Oral antibiotics help kill the bacteria involved with acne, called cutibacterium acnes, and deliver anti-inflammatory effects in the skin to heal breakouts. While the side effects largely depend on the person, they can cause allergic reactions such as hives. "They can also render the skin sun-sensitive," Kenneth Howe of Wexler Dermatology told POPSUGAR. "Rarely, the oral antibiotic minocycline can cause drug-induced lupus, a serious condition in which patients become quite ill."
Spironolactone was originally developed to treat high blood pressure, but is often prescribed for hormonal acne. "Many patients with hormonal acne do not respond to anything else," Dr. Howe said. "Spironolactone works by blocking androgen activity. In so doing, it stops the development of pimples at their inception."
Because it was intended to treat high blood pressure, there are a few side effects to take into account. "Spironolactone can cause elevated serum potassium levels, breast enlargement or tenderness, irregular periods," Dr. Howe said. "Spironolactone can also cause dizziness if it lowers a patient's blood pressure too much."
You've probably heard both good and bad about the oral medication called Isotretinoin (or, as it was formerly called, Accutane); it's the strongest, most powerful acne medicine. "A derivative of vitamin A, Isotretinoin is a powerful differentiating agent," said Dr. Howe. "Put in simpler terms, it "teaches" the cells lining our follicles to shed properly so that they no longer form plugs. Isotretinoin also shrinks the enlarged oil glands characteristic of acne, down to normal size."
While Isotretinoin is the most powerful acne-fighting medication it has quite a few risks associated with it. "It can cause dryness of skin and lips, sun sensitivity, skin fragility (you can't get waxed while taking it), hair loss, liver irritation, temporary elevation of serum lipids such as triglycerides (these contribute to body fat), joint pain, and depression," said Dr. Howe. Because of this, it's not recommended for those who have a history of depression.