One of the most commonly thought of oral acne treatments has always been antibiotics. Many doctors prescribe antibiotics to their acne-suffering patients to help kill the P. acnes bacteria that leads to acne. Antibiotics, such as tetracycline, have been used for many years to treat and kill the acne bacteria. But the problem with staying on antibiotics for too long is that other potential bacteria (such as staph infections) can become resistant to antibiotics. Not good.
One of the newer ways to treat acne with a pill is by using a drug that brings down the androgen hormone levels in your body. Androgen is the hormone we have to thank for producing the oil that leads to pore-clogging. If you suffer from acne breakouts right around the time of your menstrual cycle, then you are most likely someone who has hormonal acne. The drug prescribed to patients with hormonal acne is called spironolactone, which is often prescribed to people with high blood pressure. Treating acne with spironolactone is an off-label use of the drug, which is sold under the brand name Aldactone.
Antibiotics are still very effective for men and women with acne caused by other issues besides purely just hormones and there are some antibiotics that will produce less resistance to staph infections. Spironolactone is not recommended for pregnancy or nursing moms.