Topical acne prescription medications have some proven effectiveness but still may contain harmful side effects and should be avoided if possible. Most topical prescriptions are typically less harmful than oral medications and helpful if you have are okay with not treating the root cause of acne.
Retin-A (Renova, Tretinoin, Etc.)
Retin-A is a topical retinoid, which is a form of vitamin A used in the treatment of acne. It increases keratinization of the skin cells (or speeds up skin cell turnover) so that dead skin cells are less likely to get clogged in pores and form acne. It also shrinks follicles and regulates sebum production. Improvement is seen in about 3 to 4 weeks.
A third generation retinoid, Tazorac treats acne by reducing inflammation and keeping pores clear. It also reduces skin cell overgrowth in pores so that they do not become clogged by excess skin debris. Improvement is seen in about 3 to 4 weeks.
Another third generation retinoid known as adapalene, Differin is now available OTC. It prevents pores from clogging by reducing the amount of skin cells formed inside pores. It takes about two months to work but after this time period, is very effective.
EpiDuo is simply prescription differin that is formulated with benzoyl peroxide. The benzoyl peroxide works in conjunction with the differin to kill the acne bacteria by introducing it to oxygen. Side effects for this medication are more severe as benzoyl peroxide can be a bit harsh on the skin. Watch out for extreme redness or rash.
Side Effects of Retinol Topicals
Side effects of all retinoids are mostly similar and include: dryness, redness, skin irritation, flakiness and sun sensitivity.
Topical Antibiotics come with less side effects than oral antibiotics when used to treat acne. However, they work based on the same principle and are just as effective, if not more. They kill acne causing bacteria directly on the skin to reduce breakouts, inflammation and keep follicles clear. These topical antibiotics come in lotion, solution, or gel form in various strengths and are usually applied once or twice a day all over the face. Erythromycin, Clindamycin and Dapsone are the two most commonly prescribed topical antibiotics used to treat acne. Treatment begins to be effective after about 2 to 3 weeks.
Side effects include itchiness, dryness, flakiness, mild irritation and sensitivity to the sun. Antibiotic resistance is also a possibility with topical antibiotics, but much less so than with oral antibiotics.
Azelaic acid is a naturally occurring acid that comes from grains. It is effective against acne because of its antibacterial, exfoliative, and antioxidant properties. It unclogs pores and regulates skin cell renewal within the pore. The PH of azelaic acid is also helpful because it is nearly the same as skin’s.
Side effects are mild and may include skin irritation and sun sensitivity. Some patients experience a slight stinging sensation when first applying azelaic acid.
Sodium sulfacetamide is a topical sulfur with antibacterial properties that is effective against acne because it kills acne causing bacteria and dries out lesions. This medicine is used to spot treat and not to prevent new lesions from forming, as some of the other medicines are.
Side effects are minimal and include dryness and skin irritation. Some people are allergic to sulfa drugs, so they must be used with caution.