Acne medication: Commonly prescribed medications and their side effects

Before deciding which non-medicinal treatment to use, it’s important to identify the symptoms that are causing concern. Treatments for blemishes and mild to moderate blemish-prone skin tend to address one or more of the four issues that contribute to the condition.

It is also important to differentiate between impure, blemish-prone, and hypersensitive skin reactions, including pimples or rosacea. The papules and pustules that appear in the hypersensitive disorder rosacea, for example, are similar in appearance to acne, but there are no blocked pores, the skin is more likely to be dry than greasy, and rosacea spots don't leave scars.

Impure, blemish-prone skin is a common condition that often begins in puberty, when rising androgen levels stimulate the sebaceous glands to produce excess sebum (seborrhea), disrupting normal skin shedding. When too much sebum combines with insufficiently shed dead skin cells, they can accumulate in the hair follicle to form a soft plug that either causes the follicle wall to bulge into a whitehead or remains open and darkens into a blackhead.

Key contributors include:  

• Hormonal fluctuations - not only in adolescence but also during pregnancy, menstruation, or hormone-related conditions. 
• Bacterial overgrowth - excess sebum creates an environment where normally harmless acne bacteria multiply and inflame follicles. 
• Genetic predisposition - individuals with a family history of acne are more likely to develop blemish-prone skin. 

After a close examination of your skin, your doctor or dermatologist (a doctor specialising in skin) will be able to advise on which treatment is best for you and most likely to address the causes and symptoms of your acne. You can read more about what causes acne here.

Medical professionals generally agree that, in moderate to severe cases of acne, the timely use of drugs can help to prevent symptoms from worsening and reduce the risk of scarring. Your doctor will be able to advise on and prescribe the most appropriate acne treatment for you and your skin.

The following list outlines the most commonly prescribed medication for acne, how each one works, and the possible side effects to be aware of: 

• Benzoyl Peroxide
  If your acne is mild to moderate, your doctor may well recommend Benzoyl Peroxide in the first instance. It comes as a cream or a gel which you apply to your affected skin and, in many countries, is available without a prescription. 
• Topical retinoids
  As an alternative to Benzoyl Peroxide, your doctor may prescribe a topical retinoid. A topical product is a cream or gel that you apply to your affected skin. A retinoid is a retinol, or Vitamin A, derivative. 

• Azelaic acid
  Recommended when Benzoyl Peroxide and topical retinoids have not delivered results or if someone has experienced negative side effects using them. Also recommended for skin that is particularly sensitive to sunlight, as it does not exacerbate the condition.
• Topical and oral antibiotics
  These are only prescribed for use in combination with another medical acne treatment to prevent bacterial resistance, reduce the growth of P.acnes bacteria, and help to prevent skin infections. Topical antibiotics are applied externally to the affected area, and oral antibiotics come in tablet or liquid form. You can find out more about P.acnes in the development of acne.
• Combined oral contraceptive pill
  Acne is directly related to fluctuations in our hormones, and for women who experience hormone-related flare-ups, dermatologists may recommend certain oral contraceptives proven to be effective against acne.
• Isotretinoin
  For severe, stubborn, and persistent acne, the most common and effective medication is a drug called Isotretinoin. It is only prescribed when other medications have not worked.

Prescription acne medications can be highly effective, but they can also cause temporary side effects such as dryness, irritation, or increased sun sensitivity. Using complementary skincare products and routines can help your skin tolerate treatment better and maximise results.

Maintaining a gentle and consistent cleansing routine is an essential part of supporting your acne treatment. Proper hygiene helps remove excess oil and impurities while reducing the risk of irritation or bacterial flare-ups.

• Cleanse your skin regularly with a gentle, non-comedogenic cleanser, like Eucerin DERMOPURE Clinical Purifying Cleanser, to remove excess sebum, sweat, and makeup without aggravating acne.  
• Avoid harsh scrubs or over-washing, which can worsen irritation.  
• Keep hands, phones, towels, and pillowcases clean to minimise bacterial exposure.

Using the right moisturiser can help your skin stay comfortable and balanced. Choosing lightweight, non-greasy formulas ensures hydration without clogging pores or interfering with any acne treatment.  

• Moisturisers specially formulated for blemish-prone skin can help counteract dryness and irritation caused by medication. 
• Look for lightweight, non-greasy options such as Eucerin DERMOPURE CLINICAL Hydra Repair, which soothe and protect the skin without clogging pores. 

Small lifestyle changes can go a long way in supporting clearer, healthier skin. A few simple habits can make a noticeable difference over time.

• Choose non-comedogenic makeup: If you use makeup to conceal blemishes, opt for non-comedogenic products to avoid clogging pores. 
• Maintain healthy lifestyle choices: Eat a balanced diet, minimise exposure to smoke and pollution and engage in activities that promote emotional well-being.  
• Avoid harsh home remedies: Home treatments like toothpaste or aspirin masks can irritate the skin and may worsen acne.  
• Manage stress: Easier said than done, but stress can trigger hormonal changes that may worsen acne. Simple relaxation techniques or mindfulness practices can help support healthier skin.

Sadly, no acne medicine or skincare routine promises instant results, and treatment needs to be applied or taken consistently for the recommended period of time. 

As with any medication, there are potential side effects to taking medication for acne. Some of the most common side effects from using topical acne treatments are dry skin and itching, whereas antibiotic treatments can have more serious side effects, such as causing an upset stomach or making you feel lightheaded.

Occasionally, symptoms can worsen in the short term as your body adapts to the treatment.

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.

If you experience dry skin, try a soothing moisturiser such as Eucerin DERMOPURE CLINICAL Hydra Repair. 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 Oil Control Sun Gel-Cream Dry Touch SPF50+.

Acne can affect people of all ages, with causes ranging from hormonal changes and genetics to excess sebum and bacterial growth. Prescription acne medications, such as benzoyl peroxide, topical retinoids, antibiotics, oral contraceptives, and isotretinoin, can effectively treat mild to severe cases and help prevent scarring.

It’s important to follow your doctor’s guidance, be patient with treatment, and use complementary skincare to minimise side effects. Gentle cleansing, non-comedogenic moisturisers, sun protection, and adjunctive dermo-cosmetic care can all support skin health and improve treatment outcomes. Mild acne may also benefit from non-medication approaches, including topical antibacterials, anti-inflammatory ingredients, and lifestyle measures, as part of a holistic skincare routine.