Topical vs. Oral Medications For Cystic Acne: Weighing Options

Topical vs. Oral Medications For Cystic Acne: Weighing Options

Cystic acne can be an incredibly frustrating skin condition. Categorised by large, painful, and often deeply rooted pimples, it can leave lasting scars if not managed properly. For those who are looking for the best method to eliminate or prevent acne from developing further, fortunately, there are various cystic acne treatment options available, including topical medications like Benzoyl Peroxide and Topical Retinoids, as well as oral medications such as Isotretinoin (Accutane) and Oral Antibiotics. These are the two primary choices for treating cystic acne.

Read on as we explore the pros and cons of both to help you make an informed decision about which may be the best option for your unique skin needs.

Topical medications

Topical medications are applied directly to the skin’s surface and are a popular choice for treating cystic acne. Here are some of their advantages and disadvantages:

Advantages of topical medications

1. Targeted application 

One of the most significant advantages of topical medications is its precision. They allow you to apply treatment directly to the affected areas, minimising the risk of side effects on unaffected skin.

2. Combination therapy

Topical medications are often used in combination with other topical treatments or skincare products. This approach can be tailored to address various aspects of acne, such as inflammation, bacteria, and excess oil production.

3. Less systemic impact

Since topical medications are absorbed primarily at the application site, they generally have fewer systemic side effects than oral medications. This can be particularly beneficial if you are concerned about potential internal health risks.

Disadvantages of topical medications

1. Skin sensitivity

Some topical medications can cause skin dryness, redness, and irritation, which may be challenging for individuals with sensitive skin. Finding the right product and dosage for your skin type can be a trial-and-error process.

2. Limited reach

Topical medication may not penetrate deep enough to reach the root of cystic acne, which often resides beneath the skin’s surface. This limitation can make it challenging to treat the condition effectively.

 3. Time-consuming 

Applying topical treatments can be time-consuming, especially if you have a large area to cover or multiple cystic acne lesions. Consistency in application is key for effectiveness, which may require a commitment to a daily skincare routine.

Oral medications

1. Less time-consuming

Unlike topical treatments that require multiple applications, oral medications are typically taken once or twice a day, making them a more convenient option for many people.

2. Systemic action

Oral medications circulate through the bloodstream, which means they can target cystic acne lesions deep within the skin. This can lead to faster and more comprehensive results.

3. Effective for severe cases

Oral medications are often recommended for individuals with severe or persistent cystic acne that has not responded well to topical treatments. They can provide a more potent and holistic approach to clearing the skin.

Disadvantages of oral medications

1. Monitoring required

Some oral medications, like isotretinoin (commonly known as Accutane), require regular monitoring by a healthcare provider due to their potential for serious side effects. This means frequent doctor visits and blood tests.

2. Systemic side effects

Because oral medications affect the entire body, they can have a range of systemic side effects, including gastrointestinal upset, headaches, and changes in mood. For some individuals, these side effects can be intolerable.

3. Not suitable for everyone

Oral medications are not recommended for pregnant women, as they can cause birth defects. Additionally, they may not be suitable for individuals with certain medical conditions or those taking specific medications.

How to choose the right approach

Ultimately, the choice between topical and oral medications for cystic acne depends on several factors, including the severity of your condition, your skin type, and your overall health. Here are some key considerations to help you make an informed decision.

  • Consult a dermatologist 

The first and most crucial step is to consult a dermatologist. They can assess your skin and provide personalised recommendations based on your unique needs and circumstances.

  • Tolerance of side effects

Consider your tolerance for potential side effects. If you have sensitive skin or are concerned about systemic effects, you may prefer to start with topical treatments and only explore oral medications if necessary.

  • Severity of acne

If your cystic acne is severe and resistant to topical treatments, your dermatologist may recommend oral medications as a more effective option.

  • Commitment to treatment

Topical treatments require a consistent application, which may not be suitable for everyone’s lifestyle. Be honest with yourself about your ability to adhere to a skincare regimen.


Cystic acne can be tough to manage, but with the right approach, this condition is definitely treatable. Topical medications offer targeted and less invasive options, while oral medications provide a systemic solution for more severe cases. Ultimately, the decision between topical and oral treatments should be made in consultation with a healthcare professional who can tailor an approach based on your specific needs.

At APAX Medical & Aesthetics Clinic, we understand that dealing with cystic acne can be a deeply personal and sometimes frustrating journey. Our dedicated team of skincare experts are here to guide you through your cystic acne treatment journey. Our branches span from our Woodlands aesthetics medical clinic, located near Bukit Panjang MRT station, to our Hougang aesthetics clinic, located just around the corner from Kovan MRT station. Contact us today for more information on our range of services.

Request a CallBack

Get in touch with us with any questions, pricing, or bookings.

Or give us a call at +65 6769 6007 | WhatsApp us +65 9855 3022

Recommended Posts