Acne Treatment Pills- Which Ones Actually Work in 2022?

Pills for acne treatment help women, men, and teens; but can these treatments cause side effects?

Do Antibiotic Acne Treatment Pills Help Breakouts?

Antibiotics aid in the treatment of pimples by decreasing bacteria and inflammation in the skin. The antibiotics that are prescribed are Tetracyclines which are broad-spectrum antibiotics that fight numerous types of bacteria. These drugs are also similar to Isotretinoin which is popularly prescribed by dermatologists for severe pimples.

Antibiotics are prescribed by a dermatologist for the treatment of severe acne. Severe breakouts include cystic acne, nodules, pimples that are highly inflamed, and comedones which are blackheads and whiteheads.

History of Tetracyclines

Tetracyclines were discovered in the late 1940s by an American plant physiologist named Benjamin Minge Duggar from soil bacteria called actinomycetes. In this bacteria was chlortetracycline which became the first tetracycline antibiotic. It was shown in studies in the 1950s that tetracycline had powerful antibacterial properties (1) which led to multiple derivates of the antibiotic.


Benjamin Minge Duggar

Prescription Acne Medication List

Antibiotics can be taken orally or applied topically to the skin. They may come in the form of pimple medicine capsules, acne treatment pills, gels, or creams. Each type of medication for severe breakouts is used for different types of blemishes or if a person is allergic to one of the other antibiotics.

Oral and Topical Antibioitcs For Pimples:

  • Tetracycline
  • Erythromicin
  • Clyndimicin

There are different types of Tetracycline acne antibiotics including Doxycycline, Lymecycline, and Minocycline. Although they are all in the same class of antibiotics, the acne medication pills names are different because they have different chemical structures and may be prescribed for different reasons as one may be more effective for fighting a certain infection than the other. (2)

Dosing and Miligrams:

Each Tetracycline antibiotics have different dosages and miligrams.






50mg once or twice daily

50mg once or twice daily

250mg twice-four times daily


100mg once or twice daily

100mg once or twice daily

500mg twice-four times daily


Side Effects


Dryness in area where antibiotic was applied

Skin irritation

Contact dermatitis (rash)



Photosensitivity which increases the risk of sunburn

Upset stomach; nausea, vomiting, diarrhea, loss of appetite

Headaches, dizziness, and blurred vision

Sores inside mouth or lips

Decreases the amount of gut flora which is the "good bacteria" inside our body.

Birth control may be less effective when taking prescription antibiotic pills for blackheads.

Antibiotic resistance: medication may stop working as effectively and breakouts may reoccur

Other Topical Medication Creams

Prescription Free

Brexoxyl or Triaz which is a stronger form of Benzoyl Peroxide

Azeleic Acid

Salicylic Acid

Prescription Needed

Tretinoin (Retin-A)

Adapalene (differin)

Tazarotene (Tazorac)

Isotretinoin Pimple Tablets

Isotretinoin is a synthetic retinoid that is a derivative of Vitamin A (retinol).

Isotretinoin can be taken as an oral medication for acne and comes in capsule form. These pimple medicine capsules can also be applied topically as you can use a Vitamin A gel for acne. The topical versions of Isotretinoin are called Isotrex or Isotrexin which contains Isotretinoin as well as Erthyromicin.

History of Retinoids

Natural retinoids are found in all living things as they are necessary for important processes such as cell growth and vision. In ancient Egypt, liver was used to treat night blindness as it contains retinoids.

In 1943 the first study using retinoids for pimples was published and in 1959 tretinoin was first used topically for skin issues. (3)

What Is Isotretinoin Used For?

This acne medicine pill is used to treat severe nodules by reducing sebum production from the sebaceous glands in the skin. Sebum is the oil that our body naturally produces to lubricate our skin, but when too much oil is produced it can lead to pimples.

Dosing & Miligrams

The recommended dose of Isotretinoin is 0.5-1.0mg per day. It should be split up throughout the day and taken with food. After 15-20 weeks the dermatologist will observe the progress or lack thereof and adjust the dosage accordingly.


Isotretinoin Acne Tablets Side Effects

Common Side Effects:

Dry eyes

Dry skin

Cracked lips

Muscle and joint pain

Increased triglycerides (fat cells) in the blood


Rare Side Effects:

Depression, anxiety, mood swings, mental instabilities.

Hair Loss

Keratitis which is the inflammation of the surface of the eye

Pros And Cons


Decreased oil production

Prevents scarring from severe breakouts

More powerful than any OTC blemish treatment tablets

Covered by insurance


Extensive side effects

Should not be taken during pregnancy as it may cause serious birth defects

Must be prescribed by a doctor

If you plan to pay out of pocket it can cost $300-$400 per month

Most people need 5-6 months of daily treatment

What type of antibiotics work best for each type of severe breakout?

Antibiotic Pills For Cysts and Nodules

Topical and oral acne medications like erythromicin, clindamycin, and tetracylcine are the most commonly prescribed for cysts and nodules. These two types of severe breakouts are not the same, but many times people can experience both kinds at the same time.

Cysts and nodules are both deep within the skin, but cysts are softer as they contain pus whereas nodules are harder and tend to hurt more. (4)

Much like nodules, cysts also reside deep underneath the skin’s surface. But because they’re filled with pus, cysts are softer.

Using just one type of treatment pills for cysts and nodules may eventually become ineffective as antibiotic resistance may occur which means that the body will stop responding to the treatment. For this reason it may be beneficial to also use a topical retinoid like Isotretinoin in conjunction with an antibiotic. (5)

Antibiotics For Comedones

Isotretinoin is a prescribed pimple medication for adults which is prescribed for comedonal blemishes.

Comedones are not known as an inflammatory type of breakout as it is characterized by open comedones (blackheads) which contain oxidized melanin.

Melanin is the pigment made by skin cells and when it is exposed to oxygen it turns black. It is not dirt or bacteria from poor hygiene as most people are lead to believe.

It is also characterized by closed comedones (whiteheads) which are skin colored and occurs when the follicle is completely blocked by sebum which is the oil in our skin. Another type of closed comedone is milia.

The reason why comedones are not considered inflammatory is because they do not appear red and they do not hurt.

Birth Control

Birth control is used to prevent a woman from becoming pregnant, but can also be prescribed for breakouts if antibiotics and topical creams have not worked to clear up the skin.

Which Birth Control Pills Reduce Breakouts?

Three different birth control brands are approved by the FBA for the treatment of breakouts.
They are all "combination" pills meaning that they contain the hormones estrogen and progesterone.

They all contain a low dose of estrogen, but they are different in that each pills contains a different dose of progesterone.

Birth control pills that only contain progesterone can actually exacerbate pimples.

acne pills

Names of Birth Control Acne Pills

  • Ortho Tri-Cyclen
  • Estrostep
  • YAZ

These birth control pills help by decreasing testosterone which is the androgen that causes pimples to form.


Spironolactone was originally prescribed for hypertension, but was found that at a low dose it can help with hormonal pimples in women. It is only prescribed to women because it is an androgen blocker which means that it blocks male hormones like testosterone.


Decreases sebum production

Does not cause your body to lose potassium

Diuretic effect helps you lose bloat


Takes months to kick in

Does not cure pimples as you may still experience flareups

May cause irregular menstrual cycle

Not FDA approved for the treatment of breakouts

acne pills treatment

Acne Pills and Alcohol

Drinking alcohol while taking prescription antibiotics for acne is not prohibited, but it is not recommended as alcohol can decrease the effectiveness of the antibiotics. It decreases the effectiveness because your body excretes it faster when you drink alcohol.

Isotretinoin has the potential to cause liver toxicity and drinking alcohol can increase your chances of experiencing that side effect.

You may be able to have an occasional one drink, but binge drinking is definitely not a good idea. Be sure to run questions like by your doctor.

Acne Vitamins

We can help our acne breakouts and other skin issues by taking acne vitamins. Some of these include Vitamin A, B, and D.

These vitamins can be helpful in the treatment and prevention of acne as they are necessary for vital body functions. They are important because they keep the immune system, skin, organ, bones, and brain healthy.

Vitamin A

Is a common ingredient used in many OTC acne supplements and anti-aging products because it increase skin elasticity and improves fine lines and wrinkles.

Derivatives of Vitamin A are also found in topical treatments such as Retin-A as it helps reduce inflammation, decrease oily skin and kill bacteria. 

Retinoids and carotenoids are different forms of Vitamin A. Retinoids are found in animal sources and are absorbed into the body immediately whereas carotenoids are plant based and are only converted into Vitamin A when consumed.

Vitamin A is a fat soluble acne vitamin so the excess that the body does not use gets stored in fat cells in the body making it potentially toxic if you consume large amounts.

Vitamin B

B vitamins are a class of vitamins that are water-soluble. If your body does not use all of them the excess will be excreted from the body.

They work synergistically to produce positive health benefits in the body like increased immune system as well as healthy skin, bones, and organs.

List of B-Vitamins

Thiamin (b1)
Pantothenic Acid
Vitamin b6 (pyridoxine)
Folate (called folic acid when added into supplements)
Vitamin B12 (cyanocobalamin)

Vitamin B5 also known as Pantothenic Acid is one of the best vitamins for acne prone skin. It has been shown to decrease oil production in the skin also known as sebum. It has this effect on the skin when taken in high doses and since it is water-soluble it is not toxic to the body.

An article by Dr. Lit- Hung Leung showed that giving patients who were given Pantothenic Acid daily improved their acne.

Vitamin D

Vitamin D is called the “sunshine” vitamin as it helps increase our mood and boosts our immune system which is a factor in preventing breakouts.

The recommended form of Vitamin D that you should take in supplement form is Vitamin D3 (cholecalciferol). It is the natural form of Vitamin D that your body makes from sunlight.

People who do not get enough sunlight may be deficient in this vitamin which contributes to depression and dull skin.

estrogen blocker for men

Taking acne vitamins for clear skin complexion is just one way that helps keep acne at bay. We must also take into consideration our diet and lifestyle habits as well.

Why are Acne Pills Making Me Break Out?

There are a few reasons why these pills may make a person break out.

pills for acne

1. You may be allergic to the ingredients in the product.

2. An initial purging effect may occur especially with products that help detoxify the body.

3. Your body has become resistant to antibiotics so your breakouts reoccur. This can happen with over the counter pills as well, however you can cycle supplements so the effectiveness will be greater next time you take them unlike antibiotics which are more harmful to the body to take all of the time.

4. It may not be the pimple tablets or antibiotics that are making you break out as it could be the diet that you are eating and lifestyle choices that you are making which are important for fighting pimples and dark spots.

Home Remedies for Acne Treatment

There are also alternatives to pills for acne treatment and medicine tablets for pimples and dark spots in remedies that are more natural and less expensive. Most of us already have these ingredients in our homes, but they are also inexpensive to buy if we don't already have them.

Apple Cider Vinegar- ACV helps to balance the pH levels in our body which is a factor in the development of pimples if our body is too acidic or too alkaline.

Simply dilute a tablespoon of Apple Cider Vinegar in water and drink it once a day. You can also apply it directly to your skin after diluting it in water as it can help dry out your skin and existing blemishes.

Aloe Vera- Aloe contains many different nutrients, vitamins, and minerals which help are healthful for our skin. It also contains salicylic acid which helps to dry out our skin and kills bacteria. Like ACV, you can apply it to your face or drink it.

Coconut Oil- By now you may have heard of all the wonderful benefits of coconut oil.

Along with cooking with it or putting it in your Bullet Proof Coffee, you can also apply it to your skin as a moisturizer if your skin is dry and it is also effective for preventing breakouts.

It contains Lauric Acid which has antimicrobial properties that help fight inflammatory blemishes. (7)

Lemon Juice- Many people look for tablets for pimples and dark spots when in actuality you may be able to help these issues by using lemon juice on the skin.

The citric acid in lemons have been used as a natural remedy for bleaching the skin which is why it may help with dark spots. Simply squeeze some juice out of a lemon, dip a cotton ball in it and then apply it to the dark spots.

Lemons also contain antibacterial and anti-fungal properties which help with killing bacteria in our pores which may cause breakouts.

acne pills


In general, breakouts are an inflammatory response to CURED. Once we address the hormone fluctuations we may see a reduction in acne, oily skin, and overall inflammation.

Acne treatment tablets  have shown to be successful for most people, but the best acne medication is determined by the type of breakout you have.

Acne pill side effects may occur with any type of acne treatment. It is important to speak with a professional dermatologist to figure out what the best treating option is for your specific breakout and skin type.

What has worked best to help you with your breakouts? Please leave a comment below and let us know! Be sure to also check out our other reviews on this site.








The content, information, and advice in this article is solely for educational purposes only. It is not meant to treat any disease or medical conditions. Always speak with your doctor if you have any questions regarding your health.