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The 7 Greatest Acne Medications on the Market

By Megan Griffith

Reviewed for medical accuracy by Dr. Jaggi Rao,
MD, FRCPC Double board-certified dermatologist

If you talk with acne patients or if you read acne “experts” on the Internet, you might get the impression that the only medications that doctors ever use to treat acne are antibiotics (such as tetracycline, minocycline, doxycycline, and clindamycin), hormonal therapy (birth control pills), topical over the counter products with benzoyl peroxide, and retinoid drugs such as Accutane (oral isotretinoin), Retin-A, Adapalene, and Differin.

prescribed acne treatments
Work with your doctor to choose the best acne medication for you; there are many alternatives on the market that do not cause as many side effects.

The truth is, however, that you can work with your doctor to choose other drugs1 that may resolve your blemishes faster, cost less, and cause fewer side effects. You only have to ask for the drug that will really work for you and finally help you get clear.

Summary:

  • Acne medications almost never get rid of 100% of blemishes and pimples.
  • One approach to acne medication is to use low doses of two of the most important acne treatments, Differen and benzoyl peroxide, neither of them being in a strong enough concentration to cause skin irritation.
  • Another approach to acne in men is to use Korean herbal formulas manufactured under high quality standards along with acupuncture. The results are better than antibiotics and less expensive than Retin-A.
  • An alternative approach to acne in women is to use bath products made with cherry bark extract (not the bark itself). A compound in the bark makes the skin less sensitive to estrogen.
  • Once you get acne under control, keep it under control with a complete acne care system.

Combining Conventional Treatments and Unconventional Ways to Treat Acne

Adapalene2, also known by its trade names Differin, Teva, Gallet, Pimpal, and Adelene, is a gentler alternative to the better known Accutane and Retin-A. Unlike most acne treatments, it is both anti-inflammatory and exfoliating. That is, it reduces redness and irritation while it opens up the skin to drain pimples and cysts, as well as whiteheads and blackheads. It may not work as fast as Accutane and Retin-A3, but it has far fewer side effects than Accutane4 and Retin-A.

Benzoyl peroxide5 is a familiar antibacterial treatment used to kill acne bacteria. The problem with benzoyl peroxide is that most people are only comfortable using a 2.5% solution. Stronger solutions of benzoyl peroxide cause redness, inflammation, itching, and peeling of the skin in most people who use it. But it usually takes a 5% to 10% of benzoyl peroxide to kill the majority of acne germs in the skin.

Doctors have been experimenting with the combination of these two relatively mild acne drugs. In one clinical study, 517 acne patients were asked to use various combinations of 0.1% adapalene and 2.5% benzoyl peroxide (adapalene and benzoyl peroxide6, adapalene without benzoyl peroxide, benzoyl peroxide without adapalene, and placebo).

Researchers found that adapalene by itself reduced the number of pimples by an average of 46% and the number of whiteheads and blackheads by an average of 33%. Benzoyl peroxide by itself reduced the number of pimples by an average of 44% and the number of whiteheads and blackheads by an average of 36%. Using both medications together reduced the number of pimples7 by an average of 63% and the number of whiteheads and blackheads by an average of 51%. Nearly twice as many pimples disappeared when test participants were treated with a combination of both medications, along with nearly 50% more whiteheads and blackheads.

Neither of these drugs is a complete and total cure for acne. Over the short term, they improve acne8. They don’t eliminate it. But acne patients get much better results when they use low doses of both drugs instead of high doses of either one. Only 2% of the volunteers in the study discontinued the combination medication due to side effects. About 75% of users of higher-dose benzoyl peroxide and 50% of users of higher-dose Adapalene can’t continue their treatment because of drug-induced inflammation of the skin.

Keigai-rengyo-to and Acupuncture

Some herbal medicines from China are made up on the spot for each patient from sources of herbs that are not carefully regulated. Herbal formulas in the Korea and Japan, however, are made to the same standards as pharmaceutical drugs. Exact amounts of herbs from sources monitored for purity are mixed under exact pharmaceutical standards into pills of known botanical content that are stable in storage for up to three years. These medications are available under the national health insurance plans in Korea and Japan, and they are available without a prescription in the United States—although most of the Traditional Chinese Medicine practitioners who sell them will insist that you use them under their supervision.

Korean scientists have tested treatment of one of these traditional formulas, keigai-rengyo-to, along with acupuncture, to deal with acne in adult men. This formula is a fixed combination of 13 herbs, most of which contain chemicals that regulate the immune system. When the herbs are combined together in the right amounts, they form active chemicals that have a gentle effect on inflammation in the skin.

In a randomized, double-blind, placebo-controlled clinical trial, South Korean scientists found that combination of this herb and weekly acupuncture treatments9 that the herb gets better results10 than treatment with antibiotics, with or without acupuncture. Acupuncture treatments further reduce inflammation.

You can buy the formula on amazon.com, but don’t. Instead, see a practitioner of Traditional Chinese Medicine and inquire if there are standardized herbal formulas—you want brands that are made by Japanese or South Korean companies—or acupuncture treatments that may help your acne. The overall cost of weekly acupuncture and herbs is usually lower than the cost of Retin-A, Accutane, or Differin, and the likelihood of side effects is lower, too.

Cherry Bark Baths

Oak bark11 is a traditional remedy for inflammation of the skin. Traditionally, someone who had eczema, hives, psoriasis, or acne would be asked to bathe the affected body parts in warm water to which an oak bark tea had been added. Japanese bath product makers have devised bath washes made with an extract from the bark of Prunus jamasakura, also known as the Japanese cherry tree, which is more effective than washes made with oak bark extracts.

These cherry bark extracts have been found to have an unusual effect on acne in adult women. There is a compound in the bark called sakuranetin12 that binds to estrogen receptors in the skin. What this does is to reduce the effects of increasing estrogen levels on the skin. Most women of reproductive age experience their greatest jump in estrogen levels just before they have their periods. This is when they are most likely to break out in acne. Cherry bark bath products prevent acne breakouts.

In Japan, these bath products are considered so useful that health insurance pays for them. In the United States, Canada, Australia, and Europe, however, you can buy them as cherry “blossom” bath products—although the cherry extract is really from the bark, not the flowers. Sometimes that little bit of added treatment is what a woman needs to get rid of acne for good.

You can find lots of information on other acne medications on tens of thousands of web pages, but before you look for that same old thing, consider whether one of these three approaches might be what you need. And to keep acne under control once you get it under control, consider a complete acne treatment system offered with a money-back guarantee, such as Exposed Skin Care.

References:

  1. Acne – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. 2019.
  2. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4.
  3. Gerd Plewig, Heidrun Dressel, Maike Pfleger, Silke Michelsen, Albert M. Kligman. Low dose isotretinoin combined with tretinoin is effective to correct abnormalities of acne.. J Dtsch Dermatol Ges. 2004 Jan; 2(1): 31–45.
  4. Lerman. Ocular side effects of accutane therapy.Lens Eye Toxic Res. 1992; 9(3-4): 429–438.
  5. Matt Sagransky, Brad A Yentzer & Steven R Feldman Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris, Expert Opinion on Pharmacotherapy, (2009) 10:15, 2555-256.
  6. Andrew F. Alexis, Fran E. Cook-Bolden, J. P. York. Adapalene/Benzoyl Peroxide Gel 0.3%/2.5%: A safe and effective acne therapy in all skin phototypes. J Drugs Dermatol. 2017 Jun 1; 16(6): 574–581.
  7. Babaeinejad SH, Fouladi RF. The efficacy, safety and tolerability of adapalene versus benzoyl peroxide in the treatment of mild acne vulgaris; a randomized trial. J Drugs Dermatol. 2013 Sep;12(9):1033-8.
  8. 1Treatment [Internet]. nhs.uk. 2019.
  9. Mansu SSY, Liang H, Parker S, Coyle ME, Wang K, Zhang AL, Guo X, Lu C, Xue CCL. Acupuncture for Acne Vulgaris: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2018 Mar 12;2018:4806734.
  10. Lubtikulthum P, Kamanamool N, Udompataikul M. A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris. J Cosmet Dermatol. 2019 Apr 23. 12962.
  11. Oak Bark | Winchester Hospital. Winchesterhospital.org. 2019.
  12. Tohno H, Horii C, Fuse T, Okonogi A, Yomoda S. Evaluation of estrogen receptor Beta binding of pruni cortex and its constituents. Yakugaku Zasshi. 2010 Jul;130(7):989-97.
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