Is Acne Medication Healing Your Skin – Or Hiding the Root Cause?

Acne is the most common reason pediatric patients see a dermatologist, and the third most common reason for adults.¹

Yet, rather than addressing the root cause(s), dermatologists are trained to prescribe acne medications. And while it may bring temporary relief, this band-aid fix∫of short-term fixes and frustrating side effects.

Today’s most popular acne medications – like Spironolactone and Tretinoin – have become the new norm, especially for adult women. They’re celebrated on TikTok, casually handed out like candy at derm visits, and often sold as the “simple solution” to clear skin. 

But as these treatments become more normalized, it’s worth asking: Is acne medication truly healing acne, or simply suppressing symptoms in the short term?

As a holistic skincare company, we’ve heard thousands of real-life stories from our customers healing acne through holistic products + practices. And because we’ve seen what’s possible when you support the body naturally, we feel a responsibility to shed light on the other side of the story.

In this post, we’re exploring the three most commonly prescribed acne medications. We’re giving you the honest truth about:

→ How acne medications work

→ The risks no one wants to discuss

→ The best natural alternatives

Because acne isn’t a surface-level issue, and your path to clear skin shouldn’t compromise your health.

The Rise of Acne Medication

Truthfully, acne is a complex health concern. It can be really challenging to pinpoint the root cause(s) because it comes in many different forms. It’s also influenced or exacerbated by many factors. This can include things like: 

• Gut health

• Hormonal imbalances

• Endocrine disruptors

• Poor diet 

• Chronic stress 

• Microbiome imbalances 

And yet, the conversation has shifted almost entirely to pharmaceutical fixes. Over the last decade or more, prescription acne medications seem to be the only solution from dermatologists. (And to no fault of their own – it’s how they were trained.)

Still, for something as multi-faceted as acne, the solutions have become surprisingly one-dimensional.

In most cases, there's little to no discussion about how these medications actually work or the potential trade-offs they may carry. Acne medications that suppress symptoms are now seen as routine, even empowering. And unsurprisingly, they’re eagerly embraced in a culture that prioritizes fast results. 

But under the surface, there’s growing concern around long-term use and the laundry list of acne medication side effects.  When acne medication becomes the default, not the exception, it’s worth pausing to consider the darker side of this “quick fix.” 

These drugs, among others, may temporarily clear your skin, but they don’t offer true healing. Instead, they work by disrupting natural processes, manipulating hormones, or suppressing inflammation in unnatural ways. 

Acne medications may calm your skin on the surface, but they often come at the cost of long-term health. Let’s take a closer look. 

Spironolactone: The New Go-To Acne Prescription

Nicknamed the “new gentler Accutane,” Spironolactone is one of the most widely prescribed acne medications for adult women. It’s especially common for persistent hormonal acne. Recently, it has been praised all over social media. 

Misleading testimonials promise no acne, thick hair, and TikTok-worthy “glass skin.” 

But few are talking about what Spironolactone is and what it does to your body.

Spironolactone was originally developed as a medication for treating high blood pressure. That means using Spironolactone for acne is actually an off-label use of a pill.² Because of this, it requires regular blood checks to monitor kidney health and electrolyte levels. 

Spironolactone is a potent anti-androgen that alters your body's interaction with hormones. Many dermatologists view it as a safer alternative to antibiotics because it doesn’t risk antibiotic resistance. 

Instead of addressing bacteria, Spironolactone works by blocking certain hormones to suppress oil production. For many women, this does result in clearer skin. But at what cost? 

Spironolactone comes with a lot of frustrating side effects, like:²

• Frequent urination

• Fatigue

• Headaches + dizziness

• Breast tenderness + irregular periods

• Low blood pressure 

• Nausea, vomiting, and diarrhea

• Stomach + leg cramping 

• Lower sex drive/sexual dysfunction

And more serious side effects can include things like:²  

• High potassium, which can lead to weakness, numbness, a racing heart, chest pain, nausea, vomiting

• Abnormal electrolyte levels, which can lead to cramps, fainting, irregular heartbeat, and even seizures 

• Kidney failure, which affects a critical detox pathway in your body

• Serious skin reactions, including rash, itchiness, peeling, or blistering skin

While it may offer short-term relief, Spironolactone disrupts your body’s delicate hormone balance. As a diuretic, it interferes with key detoxification pathways, including your kidneys. It’s also not pregnancy safe and may interact with other medications. 

One of the biggest issues with this acne medication is that it shuts down oil production, an essential component for skin health and barrier function.

Some women have even reported severe side effects, including anxiety, intrusive thoughts, and heart palpitations. For us, this raises serious concerns, especially for long-term use. Spironolactone’s symptom suppression does nothing to support the body’s natural healing. Simply put, we just can’t get on this bandwagon.

Tretinoin: The Prescription-Grade Retinoid

Tretinoin is a long-time favorite acne medication in the conventional skincare world. But what’s marketed as a dermatologist-backed solution for acne may actually be working against your skin’s natural healing process. That’s why it’s also commonly accepted as a harsh medication.

This acne medication is a prescription-strength retinol – with risks. Typically, Tretinoin is a topical cream or gel. It’s a synthetic form of vitamin A known to accelerate cell turnover and clear pores. It also eliminates excess oil in the process. Many rave about its ability to clear acne, but it's worth noting that it can take up to 12 weeks to work.  

The most common Tretinoin side effects include:^3,4

• Burning or itching 

• Warm skin 

• Redness + skin discoloration 

• Peeling or scaling

• Severe dryness 

• Increased susceptibility to sun damage 

• Skin irritation or swelling

• Worsening acne (yes, really)

• Long-term barrier disruption to the skin 

While Tretinoin is often praised for clearing acne, the reality is harder to ignore. Most people experience significant irritation, flares, and sun sensitivity, even with heavy moisturizing. 

And because this form of synthetic vitamin A isn’t bioavailable, it doesn’t work with your body’s innate healing process the way natural ingredients or protocols can. Its tendency to weaken the skin barrier and increase vulnerability to sun damage raises serious concerns well beyond your immediate skin health. It also blunts your skin’s natural ability to heal, protect, and address the deeper root causes of acne. Ironically, it can even worsen acne at first. 

To us, the biggest red flag with this acne medication is that it speeds up skin turnover without addressing the true causes of acne. An approach like this often leaves the skin more fragile and inflamed than before, trading long-term skin health for a short-term fix.

Accutane: The “Last Resort” Acne Medication

Accutane is a name that carries weight in the acne world. It might promise clear skin, and for many, it delivers. But the fine print on Accutane tells a different story. 

Accutane (isotretinoin) is a powerful oral acne medication derived from vitamin A. While it’s often reserved as a so-called “last resort,” it’s still prescribed far more often than most realize. And it comes with a dark history that’s rarely discussed.  

Here’s the short version: 

→ Accutane was originally created to treat skin cancer. But when researchers realized it caused severe birth defects in animals, its development was halted. However, a few decades later, big pharma picked it up when they discovered its potential as a powerful acne medication. 

Due to its efficient clearing of acne (on a surface level), approvals were rushed, and side effects were ignored. Soon, Accutane was sold as the ultimate acne medication.

In the short term, Accutane works by completely drying up oil glands, reducing acne and oil production. For years, this acne medication has been touted as the “cure” for acne. But the reality is far more complicated – and damaging.

The many lawsuits filed against Accutane speak for themselves. And its black box warning (the most severe FDA warning) is there for good reason. Accutane side effects are extensive, and include:^5,6

• Dry skin (especially dry + peeling lips)

• Dry airway 

• Skin infection or rash 

• Changes in skin color 

• Burning eyes 

• Extreme vulnerability to sun damage 

• Nosebleeds 

• Hearing + vision problems

• Headaches

• Upset stomach

• Thinning hair or unwanted hair growth

• Bleeding gums

• Slowed healing of cuts/bruises

• Rectal bleeding

• Blood sugar issues 

• Joint pain 

• Itchy skin 

• Potential link to IBD, Crohn's, and ulcerative colitis 

• Mood changes 

• Potential long-term impacts on skin health 

• An intense purge phase 

• Lower red and white blood cells 

And it doesn’t stop there. More serious Accutane side effects include: 

• Birth defects – even with one dose⁶  

• Increased pressure in the brain 

• Mental health issues

• Muscle weakness

• Severe stomach, chest, or bowel pain 

• Anaphylaxis reactions 

• A long list of drug interactions 

• Liver and other organ damage

• Difficulty breathing

• Hallucinations

These symptoms (especially birth defects) are so severe that to prescribe Accutane, doctors must enroll patients in a special program called iPLEDGE. This program requires: 

• Regular pregnancy tests

• Dual forms of birth control

• Abstaining from blood donation for months after stopping treatment 

While it’s claimed that Accutane “clears acne-causing bacteria,” we now know that acne is caused by more than bacteria. Like many other acne medications, it tackles the symptoms rather than the underlying causes of inflammation, hormone imbalance, or gut health issues.

While Accutane may clear breakouts, the cost is high – and often swept under the rug. Patients face a long list of serious, life-altering risks, many of which extend far beyond skin health. For us, this raises serious concerns about using this acne medication – ever. 

Beyond the side effects, Accutane’s approach, which targets oil and bacteria without addressing the root causes, offers suppression, not healing.

If you want to truly heal acne, you have to work with your body’s natural systems, not shut them down. Despite the traditional narratives, natural support is effective. Thankfully, you’re in the right place to learn more. ;) 

Natural Acne Remedies: Ancestral Tools for Modern Skin

Rooted in ancestral wisdom and modern wellness, these gentle yet powerful natural acne remedies can help support clear skin. While natural acne remedies can take time and patience, stick with the process. You’ll never regret helping your body heal fully, in a way aligned with its design. Let’s explore our tried-and-true remedies for naturally clearing up acne.

Oil Cleansing + Minimalism (Skinimalism)

One of the most underrated but effective natural acne remedies is oil cleansing. Contrary to popular belief, the right kind of oils are amazing for healing acne naturally. Like attracts like, and a cleansing oil is incredibly effective in helping gently lift impurities from pores – all without stripping your skin barrier and microbiome. 

Sometimes less really is more – this is the heart of our skinimalism concept. :)

Regenerative Hemp Collection 

Whole flower hemp is one of the most powerful yet gentle ingredients for acne healing. This hemp is especially rich in antioxidants and anti-inflammatory compounds. It supports the skin’s natural repair processes without clogging pores or disrupting the skin barrier.

Our Regenerative Hemp Collection is designed to naturally calm inflammation and balance oil production. With zero synthetics and chemicals found in conventional acne products,  these products are rooted in the healing power of nature.

Stress Support 

The gut-skin connection and the mind-skin connection are deeply intertwined. Chronic stress can contribute to inflammation, hormone disruption, and impaired skin barrier function. This combination is a recipe for the development (and persistence) of acne. 

Support your nervous system with gentle practices like: 

• Somatic movement that reconnects the vital mind-body healing process

• Grounding outside barefoot, which is shown to reduce inflammation 

• Deep gratitude journaling or meditation to reframe your stress response
  

Although it may seem too simple to be true, calming the nervous system is one of the most overlooked yet effective natural acne remedies – and often, one of the most transformative. 

Balanced + Nutrient-Dense Diet for Gut and Skin Health

Nourishing your body with real, nutrient-dense food is foundational to healing acne naturally. Every meal is an opportunity to either feed inflammation or help heal it. Focus on nutrition that supports gut health, hormonal balance, and whole-body resilience, such as:

• Hydration through mineral water and electrolytes

• Regenerative or organic whole foods

• Gut-healing bone broth 

• Cooking with healthy fats like grass-fed tallow or butter, olive oil, and coconut oil 

• Eliminating seed oils, sugar, gluten, and alcohol as much as possible 

• Well-balanced meals to support blood sugar (prioritizing protein, fat, + fiber)

By choosing foods that nourish your body instead of creating more inflammation and damage, you create the foundation for calmer, clearer skin that can truly thrive from within.

*Tip: Check out this post for an even deeper dive into a diet geared towards healing acne naturally. 

Wellness Tools + Holistic Treatments

Incorporating simple wellness practices into your routine can help support detox pathways, improve circulation, and naturally encourage a clear, radiant complexion. Try out a few of these holistic (and relaxing!) options:

• Lymphatic drainage to boost detox + circulation 

• Dry brushing

• Facial massage

• Facial cupping at home is a great way to move out stagnant lymph and create new healing pathways under the skin with fresh, nutrient-rich blood flow 

• Facial Acupuncture with a TCM specialist

*Tip: Always work around active breakouts or irritation. If your facial skin is feeling really inflamed, focus on supporting your neck to help move stagnant lymph and promote detoxification + healing. 

When you lean into these gentle, supportive rituals, you’re doing more than treating the surface. You’re creating space for your skin to do what it’s designed to do – heal, restore, and reveal a healthier, more resilient glow from within.

Rethinking Acne Medication: A Holistic Path to Clear Skin

Acne is complex – and so is the journey to heal it.

While prescriptions like acne medications are often praised as quick fixes, they work by shutting down natural functions in your body. They don’t address the deeper imbalances that contribute to breakouts in the first place.

Your breakouts aren’t random. They’re a sign your body is communicating. When you stop suppressing symptoms and start supporting your system as a whole, true healing begins – and it lasts.

If you’re navigating acne medication decisions, know this: real healing doesn’t ask you to shut down your body’s signals – it invites you to listen more closely.

XO

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Sources: 

1. MDPI | Prescribing Trends for Acne Vulgaris Visits in the United States
2. GoodRx | Spironolactone
3. Derm Collective | Tretinoin for Acne: How to Use It, Efficacy, Side Effects, and More
4. Drugs.com | Tretinoin Topical Side Effects 
5. Medline Plus | Isotretinoin
6. Drugs.com | Accutane

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