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Common acne Prescription drugs Isotretinoin (Accutane/Roaccutane)
If the topical treatments fail, acne is treated next with oral antibiotics
(usually tetracycline) or isotretinoin (Accutane/Roaccutne), however, these medications can have strong side effects, thus the treatment should be closely supervised by dermatologist. Also, because isotretinoin
causes birth defects, women on the medication who are sexually active must use contraception to make absolutely sure they do not become pregnant during the four months of Accutane treatment and the one month after
treatment.
Isotretinoin was released in United State in 1982 for the treatment of severe acne. The drug produces improvement and prolonged
remission. It is frequently prescribed for moderate acne unresponsive to oral antibiotics or topical treatment fail. It may also be used to treat other conditions as determined by your doctor Tretinoin(Ratin-A)
Tretinoin is approved only for treatment of acne. Topical preparation contain from 0.01% to 0.1%Initiation of
therapy with lower-strength preparation and progressive to higher strength isRecommended. The medication is apply once daily before bedtime to minimize photodegradation. Acne can almost always be controlled with
medication, although result may not be seen for weeks or months. For example, most topical medications (treatment applied directly to the skin) work within 4-8 weeks. Tretinoin may show peak result in 3-6 months.
Oral antibiotics
Mild acne should initially be treated with topical agents. Drug choice depends on
whether comedonal or inflammatory lesions predominate. Benzoyl peroxide or a topical retinoid are first choice agents, depending on tolerance, formulation and cost. Oral antibiotics should be added to topical therapy in moderate to severe acne. The four major drugs in current use are tetracycline,miocycline,doxycycline,and erythromycine.
Tetracycline
is the least expensive and has been in use the longest. It is still an effective treatment for acne and often is the first agent tried.Its drawbacks include photosensitivity,gastrointestinal discomfort,and poor absorption with dairy products,which necessitates its being taken 30 minutes before or 2 hours after meals.
Minocycline
is one of the most expensive and most effective treatments. As reports of P.acne resistance to minocycline are rare,it may be tried in patients who fail to respond to first choice agents and can be taken with or without food,including dairy product.It induces little photosensitivity.Disadvantages include cost,potential deposition of reversible blue pigmentation,especially in scarred areas such as the face and shins,and rarely,irreversible tooth discoloration.
Doxycycline,also an effective antibiotic,is intermediate in cost and be taken with meals. It is, however,highly
photosensitizing.All three of these tetracycline-derivertives often prescribed for moderate or severe cases, especially when there is a lot of acne on the back or chest. Antibiotics reduce the
bacteria in the follicle and may also decrease the skin redness directly. When taking oral antibiotics, some women may develop a vaginal yeast infection. If this occurs, discontinue your medicine and contact your
dermatologist immediately for treatment of the yeast. All three of these are contraindicated in pregnant women or young children,because they may stain developing teeth.Also,because these antibiotics may interfere
with effectiveness of birth control pills,use of an alternate or additional method of birth control may be advisable.
Erythromycin
is relatively inexpensive antibiotic that is not photosensitizing.However, many patients cannot tolerate the gastrointestinal irritation of erythromycin,and bacterial resistance is common. |
