ORAL
(PILL) TREATMENTS OF ACNE
Oral
Antibiotics (tetracycline, erythromycin)
Antibiotics taken by mouth, is usually the next step in
the treatment of acne. Antibiotics limit the growth of P.
acne and decrease redness and inflammation. Over time,
however, resistance to these drugs can occur.
Tetracyclines,
including doxycycline and minocycline are the most common
antibiotics used in the treatment of acne. Usually these
are once or twice daily and are taken on an empty stomach
for improved absorption. These medications often increase
one's sensitivity to sun's ultraviolet rays and rash is
common in those exposed to sunlight while taking the medications.
They are obtained only by prescription. Other
Antibiotics, including erythromycin
and bactrim are used less frequently but can work quite
well as well. After
good acne control is achieved, the oral antibiotic dosage
is usually slowly lowered to the lowest level needed to
keep the person acne free.
Hormone-related
Therapy (the Pill)
Estrogen
at a sufficient dose can reduce sebum production and improve
acne. The FDA has approved the triphasic oral birth-control
pill, which has estrogen in combination with progestin,
for treatment of moderate acne. So far, there is no role
for estrogen therapy in males.
Accutane
(Isotretinoin)
Up
to 90% of people with severe acne can be in complete or
near complete cure within 12 to 16 weeks of Accutane treatment!
This medication is reserved for those people whose acne
is not responding to the above managements or if scarring
is occuring. While it is an incredible medication for treating
acne, it is a "big gun" and can cause a number
of bothersome, serious, and even deadly side effects.
Accutane's
effect on acne is on several different levels. It
decreases the size of sebaceous glands, it decreases the
amount of bacteria that lives in the skin, it helps skin
shed old layers properly, and it decreases inflammation.
In people who do not initially respond to Accutane, it is
suggested by many physicians to try another 16 week course
again one to two months later.
Side-Effects
of Accutane include:
- Fissuring
(cuts) at the corners of the mouth
- Inflammation
of the eyelids and conjuntiva
- Nose
bleeds
- Abnormal
dryness of skin (usually back of the hands)
- Photosensitivity
- Muscleaches
- Headache
- Hairloss
- Diminished
night vision
- Depression
- Liver
problems
- Elevated
cholesterol and lipid levels
- Birth
Defects - Accutane
is highly teratogenic (causes birth defects) and should
UNDER NO CIRCUMSTANCE be used before or during pregnancy.
Furthermore, It is essential and women who are sexually
active and on Accutane to use at least one form of birth-control
(e.g., the pill).
Women who are going to be started on Accutane should have
a pregnancy test before and monthly during therapy.
