It is not uncommon for an acne sufferer to have used a variety of over-the-counter products and prescription treatments in their journey to achieve clear skin.  Some go it alone and decide on their own treatments while others rely on medical professionals to recommend appropriate therapy.

In both cases, trial and error usually win out over settling on the right treatment from the get-go.  Many factors are involved in each treatment decision including individual treatment goals, tolerance for risk of side effects, degree of patience in allowing time for results to be achieved as well as many other considerations and circumstances.

As an acne sufferer travels the road toward treatment success, many challenges are encountered that can make for a bumpy ride.

Questions arise along the way yet answers are difficult to come by.  This makes the journey even more frustrating for many acne sufferers hopeful for an effective solution.

A common question involves the effectiveness of different treatments.  While this is a very logical thing to ask, helpful answers are unfortunately seldom provided.  This is true whether searching online or during an in-person dermatology visit.

Making the decision

Commonly, acne sufferers are confronted with the decision to use a systemic treatment if topical medications alone are not helping.

Female acne sufferers have a variety of systemic acne treatment options to choose from, including oral antibiotic pills, acne-friendly birth control pills, a medication called spironolactone that blocks acne causing hormones and Accutane, the most effective medication of all.

Males suffering with acne however, are generally limited to only two systemic treatment options, i.e. oral antibiotic pills or Accutane if topical prescriptions are not helpful.  The other treatments that are available only to females pertain to hormonal actions and are not indicated for treating males.

For both female and male acne sufferers, when deciding on a systemic treatment, antibiotic pills are usually the first to be offered. They are typically the easiest to prescribe and manage by the dermatologist.

One of the most common antibiotic pills for acne is called doxycycline.  Doxycycline is one of the most, if not the most common antibiotics used for treating acne and is so often prescribed that is almost a reflexive action by the dermatologist.

So it is very likely that an acne sufferer will be offered this antibiotic pill first if topical medications are not effective.  But is it effective?  Or is Accutane a better choice with a higher likelihood of success?

Doxycycline vs Accutane

Well, the answer depends on a variety of factors.

First, the decision by a dermatologist to prescribe a given medication over another can depend on the patient’s medical history and individual circumstances.  What might be right for one person may not be appropriate for someone else.

Second, the treatment goal of each patient may be different.  Some may be seeking a degree of improvement while others’ expectations may be for completely clear skin.

Third, the risk of side effects of a given medication may be an important deciding factor for some patients more than others.

These are just some of the considerations that must be taken into account when deciding which systemic treatment is most appropriate for a given patient.

With these considerations in mind, generally speaking, oral antibiotics, including doxycycline, are sometimes very helpful for acne but often disappointing.  However, different treatment outcomes can be observed for different patients.

Some who take doxycycline may have a very good outcome.  In our experience, this is more likely to be the case for acne that has resulted from a situational circumstance.

For example, students who are having acne breakouts associated with the stress of final exams may respond well to a short duration of an antibiotic such as doxycycline.  The same for those who may be experiencing a stressful life event that is expected to be short-lived.

For those who are battling chronic acne, an antibiotic such as doxycycline may not be as effective.  Even if it does help, dermatologists typically do not like to maintain a patient on treatment with an antibiotic for a lengthy period of time.

Also, in cases of more severe acne or acne that has been resistant to antibiotic pills, Accutane is an option that may be considered.

In most cases of significant acne, treatment with Accutane is relied upon to provide a more complete response.   The expectation of Accutane treatment is for completely clear skin for most patients.

An additional consideration is that Accutane can potentially result in sustained remission of acne breakouts once the initial course of treatment is completed.  This is in contrast to treatment with doxycycline and other antibiotic pills that frequently result in a relapse of acne once they are discontinued.

The treatment benefits of Accutane must be balanced with the more intensive nature of its secondary effects and more involved treatment requirements.

In conclusion, a meaningful discussion with the dermatologist is always necessary when deciding which treatment is best for each patient.

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.