Acne Medications: Side Effects, Relapse & What You Need to Know
- MW Skin Studio
- Oct 29
- 4 min read
If you’ve been struggling with acne, chances are you’ve already tried some form of medication, maybe a topical cream from your GP, a long course of antibiotics, or even the contraceptive pill to help calm breakouts. These treatments can help for a while, but for many of the clients I work with, the results don’t last.
Breakouts return as soon as medication is stopped, skin becomes more sensitive, or new symptoms appear like digestive issues, mood changes, or irregular cycles. And often, there’s been very little discussion about side effects and long term impacts, or the root cause behind the acne in the first place.
That’s why more people are beginning to question the conventional route and look towards a more holistic, functional approach to skin health. That’s the approach I take with all of my acne clients - we don’t focus on suppressing the breakouts but rather finding out what’s really driving the acne, and how can we support the body from the inside out?
The Four Main Types of Acne Medication & Side Effects
Let’s take a closer look at what’s most commonly prescribed as acne medication, side effects and what patients aren’t always told.
Topical Treatments
Examples: Clindamycin, Benzoyl Peroxide, Duac, Zineryt, Epiduo
Topicals are often the first line of treatment for mild to moderate acne. They work by:
Killing acne causing bacteria
Increasing skin cell turnover to unclog pores
While they can offer temporary relief, many people experience dryness, irritation, or a damaged skin barrier after long term use. Topical antibiotics also disrupt the skin microbiome which makes the skin more vulnerable to sensitivity, dehydration, or inflammation.
Most importantly, topicals do not address the root cause of why your skin is breaking out which could be hormonal, digestive, stress related or something else.
Oral Antibiotics
Examples: Doxycycline, Erythromycin, Lymecycline
Oral antibiotics are often prescribed for moderate to severe acne, especially inflammatory types. They reduce bacteria and inflammation and may be combined with topicals.
However, prolonged use can lead to:
Antibiotic resistance (a growing global issue)
Disrupted gut health and microbiome imbalance
Yeast infections, fatigue, or digestive issues
Acne relapse once the course is finished
Like topicals, oral antibiotics manage symptoms, but they don’t address deeper drivers like hormone imbalances, insulin resistance, or inflammation.
Oral Contraceptives
Examples: Yasmin, Rigevidon, Cerazette, Microgynon
Hormonal birth control is often prescribed for acne because it suppresses androgen production which reduces oil and breakouts while the pill is taken.
While it may help clear the skin temporarily, it can also:
Deplete essential nutrients (including B vitamins, magnesium, zinc)
Cause delayed results (it can take months to work)
Lead to acne relapse after discontinuation
Mask underlying hormone issues rather than resolve them
Be gender specific and unsuitable for many women trying to conceive or avoid synthetic hormones
If you’re interested in how birth control can impact your skin and acne in particular, we have a 3 part blog series as well as an e-book addressing this topic in detail!
Read Part 1 here.
Isotretinoin (Accutane)
Isotretinoin is considered the most aggressive and powerful acne medication and is often a last resort for severe or cystic acne.
It works by:
Dramatically reducing sebum (oil) production
Shrinking sebaceous glands
Providing long-lasting or even permanent results in some cases
But it also carries some of the most serious risks, including:
Severe dryness (skin, lips, eyes)
Mood changes and psychiatric effects (including depression and anxiety)
Liver strain - it requires regular blood tests during treatment
Requires contraception due to high risk of birth defects if taken during pregnancy
Acne relapse is still possible after the course ends
While it can be life changing for some, it’s crucial that patients are given informed consent, full information, and support before, during, and after treatment.
Why Acne Often Comes Back After Medication
Acne is a symptom, not a condition in itself. It’s a message from the body that something deeper needs attention.
When we suppress that signal without investigating the root cause, acne tends to return as soon as the treatment stops.
That’s because the underlying drivers are still there:
Hormonal imbalances (e.g. high androgens, PCOS, post-pill shifts)
Insulin resistance or blood sugar spikes
Inflammation or poor gut health
Chronic stress and poor sleep
Nutrient deficiencies
The skin is one of the body’s detox pathways. When something’s off internally, it often shows up externally.
What a Functional, Root-Cause Approach To Acne Looks Like
Functional skin health looks beyond the breakout.
Instead of asking, “how do I get rid of this spot quickly?” it asks “why is my skin reacting in this way? And what does my body need to heal?”
How I treat acne at MW Skin Studio is by:
Exploring your medical history, lifestyle, diet, and hormonal picture
Looking at possible nutrient gaps and supporting skin from within
Supporting the gut-liver-skin axis
Using evidence based skincare without overloading or stripping the skin
Empowering you with education and tools so you can understand your own skin
Granted, my clients don’t see their breakouts disappearing within a week - instead they start to see differences in their skin, health and mood after a month that lasts their whole lives!
Your Skin Deserves the Full Picture
Conventional medications can offer relief but they’re not the whole picture. For many people, they come with trade offs: nutrient depletion, hormonal disruption, gut issues, or emotional side effects that no one explained upfront.
If you’ve tried the medications and still feel stuck, or you simply want to take a more holistic path from the start - I see you and you’re not alone!
Melanie offers 1:1 Virtual Consultations, where you’ll receive a personalised plan based on your skin, hormones, lifestyle, and goals. This is about giving your skin what it really needs, not just putting a plaster over the symptoms.
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