Acne treatments How do they work and what are their possible side effects?

Acne treatments can help to reduce blemishes, prevent them from re-appearing and reduce the risk of permanent damage to your skin. You can find out more about the different options available in Acne medication: what are the most common treatments? 
This article summarises how each of those treatments works. It identifies the possible side effects for each treatment, looks at what you can do to help alleviate some of those side effects and makes suggestions on other steps you can take to give your medication the best chance of working.

 

Summary of the most common acne medications and their possible side effects

Your doctor will be able to advise on, and prescribe, the most appropriate acne treatment for you and your skin. The table below is intended to give you a little bit of background on the most common medical acne treatments - how they work and the possible side effects of each treatment. You can find out more about the underlying symptoms that these medicines are treating and how acne develops in the causes and triggers of acne and the development of acne.

Creme gegen Akne
Your doctor will advise on the best acne treatment for you and your skin

Benzoyl Peroxide (BPO)

OTC or prescription? OTC

Format: Cream, gel

How it works: 

  • Reduces P. acnes bacteria on skin’s surface
  • Anti-inflammatory
  • Mild comedolytic effect (breaks down pimples)

Possible side effects: 

 Side effects are mild and normally go once treatment is finished. They include: dryness, tightness, burning, itching, stinging and redness

Topical retinoids (e.g. Tretinoin & Adapalene)

OTC or prescription? Prescription

Format: Cream, gel

How it works: 

  • Unblocks clogged pores to improve sebum flow
  • Anti-inflammatory

Possible side effects: 

Dryness, tightness, burning, itching, stinging, redness and photosensitivity

Topical antibiotics

OTC or prescription? Prescription

Format: Lotion, gel

How it works: 

  • Reduces P.acnes bacteria on skin’s surface
  • Anti-inflammatory

Possible side effects:

 Uncommon, but can include: minor irritation, redness and burning

Azelaic Acid

OTC or prescription? Prescription

Format: Cream, gel

How it works: 

  • Exfoliates skin  
  • Reduces P.acnes bacteria on skin’s surface

Possible side effects:

Usually mild. Can include: burning, stinging and dryness 

Combined oral contraceptive pill

OTC or prescription? Prescription

Format: Tablet

How it works: 

  • Regulates androgens (male hormones) and therefore reduces sebum production

Possible side effects: 

  • Temporary side effects can include headaches, nausea, breast tenderness and mood swings
  • Can increase blood pressure and has been linked to a greater risk of thrombosis (blood clots) 

Isotretinoin

OTC or prescription? Prescription

Format: Tablet

How it works: 

  • Reduces sebum production
  • Prevents sebaceous gland´s duct from getting blocked 
  • Comedolytic (breaks down pimples)
  • Reduces P.acnes bacteria on skin’s surface
  • Anti-inflammatory

Possible side effects: 

A broad spectrum of side effects, so regular medical monitoring is essential.

These include:

  • extreme dryness and cracking of skin and lips
  • cheilitis (inflammation of lips)
  • blepharitis (inflammation of eyelids)
  • eye irritation
  • dry nasal mucus
  • light hair loss
  • muscle/join pain
  • nosebleeds

Some patients also report mood changes, depression, anxiety and suicidal thoughts though there is no evidence to support the fact that these were caused by the medication.

Isotretinoin

Blue light

OTC or prescription? Neither. But always consult your doctor first

Format: Light with specific wavelength

How it works: 

  • Light treatment that kills P. acnes bacteria

Oral antibiotics (e.g. Tetracycline & Erythromycin)

OTC or prescription? Prescription

Format: Tablet or liquid

How it works: 

  • Reduces P.acnes bacteria on skin’s surface
  • Anti-inflammatory

Possible side effects: 

  • A broad spectrum of side effects, especially in the case of Erythromycin, so Tetracycline recommended first
  • Tetracycline can make your skin sensitive to UV and can make oral contraceptives less effective during the first few weeks of treatment

What can I do to help alleviate the possible side effects?

A regular skincare routine, using non-comedogenic cleansing and care products specially formulated for blemish-prone skin, will help to keep your skin healthy and complement your medication. You can find out more in the ideal skincare products and routine for blemish-prone skin.

Acne medication can take time to deliver visible results − between four to eight weeks after starting treatment but sometimes up to three months. And, occasionally, symptoms can worsen in the short term as your body adapts to the treatment.  It’s important to be as patient as possible and stick with your treatment as prescribed to give it the best chance of working.

Some patients find the side effects of the medication (such as the extremely dry skin caused by Isotretinoin) difficult to cope with and stop taking their acne treatment before the end of the course.

Facial acne treatment
Results can take time so persevere with your medical treatment and skincare routine

In my experience, it’s the side-effects of medication that cause many acne patients to terminate their therapy prematurely.

Dr med. Markus Reinholz, Dermatologist

If you experience dry skin try a soothing moisturiser such as Eucerin DermoPURIFYER Adjunctive Soothing Cream. This intensely moisturising, non-greasy cream has been specially formulated to soothe skin undergoing medical acne treatment and to leave it feeling smooth and supple after the first application.

Many medical acne treatments make skin more sensitive to the sun, so it is especially important to use appropriate sun protection such as Eucerin Sun Gel-Creme Oil Control Dry Touch SPF50+

If you experience any side effects consult your doctor or dermatologist for advice.

Side effects of acne treatment
Acne treatment can make skin more sensitive to light so adequate sun protection is essential

 

What else can I do to help my blemish-prone skin?

 The following suggestions won’t necessarily alleviate side effects, but they will help you to care for your acne-prone skin:

Keep skin as clean as possible
In addition to regular, thorough yet gentle cleansing try to keep your hands away from your face and clean your mobile phone, pillow cases and towels regularly to keep bacteria to a minimum.

Look after yourself
Exercise and a healthy, balanced diet will help you to keep your spirits, and your skin, in good shape.

Try not to get stressed
Easier said than done we know, but stress can trigger hormones and exacerbate acne.

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