Is Accutane better than Retin-A?  Is Accutane better than benzoyl peroxide?  Is Accutane better than doxycycline?  These are common questions that are asked when different treatments are being considered.

Since Accutane is the gold standard when it comes to effectiveness, comparing Accutane to the effectiveness of other treatments makes sense. Dermatologists are often asked to compare Accutane to a variety of other therapies.

Is Accutane better than minocycline?  Is Accutane better than birth control pills? These are all questions that are commonly asked by acne sufferers searching for the most effective therapy for their acne breakouts.

Depending on your familiarity with Accutane and these other treatments, you may already know that Accutane is a pill while benzoyl peroxide and retinoids are topical therapies.  You may also already know that birth control pills are hormone-based treatments while Accutane is a Vitamin A derivative.  And that doxycycline and minocycline are antibiotic pills.

These are all very different medications that work in very different ways.  They are also best prescribed for different types of acne partially based on the respective underlying causes.

Each treatment is different

When comparing these treatments with Accutane, it is important to understand that Accutane is a systemic treatment that is often considered for use in the most severe cases of acne.  However, more recently, Accutane has begun to be used more frequently even in more moderate or even mild cases of acne depending on individual circumstances.

While Accutane is the most effective treatment for acne by far, it is often best used for inflammatory acne breakouts.  When acne mostly involves blackheads and whiteheads, also known by the technical term of comedones, topical treatments and acne facials may be effectively used.

Accutane works at the root of acne formation

 Accutane works on many aspects of the acne development process.  It can inhibit the effects of hormonal stimulation of acne-prone pores which can reduce sebum production and decrease the size of oil glands.

Accutane can also work to normalize some of the abnormal thickening that can occur within the pores when acne occurs.  Accutane’s effects can also be anti-inflammatory which can be important in healing acne.

Unlike Accutane, other therapies tend to be more focused on one aspect of the acne process and are thereby less broad-spectrum in their actions.

For example, the antibiotics doxycycline and minocycline generally target bacteria that are growing within acne-prone pores.  In addition, these antibiotics are also anti-inflammatory which can help reduce the redness and swelling of active pimples.

One of the drawbacks to antibiotics is that bacteria can become resistant.  This can make doxycycline and minocycline less effective as bacterial resistance develops.

Another drawback to using these antibiotic pills is that bacteria, while probably contributory to acne development, are not the root cause of acne formation.  Therefore, even if doxycycline or minocycline eliminate bacterial growth in the pores, they may not have a large effect on acne breakouts.  These factors may account, at least in part, for the overall disappointing results of antibiotic pills in many cases of acne.

In contrast, because of Accutane’s ability to work on multiple aspects of acne development, a much greater degree of improvement is expected.

For some of the topical medications such as benzoyl peroxide and others, there is a certain expectation that the treatment will not likely provide completely clear skin.  That is not to say, however, that for some acne sufferers, topical therapies alone cannot sometimes be very effective and result in clear skin.  The likelihood of a complete response, however, is low.

Accutane, on the other hand, is most likely to offer completely clear skin.  Furthermore and unique to Accutane, it has a very high likelihood of maintaining clear skin even after the course of Accutane treatment is concluded.

This is very different from the long term expectations for topical therapies and antibiotic pills, which may offer initial improvement but less likely to lead to a sustained remission of acne for the long term.

Often, when using a topical prescription regimen or antibiotic pills, adjunctive treatments, such as acne facials, are helpful.  Blue light treatment is another combination treatment that can provide additional benefit for those on topical prescriptions or antibiotics.

Accutane, in contrast, typically does all of the heavy lifting on its own and usually does not require the use of a second treatment in combination.  However, this is not always the case.

Accutane, which works best on inflammatory acne breakouts, can sometimes benefit from treatment of comedones though other interventions.


 Each acne treatment has its benefits and drawbacks.  Different treatment types can work in different ways and can be useful for different types of breakouts.

This underscores an important consideration when determining which treatment is best.  That is, the type of acne that is being treated can often determine the most effective therapy.

The Advanced Acne Institute is a unique dermatology practice located in Miami, Florida specializing only in the treatment of acne.   We focus solely on providing the most effective treatments to help our patients achieve clear skin.  We are pleased to share our insights and perspectives in acne treatment as an educational service, however this information is provided strictly for educational purposes only and should not be considered medical advice and is not a substitute for seeking the advice and treatment by an appropriate medical professional.


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