1. Topical antibiotics.
For powerful pimple-fighting effects, derms often prescribe an antibiotic like clindamycin in conjunction with benzoyl peroxide (either separately or in a combination product like Duac or Onexton). Dapsone (aka Aczone) is a newer alternative that's applied as a stand-alone therapy. "Topical antibiotics are usually well tolerated, which makes them great starter treatments," says Gervaise Gerstner, MD, a dermatologist in NYC. Applied once or twice daily, these gels and lotions can begin to reduce flare-ups in as soon as a few days.
In addition to improving fine lines, texture, and tone, prescription retinoid creams and gels are known for their skin-clearing powers and can take two to three months to work. The original topical retinoid is Retin A, but there are several different versions on the market.
3. Oral antibiotics.
"Because they're working from the inside out, they can be more effective than topical forms," says Rebecca Kazin, MD, of the Washington Institute of Dermatologic Laser Surgery. (Two popular pills are minocycline and doxycycline.) But like all antibiotics, they can come with side effects, like an upset stomach, sun sensitivity, and yeast infections.
4. The Pill.
If your acne is driven by fluctuating hormones, a birth-control pill reduces the level of androgens, lowering breakouts.
This diuretic (which can cause you to pee more) was originally developed to help lower blood pressure. But doctors quickly realized that it cleared acne because it acts as a hormone regulator. "It works exceedingly well for acne along the jawline, neck area, chest, or back that fluctuates with the menstrual cycle," says Dr. Kazin, who initially puts patients on it for a three-month trial.
This potent drug (flip the page to learn more) shrinks the oil glands that help bacteria breed. It can result in serious side effects (including birth defects), which is why users need to take regular, monitored pregnancy tests. Some derms won't consider putting patients with moderate acne on it until they've exhausted other options, including systemic antibiotics for three months.