12 prescription acne medications for adults used by dermatologists

Table of Content:
Acne scar treatment | Hormonal acne treatment |  Acne treatment for sensitive skin | Acne spot treatment | Retinoids | Acne treatment for teens | Adult acne treatment | Treatment for cystic acne

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Acne is a common skin condition affecting 50 million people in the US alone. 1 For many, it’s an ongoing battle to achieve clear and healthy skin. With so many over the counter and prescription acne medications for adults available, it can be overwhelming trying to choose the best acne treatment for your skin.

In this article, we compare the most widely prescribed acne medications for adults and teens that are applied topically so you and your healthcare provider can decide the best acne treatment for your type of acne.

The top 12 topical prescription acne medications for adults

Below, we will delve into more details about the best acne medications for adults, divided into four main sections:

1. Best acne scar treatment

According to Dr. Alpana Mohta , dermatologist, prescription retinoids, such as tretinoin, improve acne scars and reduce post-inflammatory hyperpigmentation².

Retinoids increase the production of collagen and stimulate cellular turnover which can help improve the appearance of acne scars over time³. Tretinoin and tazarotene are particularly effective for treating atrophic scars^4 5 , which are scars with a  sunken appearance (such as chicken pox or sometimes acne).

Altreno

Altreno is a new and improved version of tretinoin due to its unique ingredient combination. It includes micronized tretinoin (a process which  improves skin absorption), hyaluronic acid, collagen and glycerin. It is unique because in clinical trials only 1% of patients have experienced skin irritation⁶.

What is Altreno suitable for? 

Altreno is suitable for the treatment of acne and anti-aging. It can be used by people with very sensitive skin. It can be used in children as young as 9 years old.

Lowest price of Altreno in USA without insurance

Price of Altreno is $65 for a 20 gr tube and $115 for a 45 gr tube.

*Prices may vary depending on insurance, discount programs, or coupons.

Pros

• Reduces fine lines and wrinkles 
• Combats acne
• Gentle on the skin

Cons

• Causes sensitivity to the sun
• It is not safe to use during pregnancy or lactation
• It may trigger the so-called “tretinoin purge”

Tretinoin

Tretinoin also known as retinoic acid, is the most popular and widely used ingredient for acne and anti-aging. Tretinoin is a prescription-grade, first-generation retinoid that promotes cellular turnover, increases the production of collagen and has anti-inflammatory properties⁶. 

What is tretinoin suitable for?

Tretinoin is suitable for treating mild to moderate acne⁷, signs of aging and photoaging⁸. If used for acne, it can be combined with antibiotics for short term treatment. 

Lowest price of tretinoin in USA without insurance

The lowest price of a 20-gram tube of generic tretinoin 0.025% cream starts around $20 without insurance. The price of branded tretinoin products tends to be higher.* 

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Can reduce fine lines and wrinkles in addition to combating acne⁹
• It is available in various strengths
• Can be easily prescribed via a photo-based consultation

Cons:

• May cause skin irritation, dryness, redness and peeling
• It may trigger the so-called “tretinoin purge”
• Increases skin’s sensitivity to the sun
• Not safe for use during pregnancy¹⁰

Adapalene

Adapalene (Differin) is a synthetic, third generation retinoid similar to tretinoin. It works by regulating skin cell turnover, helping to unclog pores and reduce inflammation. Adapalene is as efficient as Tretinoin against acne but less irritating^{11 12} . 

What is adapalene suitable for?

Adapalene is suitable to treat mild to moderate acne and is less irritating than tretinoin, making it a good option for those with sensitive skin.

Lowest price of adapalene in USA without insurance

The lowest price of a 45-gram tube of generic adapalene 0.1% gel can cost around $10 to $20 without insurance.*  

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Better tolerated than tretinoin¹³
• Available in various strengths
• Can be prescribed via a telemedicine consultation
• Also available in fixed combination with benzoyl peroxide

Cons:

• May cause initial skin irritation or dryness
• Increased sun sensitivity
• Not effective for severe acne
• Not safe for use during pregnancy¹⁴

Tazarotene

Tazarotene (also known as Fabior foam), is a third-generation topical retinoid that is more potent than tretinoin and adapalene. Tazarotene can only be bought with a medical prescription and it is used  to treat acne, photoaging, and psoriasis. Tazarotene works similarly to other retinoids by regulating skin cell turnover and reducing inflammation¹⁵.

What is tazarotene suitable for?

Tazarotene is primarily used for moderate to severe acne and psoriasis. 

Lowest price of tazarotene in USA without insurance

The lowest price of a 30-gram tube of generic tazarotene 0.1% cream or gel can start around $70 without insurance. The price of branded tazarotene products, such as Tazorac, can be much higher.*  Get the best tazarotene discount coupons. 

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Potent and effective for moderate to severe acne
• Also combats signs of aging in addition to acne
• Can be easily prescribed via a virtual consultation 

Cons:

• May cause more skin irritation, dryness, redness and peeling than other retinoids¹⁶
• Increased sensitivity to the sun
• Not safe for use during pregnancy¹⁷

Trifarotene

Trifarotene (also known as Aklief) is the first fourth-generation topical retinoid developed specifically for acne treatment. It targets specific retinoic acid receptors in the skin, leading to fewer side effects and irritation¹⁸. It is the first topical retinoid that has been extensively studied for both safety and effectiveness in treating truncal acne¹⁹, It showed reduced side effects and irritation compared to traditional retinoids like tretinoin.

What is trifarotene suitable for?

Trifarotene can be used in the treatment of mild to severe acne on face and trunk, but since it is a new drug there is not enough research on this specific medication²⁰.

Lowest price of trifarotene in USA without insurance

Trifarotene is a newer topical retinoid currently available only under the brand name Aklief.

The lowest price for a 45-gram tube of Aklief (trifarotene) 0.005% cream starts around $600 to  $700 without insurance.*  Read our guide on how to get cheap medicines to get the best Aklief coupons and savings card.

 

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Reduced skin irritation as it helps maintain skin moisture and improve the skin’s protective barrier²¹
• Has fewer side effects²²
• Stays active in skin cells for a longer time, which may contribute to its effectiveness²³

Cons:

• May still cause some skin irritation or dryness
• Increased sun sensitivity
• Not safe for use during pregnancy²⁴

Azelaic acid

Azelaic acid is a dicarboxylic acid with many beneficial properties for the skin. In the case of acne, it targets all four causes of acne: kills bacteria, decreases production of sebum, reduces inflammation, acts and anti-keratinizing agent (preventing excessive buildup  of skin cells to promote a more balanced turnover of skin cells)²⁵.

What is azelaic acid suitable for?

Azelaic acid can be used for the treatment of acne, rosacea and hyperpigmentation. It can be used by people with sensitive skin^26. 

Lowest price of azelaic acid in USA

Lowest price for a tube of azelaic acid 20% is around $50 without insurance.
*Prices may vary depending on insurance, discount programs, or coupons.

Pros

• Effective against acne and hyperpigmentation
• Well tolerated for sensitive skin
• Considered safe to use during pregnancy
• It has a prescription strength and over the counter versions

Cons

• Mild side effects
• Slow to show results (several weeks)

Epiduo

Epiduo and Epiduo Forte are topical medications used for acne treatment which contain adapalene and benzoyl peroxide. The main difference between these medications is their strength, as the Forte version is stronger. Epiduo contains two ingredients that combat acne individually, which makes this combination a very effective acne treatment.

What is Epiduo suitable for?

Epiduo is suitable for individuals with acne over 9 years of age, while Epiduo Forte is suitable for people 12 years or older. 

Lowest price of Epiduo Forte in USA without insurance

The price of generic Epiduo starts around $40, if you want the branded Forte version you may pay up to $500.
*Prices may vary depending on insurance, discount programs, or coupons.

Pros

• Dual action treatment as it combines two active ingredients
• Effective against inflammatory and non-inflammatory acne lesions
• It can be used long term

Cons

• Skin irritation
• Causes sensitivity to sunlight
• Cannot be used during pregnancy

2. Topical treatment for hormonal acne

There are two topical treatments that are used for hormonal acne: topical spironolactone and Winlevi. Although topical spironolactone is a better known medication, Winlevi is FDA-approved for the treatment of hormonal acne²⁹.

Hormonal acne treatment may also be complemented with oral medications such oral spironolactone or birth control in women.  

Topical spironolactone

Topical spironolactone is used as an off-label treatment for acne. Spironolactone blocks the effects of androgens, which are hormones that can contribute to the development of acne. By reducing the impact of androgens on the skin topical spironolactone may help decrease the production of sebum (oil) and inflammation associated with acne²⁶.

Since topical spironolactone is a relatively new drug in the market and it is only used off-label for acne, there is limited research on the effectiveness of this drug compared to other more commonly prescribed acne treatments. 

What is topical spironolactone suitable for?

Topical spironolactone is suitable for mild to moderate hormonal acne.

Lowest price of topical spironolactone in USA without insurance

Topical spironolactone is only formulated by compounding pharmacies, which customize medications according to a doctor’s specifications. The price of compounded topical spironolactone can vary depending on the concentration, formulation, and pharmacy fees.

Pros:

• May be effective to treat hormonal acne
• Can be used alongside other acne medications
• Doesn’t affect blood pressure and potassium levels unlike oral spironolactone
• No risk of sun sensitivity or skin irritation unlike topical retinoids

Cons:

• It is not FDA-approved for the treatment of acne
• There is not enough research to confirm the efficacy of this hormonal acne treatment
• It is only sold by compound pharmacies
• Spironolactone is not safe for use during pregnancy

Winlevi

Winlevi (clascoterone) is a fairly new prescription acne medication that controls sebum production and has anti-inflammatory properties which can lead to redness, swelling, and inflammation around hair follicles and sebaceous gland²⁸.

What is clascoterone suitable for?

Clascoterone is suitable for mild to moderate hormonal acne.

Lowest price of Winlevi in USA without insurance

The cost of a 60-gram tube of 1% Winlevi topical cream in the United States is generally around $600, in the absence of any discount coupons.*  However we have compiled a list with the best Winlevi patient coupons so you can get it at the best price.*  

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• The only FDA-approved topical androgen receptor inhibitor for the treatment of hormonal acne
• Can be prescribed with a telemedicine consultation
• Less side effects than oral treatments for hormonal acne

Cons:

• It is very expensive if you don’t have insurance or use the patient savings card
• Not safe for use during pregnancy

3. Best topical acne medication for sensitive skin

According to Dr. Mohta, clindamycin creams and gels are considered the best acne treatment for sensitive skin. Since it is an antibiotic, it kills bacteria that cause acne, but it is much less likely to cause irritation or dryness compared to other acne medications. Due to its antibiotic nature, this drug can only be used for a maximum of three months to avoid the risk of developing antibiotic resistance with long-term use. It is typically combined with other medications such as retinoid or benzoyl peroxide.

Topical clindamycin

Clindamycin gels and creams is an antibiotic commonly used for the treatment of acne. Clindamycin helps reduce the growth of acne-causing bacteria and in addition to its antimicrobial properties, it also has anti-inflammatory properties that can help to reduce the redness, swelling, and inflammation associated with acne breakouts^29.

What is topical clindamycin suitable for?

Topical clindamycin can be used to treat mild to moderate acne and acne in people with sensitive skin. Topical clindamycin is typically used in combination with other acne treatments, to improve efficacy and reduce the risk of antibiotic resistance³⁰. 

Lowest price of topical clindamycin in USA without insurance

The lowest price for a 30-gram generic tube of (clindamycin) 1% gel starts around $35 without insurance.*  The price of branded or compound formulations is higher.

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Quite affordable compared to other acne treatments
• Anti-bacterial and anti-inflammatory properties
• Suitable for sensitive skin

Cons:

• It can only be used for a short period since it may cause bacteria resistance
• Not effective for all types of acne

4. Best acne spot treatment

According to Dr. Mohta, salicylic acid and benzoyl peroxide are considered first line-treatment for acne spots. Salicylic acid exfoliates the skin, removes dead skin cells, and dissolves oil or sebum, preventing pores from getting clogged and causing acne breakouts. On the other hand, benzoyl peroxide is bactericidal, which means it kills the bacteria that cause acne breakouts. 

Salicylic acid

Salicylic acid is a Beta Hydroxy Acid (BHA), and it works as a chemical exfoliant since it causes the cells of the outermost layer of the skin to shed, making room for the regrowth of new skin cells³¹. In addition to exfoliating the skin, salicylic acid also reduces excess sebum and prevents pores from clogging.

What is salicylic acid suitable for?

Salicylic acid is suitable to treat mild to moderate acne (both inflammatory and non-inflammatory acne) such as blackheads, whiteheads, papules, and pustules.

Lowest price of  salicylic acid in USA without insurance

Since salicylic acid is widely available over the counter and with a prescription depending on the product’s concentration the price greatly varies, but the lowest price without an insurance is around $30.

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Acts as a skin exfoliator, leaving skin smoother
• Has anti-inflammatory properties
• It helps to prevent the formation of comedones
• Reduces oil production

Cons:

• Causes skin irritation and dryness
• Less effective for cystic or nodular acne

Benzoyl peroxide

Benzoyl peroxide is a topical medication approved by the FDA for the treatment of acne³². It comes in 2.5%, 5%, and 10% concentrations. The products with a higher concentration can only be bought with a medical prescription. 

Benzoyl peroxide is a bactericidal that kills acne-causing bacteria and reduces the amount of sebum in the skin³³. 

One of the advantages of benzoyl peroxide is that since it is not an antibiotic, it does not cause drug resistance^34.

What is benzoyl peroxide suitable for?

Benzoyl peroxide is generally recommended for mild to moderate acne, although it is an effective treatment for various types of acne, including inflammatory and non-inflammatory acne. Benzoyl peroxide and tretinoin together, are especially effective for moderate to severe acne.

Lowest price of benzoyl peroxide in USA without insurance

The lowest price for a 90-gram generic tube of (Benzoyl peroxide) 5% gel starts around $5 without insurance.*  The price of branded formulations is higher.

*Prices may vary depending on insurance, discount programs, or coupons.

Pros:

• Is effective for different types of acne
• Is extremely affordable, even without an insurance
• In an antibacterial, (not antibiotic) so it can be used by extended periods 

Cons:

• It causes skin irritation
• It has a bleaching effect, which means you should be careful it doesn’t come in contact with hair or clothing

There are several prescription medications for acne treatment that are more effective at clearing acne than over-the-counter variants. But which one is the best treatment for you? It depends on severity and the type of acne, so it is best to discuss that with your online dermatologist and request an effective acne prescription medication. 

Read our Patient Guide to get the best discount coupons and patient savings cards, so you can get affordable medication.

Got more questions about acne medications?

Lee este artículo en Español ¿Cuáles son las mejores cremas y tratamientos para el acné?

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