Acne treatment usually benefits from a multiple step approach. Topical treatments may be started first that either are over-the-counter or prescription. All medication used for acne attempts to battle the main contributors: excess oil, excess skin clogging the pores, skin bacteria particularly P. acnes and hormones levels.
Oral medications may be added or used instead, depending on how your acne responds. Oral medications tend to have more serious side effects since they are taken internally so monitoring and reporting possible problems to your dermatologist is very important.
Types of Oral Medications:
Oral antibiotics may be prescribed to reduce bacteria and fight inflammation but are usually only given for limited periods of time due to antibiotic resistance. Oral erythromycin, tetracycline or one of the others in these groups is often used.
According to Mayoclinic.com, studies have shown that antibiotics given with benzoyl peroxide may reduce antibiotic resistance. Antibiotics may have side effects of GI distress and increased skin sensitivity.
Birth control pills have been found to improve acne in women who have taken them by decreasing testosterone (androgen) levels. BCPs do have other side effects that need to be discussed with your doctor such as increased risk of blood clots or heart disease.
Spironolactone acts similar to BCPs by reducing androgen levels, which contribute to hair growth and acne breakouts. It has been used for hirsutism because of this effect and sometimes is combined with BCPs or other acne treatments.
According to Acne.org, spiroactone has had mixed results in studies from being as effective as 80 percent in reducing acne to not showing any significant benefit at all. Side effects may include increased breast tenderness, headache or fatigue. Because spironalactone can cause breast growth (gynemasticia) it is usually not given to men to treat acne.
Accutane (isotretinoin) is an oral retinoid, derived from vitamin A, that reduces oil in the glands.