Oral acne meds: an overview

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Oral acne meds: an overview
Oral acne meds: an overview

by Kathleen Morrison, Lead Writer

July 2nd, 2019

What do you think of when you think about acne treatments? Cleansers, creams, and ointments? Maybe the neverending aisle of acne products at the drugstore? Most people don’t leap to oral medicines when considering how to tackle their acne, but these treatments can play an important role in handling inflamed skin and addressing the hormones that make your skin go wild. There are a lot of different options when it comes to oral medications for acne, so we’re here to explain a few of the most common and how they might be able to help you!


can be an in your battle against acne. They are typically prescribed for a short period of time (often three to six months) to help give your skin an initial headstart and give other topical or oral treatments a chance to kick in. Contrary to their name, antibiotics primarily work to treat acne by reducing inflammation in the skin. Killing acne-causing bacteria is a secondary effect. All antibiotics can cause gastrointestinal side effects (the result of antibiotics affecting the good bacteria in your gut) as well as other, less common, side effects like photosensitivity or dizziness. Be sure to talk to your doctor if you experience any adverse side effects like these so they can prescribe the right treatment for you!

Our pharmacy is open!

As you may have heard, Apostrophe is now dispensing antibiotics from our own Apostrophe pharmacy! Our medical director has selected these medications based on her experience and knowledge as a board-certified dermatologist. Here are the antibiotics she believes to be the safest and most effective against acne:

Doxycycline and minocycline – Doxycycline and are both classified as a tetracyclines (more on tetracyclines below) and are both commonly prescribed for acne and rosacea. They primarily target inflammation and also reduce the amount of acne-causing bacteria on the skin. Our medical director, Dr. Aimee Paik, notes the primary difference between the two drugs are their side effects: “Doxycycline tends to cause more photosensitivity while minocycline more commonly causes hives and initial dizziness.” Let your dermatologist know about any adverse effects so they can prescribe the right treatment for you!

  • Cephalexin - Cephalexin is part of a group of antibiotics called cephalosporins. It is not always the first choice when treating acne, but research on its efficacy has shown it to be a good option. In 4% saw their acne completely clear and 45% were much improved.
  • Ampicillin - Ampicillin is a penicillin-type antibiotic that doctors have noticed is effective at clearing acne. In a letter to the one dermatologist notes, “In my experience, ampicillin has been most useful for achieving very good control of mildly to moderately inflammatory acne when topical therapy was not satisfactory.” These medication is also useful when a patient has a tetracycline allergy that prevents them from taking doxycycline or minocycline.

We decided not to kick it old school…

There are a couple antibiotics that you may have heard of that used to be commonly prescribed for acne, but no longer are.

  • Tetracycline – The class of antibiotics called also includes minocycline and doxycycline (why did science decide to name both this antibiotic and the entire class of antibiotics the same thing? We don’t know but we think it’s very confusing). It’s important to note that people who are pregnant or nursing cannot take this class of antibiotics since it can affect the bone development of growing fetuses and stain the teeth of young children. Doctors used to often prescribe the drug tetracycline for patients whose acne is and dosages can vary based on the individual needs of the patient. However, they typically do not prescribe it anymore because it has cumbersome food restrictions that are not present for doxycycline and minocycline (also known as second-generation tetracyclines).
  • Erythromycin is in a class of antibiotics called “macrolides” that also includes azithromycin. Doctors used to use it to treat acne more often in the past, but with newer drugs on the market, erythromycin’s use has become more restricted. There is a higher with this drug and limited data to support its effectiveness against acne. For these reasons, doctors typically look at other options before prescribing this antibiotic.


are types of drugs that affect the balance of your hormones by suppressing the activity of androgens like testosterone. While the role testosterone plays in the development of acne isn’t completely understood, researchers believe increased testosterone can trigger increased sebum production which leads to clogged pores. While anti-androgens can’t usually be prescribed to men because of their anti-androgenic activity, they can be a useful treatment for women who struggle with period-related breakouts or hormonal adult acne.

  • Spironolactone more and more dermatologists have been prescribing spironolactone to treat hormonal acne with great success. Spironolactone works by “outcompeting” androgens for their receptors so the androgens can’t bind, which in turn decreases your skin’s sebum production. With growing concerns in the medical community about antibiotic resistance, spironolactone represents a safe and effective long-term treatment option for treating adult acne. Best of all, you can get it from our Apostrophe pharmacy!
  • Contraceptives – Like spironolactone, many birth control pills thereby decreasing sebum production. concluded that pills with a combination of estrogen and any type of progestin can be effective against inflammatory and non-inflammatory acne. Our dermatologists do not prescribe contraceptives, but may suggest you talk to your gynecologist or primary care physician for a prescription if they feel you may benefit from taking a contraceptive pill.

You may have noticed there’s one big oral medication we’ve left off our list – Accutane. Accutane, or is sometimes referred to as the only “cure” for acne. However, it is typically prescribed when all other avenues of treatment have been exhausted because it can have very serious side effects. Since this medication is such a big and important topic, we will be covering it in its own blog post in the near future!

Oral medications can play an important role in your battle against acne. Our Apostrophe derms often prescribe them in tandem with your topical treatments so you can tackle your acne from both the outside and the inside and put your best face forward!

Have you tried an oral treatment for your acne? Let us know your routine on Twitter @hi_apostrophe!

Welcome to the fine print! Just so you know, this article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. It’s always best to talk to a doctor for that stuff.

Prescription medication should only be used according to doctor's instructions. Do not use medication if you are allergic to one of its ingredients. Common side effects for Apostrophe oral medication include nausea, vomiting, diarrhea, drowsiness, stomach pain, and loss of appetite. Full list of safety information can be found at:

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