Acne medicine - what are the oral treatment options?

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Isotretinoin (Accutane):
This acne medicine is one of the most potent treatments, reserved only for severe cystic or nodulocystic acne. Isotretinoin works by decreasing the amount of oil produced by the skin’s sebaceous glands. It may take up to two months before it starts to make an improvement on your skin and it can even make your skin worse during the first month. Isotretinoin isn’t a permanent acne cure, but your skin may stay clear for months after you’ve stopped the treatment.

However, there are some very serious side effects associated with isotretinoin that need to be considered when undertaking a course of this medication. The most serious being the potential to cause severe birth defects to a developing foetus. One of the most common side effects of isotretinoin acne medicine is dryness of the skin and mucous membranes. Other less common side effects may include: Bone and joint pain, headaches, thinning hair, nausea and vomiting, psychological depression and changes in blood and enzyme profiles. Regular examinations are required while taking isotretinoin to monitor side effects.

Oral Antibiotics:
Some oral antibiotics have been used as a treatment for acne for more than thirty years. This form of acne medicine is used to treat those who have moderate to severe and persistent acne. It works by reducing the number of Proprionibacterium acnes (acne bacteria) and it decreases inflammation. However, over time bacteria can become resistant to an antibiotic.

Tetracycline and derivatives (Doxycycline and Minocycline): Tetracycline antibiotics help to reduce papules and pustules. They should not be taken by a woman who is pregnant or breast feeding as it can affect the foetus or the development of a child’s bones and teeth. Some of these tetracycline derivatives may also cause lupus/hepatitis, Pseudotumor cerebri, candidiasis (yeast infections) and gastrointestinal upsets.

Hormone Therapies (Oral Contraceptives/Birth Control Pills):
Birth control pills or oral contraceptives work by helping to balance fluctuating hormones. Male hormones called androgens, found in males and females, stimulate the sebaceous glands in the skin which can result in an excess amount of oil which may lead to blemishes. Hormone acne medicine usually contains estrogen (female hormone) which counteracts the effects of androgens.

There are also a number of side effects associated with hormone therapies, such as vaginal bleeding, fluid retention, melasma and depression. Your chances of developing a heart attack, a stroke, blood clots and breast cancer also increases while taking a birth control pill.

Corticosteroids:
Oral corticosteroids are a powerful anti-inflammatory medication that is usually prescribed for a short course of treatment to for very severe acne. Corticosteroids help to suppress inflammation and androgen production. Possible side effects associated with this acne medicine may include weight gain and bone thinning. Long term use of corticosteroids may also induce the development of steroid acne.

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