurrence.
Lastly, some research suggests that sulfur, nicotinamide, resorcinol, sodium sulfacetamide, aluminum chloride, and zinc may play a role in treating acne, but more research is needed (Zaenglein, 2016).
- Fallah, H. & Rademaker, M. (2021). Isotretinoin in the management of acne vulgaris: practical prescribing. International Journal of Dermatology, 60(4), 451–460. doi:10.1111/ijd.15089. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32860434/
- Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why topical retinoids are mainstay of therapy for acne. Dermatology and Therapy, 7(3), 293–304. doi:10.1007/s13555-017-0185-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28585191/
- Zaenglein, A. L., Pathy, A. L., Schlosser, B. J., et al. (2016). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 74(5), 945–73.e33. doi:10.1016/j.jaad.2015.12.037. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26897386/
- Zaenglein, A. L. (2018). Acne vulgaris. The New England Journal of Medicine, 379(14), 1343–1352. doi:10.1056/NEJMcp1702493. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30281982/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.