Topical vs. Oral Acne Treatments: Understanding the Difference and When to Use Each
As a mom of a teen struggling with acne, you've likely felt the frustration of sorting through a dizzying array of skincare products and treatment options. From over-the-counter creams to dermatologist-prescribed pills, the options can seem endless and confusing. When your child’s self-esteem is at stake, deciding between topical and oral treatments is a big decision. In this blog, we’ll break down the differences between the two, discuss the main types of acne medications and help you determine when each option might be appropriate for your teen. And if you’re feeling overwhelmed by the prospect of medications, I’ll also share why my exclusive "Epidermal Repair Method" may be the solution you’re looking for before jumping into medications.
What’s the Difference Between Topical and Oral Acne Treatments?
Topical treatments are applied directly to the skin. These include gels, creams, lotions and acne serums that target acne at the surface level. They’re typically the first line of defense recommended for mild to moderate acne. Topical medications work by reducing bacteria, regulating oil production or promoting skin cell turnover to prevent clogged pores.
Oral treatments, on the other hand, are systemic medications taken by mouth, affecting the entire body. These are generally reserved for more severe or persistent acne cases that don’t respond well to topical treatments. Oral acne medications include antibiotics, hormonal treatments and retinoids, each targeting underlying causes of acne like bacteria, hormonal imbalances or inflammation.
Both treatment types have their place in acne management, but understanding when and how to use each is key to achieving clear skin.
The Two Primary Types of Acne Medications: What You Need to Know
Acne medications can be categorized into two main types: antimicrobial agents and retinoids. Here’s a breakdown of each type and how they work:
Antimicrobial Agents:
Antimicrobial agents include both topical and oral antibiotics as well as benzoyl peroxide, which are primarily used to target and reduce the bacteria Cutibacterium acnes (formerly known as Propionibacterium acnes) that contribute to inflammation and acne breakouts.
Topical Antimicrobials: These are commonly prescribed for mild to moderate acne. Benzoyl peroxide and topical antibiotics like clindamycin or erythromycin work by killing bacteria on the skin’s surface, reducing inflammation and preventing new breakouts. Benzoyl peroxide is often available over the counter, making it a good starting point for many teens. However, topical antibiotics should be used cautiously and usually in combination with other treatments to avoid developing antibiotic resistance and gut problems.
Oral Antibiotics: Oral antibiotics, such as doxycycline or minocycline, are generally prescribed for moderate to severe inflammatory acne that doesn’t respond to topicals. They help reduce bacteria and inflammation throughout the body. However, these medications are not meant for long-term use due to potential side effects including gut imbalance and the risk of antibiotic resistance. They’re often used in combination with other therapies, like topical retinoids, to boost effectiveness.
Retinoids:
Retinoids are vitamin A derivatives that help promote skin cell turnover and prevent clogged pores. They are highly effective for comedonal acne (whiteheads and blackheads) as well as for preventing future breakouts.
Topical Retinoids: Common topical retinoids include tretinoin, adapalene, tazarotene and Vitamin A. These work by speeding up the shedding of dead skin cells and promoting new cell growth. They’re typically used in the evening as part of a skincare routine since they can increase skin sensitivity to the sun. Topical retinoids are a great option for persistent acne but can cause initial dryness, redness and irritation, so it’s important to start slowly with lower percentages and use a gentle moisturizer alongside them.
Oral Retinoids (Isotretinoin): Often known by the brand name Accutane, oral isotretinoin is a powerful medication reserved for severe cystic acne or acne that has not responded to other treatments. It works by drastically reducing oil production, decreasing bacteria and normalizing skin cell shedding. While it can be effective, it comes with a host of potential side effects, including intense dryness, sore joints, increased sensitivity and more serious concerns like birth defects if taken during pregnancy. Isotretinoin requires close monitoring by a healthcare professional and should be considered a last resort.
When to Use Topical vs. Oral Treatments
Deciding between topical and oral treatments can depend on several factors, including the type and severity of acne, your teen’s skin type and any underlying health conditions. Here’s a general guideline:
Topical Treatments: Best for mild to moderate inflamed acne, comedonal acne (blackheads and whiteheads), or when your teen is just beginning their acne treatment journey. Topicals are a good starting point because they have fewer systemic side effects and can be targeted directly to problem areas.
Oral Treatments: More appropriate for moderate to severe acne, widespread acne (such as on the chest or back), or inflammatory acne that doesn’t respond well to topical treatments. Oral medications are typically considered when acne is causing significant emotional distress or has the potential for scarring.
Remember: Medications Aren’t Always the Only Answer
It’s easy to feel like acne medication is the only option when faced with stubborn breakouts. However, acne is often influenced by a combination of factors, including diet, hormones, stress and skincare habits. That’s why I developed the "Epidermal Repair Method", a gentle approach that addresses the root causes of acne from the inside out.
The Epidermal Repair Method focuses on the right skincare products, balancing hormones, improving gut health and creating a skin-friendly diet and lifestyle. It’s designed to empower your teen with the tools and knowledge to manage their skin naturally, reducing the need for medications. Before considering systemic treatments, it’s worth exploring this comprehensive approach to see if it’s the solution you’ve been looking for.
Choosing between topical and oral acne treatments can be daunting, but understanding the differences and when to use each can help you make an informed decision. Remember, medication isn’t always necessary, and there are more gentle options like my Epidermal Repair Method that might be the perfect solution for your teen’s skin challenges. If you’re interested in learning more about this method, let’s connect and see how we can support your teen in achieving clear, healthy skin ... naturally.
Have a fabulous day!
Jean Kelly
Licensed Esthetician
Acne Specialist
Mom's come to me when they've tried everything but their teens acne just won't clear.
PS.
You're invited to join my free Facebook Group "Parents of Teens With Acne", join HERE
If you want to get started right away with some secrets that are easy to implement and don't cost any money, grab the online mini course "Clear Skin Secrets" HERE and start using the secrets today! It's super affordable at only $28 and lots of moms are jumping in before the price goes up.
