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10 Best prescription medications for acne

Written by Andrew Le, MD

UpdatedMarch 14, 2024

Acne is a common skin condition that causes pimples, blackheads, whiteheads and cystic acne. While there are many over-the-counter treatments that can help, sometimes prescription medications are necessary to help manage more severe or persistent cases.

When it comes to acne prescription medications, there's a range to choose from. They are designed to address more severe or stubborn acne issues. Here's a look at 10 widely-used prescription medications for acne, and how they work.

1. Retinoids (e.g., Tretinoin, Adapalene, Tazarotene)

Retinoids are vitamin A derivatives that promote cell turnover and prevent the plugging of hair follicles. Tretinoin, adapalene (available over-the-counter as well but at lower strengths), and tazarotene are commonly prescribed retinoids that can help reduce acne and prevent new pimples from forming. They are often used as a long-term treatment strategy.

2. Antibiotics (Topical and Oral)

Antibiotics reduce skin bacteria and inflammation. Topical antibiotics such as clindamycin and erythromycin are applied directly to the skin, while oral antibiotics like doxycycline and minocycline are used for more severe cases. Long-term use of antibiotics is generally avoided to prevent antibiotic resistance.

3. Hormonal Agents

For women whose acne is influenced by hormonal factors, oral contraceptives or anti-androgen agents (such as spironolactone) can be effective. These medications help regulate hormones that can contribute to acne.

4. Isotretinoin (Accutane)

Isotretinoin is a powerful oral retinoid reserved for severe, cystic acne that hasn't responded to other treatments. It dramatically reduces oil production, but its potential for serious side effects, like mood changes and birth defects if you are pregnant, and requires strict medical supervision.

5. Azelaic Acid

Azelaic acid works by killing acne-causing bacteria and reducing inflammation. It also helps unclog pores and can be a good option for those with sensitive skin or for treating post-acne marks.

6. Dapsone (Aczone)

Dapsone gel is a topical anti-inflammatory and antimicrobial medication used primarily for inflammatory acne, especially in adult women. It can be effective when used in combination with other acne treatments.

7. Benzoyl Peroxide

Although available over-the-counter in lower strengths, higher concentrations of benzoyl peroxide are also prescribed to kill bacteria, reduce inflammation, and help clear blocked pores.

8. Salicylic Acid

Like benzoyl peroxide, salicylic acid can be found in over-the-counter products, but prescription-strength formulations are also available in stronger concentrations. It helps to exfoliate the skin and unclog pores.

9. Prednisone

In cases of severe inflammatory acne, short-term oral corticosteroids like prednisone might be used to reduce inflammation and improve appearance rapidly.

10. Chemical Peels and Microdermabrasion

Though not medications, these dermatological procedures are often performed in a clinical setting to help reduce the appearance of acne and scars by removing the outermost layers of the skin, promoting new skin growth.

What Are the Side Effects of Prescription Acne Medications?

Prescription acne medications may cause redness, peeling, or itching. Oral medications may cause other symptoms, like upset stomach. It is essential to consult a healthcare provider before starting any prescription acne treatment to ensure it is appropriate for your skin type and medical history.

Dryness and Irritation

Dryness and irritation are common side effects of prescription acne medications, particularly in people with inflammatory acne.

The dryness and irritation from the medications can make the skin more sensitive and inflamed. Consequently, the effectiveness of the treatment can vary, with some experiencing improved skin condition while it may seem like it's getting worse temporarily.

Sensitivity to Sunlight

Sensitivity to sunlight is a common side effect of acne medications, requiring skincare precautions.

Sun exposure can not only lead to increased risk of sunburn but can also worsen acne symptoms and post-inflammatory hyperpigmentation.

It’s important to apply a high SPF sunscreen on a daily basis, avoid the sun when possible, and wear protective clothing to reduce these risks.

Stomach Upset

Stomach upset can occur as a side effect of oral acne medications. This can create challenges, and your dermatologist will likely explore different dosages or medications if you can’t tolerate the medication.

Birth Defects (for pregnant women)

Certain oral acne medications, such as isotretinoin, pose risks of birth defects for pregnant women. For pregnant women and those of reproductive age, extra caution is advised when choosing a treatment. Consulting a dermatologist is essential to determine the most suitable and safe treatment options for managing adult acne while minimizing any potential harm during pregnancy.

How Long Does It Take To See Results From Prescription Acne Medications?

How long it takes to notice a difference varies based on how severe your acne is, how effective certain medications are for you, and how well you follow the recommendations.

You may start noticing improvements in acne symptoms within a few weeks of starting the prescription medication, but it might take longer—several weeks to months. It is common to experience initial acne flare-ups as the medication starts working to clear out the pores, but these flare-ups usually subside as the skin adjusts to the treatment. You may also find that specific skin issues, like inflammation or hyperpigmentation, take longer to improve compared to typical acne lesions.


The best prescription medication for acne depends on the type, severity, and cause of acne, as well as your skin type and overall health. A dermatologist can help determine the most appropriate treatment plan, which might include a combination of medications and lifestyle adjustments. It's essential to follow the prescribed regimen and keep your healthcare provider informed of any side effects or concerns to manage acne effectively.