Biggest risk?
There's a very high chance of XX XX!
No matter the dose,
you should stop the medication at least 1 month,
ideally 3 months, before trying to XX XX.
Not feeling great today, PD?
PD: I had medicine on an empty stomach earlier and now I feel all messed up.
Wait!
You took it on an empty stomach?
Didn't anyone warn you about that?
PD: No, they did say to eat first...
(Oh no...)
You should've listened!
Warnings exist for a reason!
〈Acne Med Side Effects 1. Today's topic〉 Hello,
[Jfeel clinic Chief Director Dr.Lee] I'm Dr.Lee, here to help you look your best.
When it comes to dermatology meds, especially acne meds,
[Isn't it too harsh?] they seem super harsh and bad for your body.
So even when a prescription is needed,
a lot say they don't want to take them.
On the flip side,
some people ask for prescription meds
even when I don't thknk they really need them.
So when should you take acne meds,
and when should you be careful?
Today, let's talk about the effects
and side effects of oral acne medication.
〈Acne Med Side Effects 2. How acne is treated〉 Acne is an inflammatory skin condition
caused by clogged pores filled with oil and dead skin cells.
Like any treatment,
acne care also has its own steps.
[No meds for just 1 or 2 pimples] We don't prescribe acne medication
just because you've got one or two small pimples.
That's why treatment is done step by step.
The first step is usually getting rid of the acne-causing bacteria,
[So antibiotics come first] which is why we start with antibiotics.
Second, often dead skin cells bloking the pores,
even more than excess oil.
So we do exfoliation.
[Clear out clogged pores!] One of the most basic acne treatments is scaling.
[Another treatment: Extraction!] Third step is things like extraction.
If there's too much oil,
antibiotics aren't enough,
so we use oil-suppressing meds.
〈Acne Med Side Effects 3. Oral acne med〉 Early-stage acne is treated with oral antibiotics,
while more severe cases are treated with isotretinoin.
When it comes to antibiotics,
we usually use things like doxycycline or minocycline.
[How antibiotics work] They block bacterial protein synthesis to fight infection,
and because of its broad-spectrum antibacterial action,
Doxycycline is often the first choice.
Minocycline, with its stronger antibacterial effects,
is considered a second-line option.
But these days, more people start with Minocin (minocycline).
We usually
prescribe antibiotics
when someone has more than 10 red,
inflamed pimples on their face.
It's also better to take acne antibiotics for a longer period.
At least 1 to 2 months, since they take time to work.
The second option is an oil-control medication.
Isotretinoin is commonly used
and has a very strong oil-suppressing effect.
A lot of people come in for it
because they’re bothered by excessive oil
or keep breaking out because of it.
Since the effect builds up over time,
it usually starts working after 2–3 weeks
[Usually taken for 4 to 6 months] It's a long-term medication
that's typically taken for about 4 to 6 months.
PD: You said people take it long-term.
PD: Won't it hurt the liver..?
All meds affect the liver to some extent.
And, of course, it’s worse if you drink while taking them.
When taking any medication long-term,
I usually tell patients to assume
'It could put some strain on the liver'.
Shh! Just between us!
〈Acne Med Side Effects 4. Side Effects of Antibiotics〉 Let’s go over some common side effects of antibiotics.
Like our PD here, people often experience
heartburn, nausea, or stomach discomfort.
Kids under 8 shouldn’t take them
because they can cause tooth discoloration.
Since they can affect the baby’s teeth and bone development,
[Not for pregnant women!] they're also off-limits during pregnancy.
[Watch out for photosensitivity! Sunscreen is a must] These meds can make your skin more sensitive to sunlight,
so make sure to wear sunscreen.
Minocycline has
stronger antibacterial effects,
but that also means stronger side effects
[Watch out for dizziness] like dizziness.
[Possible skin discoloration with long-term use] Long-term use may sometimes cause skin discoloration.
〈Acne Med Side Effects 4. Sebum suppressants〉 Isotretinoin, reduces sebum production.
As for the side effects,
common side effects include
dry lips, dry mouth, dry skin, and dry eyes.
The dryness can even lead to nosebleeds or cheilitis.
Most of these go away once you stop taking the meds.
Biggest risk?
There's a very high chance of birth defects.
According to public health guidelines, we must inform patients
about the risk of birth defects before prescribing.
No matter the dose,
you should stop the medication at least 1 month,
[Plan pregnancy after stopping the meds] ideally 3 months, before trying to get pregnant.
Also, blood donation is not allowed
because your blood could be given to a pregnant woman.
It’s approved for ages 12 and up,
but since it may interfere with bone growth,
it should be used with caution in growing children.
[Rare, but hair loss is possible too] There are reports that it affects the scalp and causes hair loss.
[Isotretinoin is a vitamin A derivative] Since it’s a derivative of Vitamin A,
[Don't take it with vitamin A] it’s not recommended to take it alongside Vitamin A supplements.
It can raise cholesterol and triglyceride levels,
so people with high cholesterol or a family history of it
should be especially careful while taking this medication.
Despite the side effects,
it’s often the only option for people
with excessive sebum production.
The original brand is no longer on the market,
and in Korea, patients are currently taking generic versions.
PD: Can you take antibiotics and sebum suppressants together?
Nope.
You should never take them together.
Everyone, if you’ve got both antibiotics and a sebum suppressant at home,
even if your acne’s really bad,
don’t take them together!
〈Acne Med Side Effects 5. Effects on acne scars〉 A common routine prescription is
Isotretinoin + Clindamycin-T (a topical antibiotic).
In theory, it sounds like a great combo.
But depending on the patient,
it can dry out the skin.
What happens when it gets dry?
It can lead to scarring, and it doesn’t heal as well.
While it reduces sebum production,
[Bad for acne scars] it can have a negative impact on acne scarring.
So if you’re getting needle RF treatments
[POTENZA, Secret] like Potenza or Secret to improve acne scars,
keep in mind that they’re strongly discouraged
[Potenza/Secret scar laser is considered taboo] while you’re on isotretinoin
because it seriously hinders your skin’s ability to heal.
So please make sure to keep that in mind.
Instead of constantly relying on isotretinoin,
I’d suggest considering a treatment
[What about Agnes laser?] that reduces the sebaceous glands themselves.
So, how was today’s deep dive into acne meds?
As with any medication, side effects are inevitable.
If there’s one tip, it’s to stick with one clinic
and work closely with your doctor
to adjust your prescription as your acne progresses.
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