Acne cures by the dozen fill up drugstore shelves, and an Internet search on "acne treatment" yields approximately 20 million results. However, there is still plenty of acne to be seen, so obviously many people still have not found the right cure for themselves. This article will present an overview of the most common prescription treatments, as well as the benefits and drawbacks of each.

Acne occurs when skin cells on the face, back and chest react to testosterone or its metabolite, dihydrotestosterone, and grow too fast, a process known as hyperkeratosis. The overgrowth of skin cells clogs sebaceous glands, which develop a secondary infection from usually innocuous skin bacteria such as Propionibacterium acnes, causing a pimple or cyst.

Prescription acne treatments are available if over the counter remedies are insufficient.

Birth control pills tend to improve acne by shutting down the body's own production of hormones, not just estrogen and progesterone but testosterone as well, and reducing levels of free testosterone . As long as the synthetic hormones in the BCP are not themselves androgenic (and some synthetic progestins are) the acne should subside. Of course, this is only an option for female acne patients. Some birth control pills such as Yasmin are marketed specifically for acne treatment; your doctor can tell you more about these medications.

Spironolactone (usually prescribed as 50mg twice a day) is helpful for acne. This drug is normally used to treat high blood pressure, however it also acts as an antiandrogen and is used in the treatment of androgen related disorders such as female pattern baldness and hirsuitism.

Antibiotics such as tetracycline or minocycline are a standard treatment for acne, but are often ineffective in the long term or if used by themselves. You may have to switch from one antibiotic to another periodically as the skin bacteria develop resistance. All antibiotics cause an imbalance in normal intestinal flora, and can cause gastric irritation.

Topical clindamycin lotions and gels are often more effective than oral antibiotics. However, longterm use can be hazardous, since this antibiotic is absorbed through the skin and linked to a potentially deadly imbalance of gut bacteria called pseudomembranous enterocolitis. Clindamycin is three times more likely to cause this disorder than any other antibiotic.

Azelaic Acid has gotten mixed results in Europe. It provides a broad spectrum of activity in acne cases, but provides slow onset of action.

Retinoid, a vitamin A derivative, helps skin exfoliation just as fruit acids do, but its effect is much stronger. Several related related retinoid medications such as Retin-A, Tazarotene and Adapalene all have slightly different effects. Also, these products come in various strengths and formulations, so you may have to experiment to find the formulation that helps the most while causing the minimum amount of irritation.

Another vitamin A derivative, Accutane, is an oral drug as opposed to a topical preparation, and due to its side effects, is usually reserved for severe or persistent adult acne. It shuts down skin oil production and hyperkeratosis quite effectively, but its effects are felt throughout the body, potentially resulting in dry skin, joint pains, dry eyes, cracked lips, hair loss, depression (not surprising since the brain is composed mostly of fatty compounds called phospholipids), liver and kidney failure. It has been linked to an increased risk of suicide. Blood tests for liver and kidney function are mandatory at the beginning of treatment. The drug is usually taken for several months at a time, sometimes for 2 or 3 courses.

The drug causes severe birth defects if taken by pregnant women, and conscientious birth control is mandatory for female patients.

The effects of Accutane are often permanent : it is a true cure for acne. However, some users have found the side effects permanent as well, and there are several lawsuits pending against the manufacturer. There is no known way to reverse the effects of the drug after taking it; that is, there is no antidote if the user finds the side effects persistent and intolerable after a course of the drug. Many websites can be found full of complaints by ex-users who wish they had never taken the drug. Due to the risks, this is a medication of last resort, and is not recommended for mild teenage acne which can be treated by other means.