A severe acne flare-up can be painful and discomforting. Deep, painful cysts and nodules can feel like they pop up almost overnight, yet they can take weeks to get under control. 

Using a targeted treatment plan, dermatology providers can use a mix of oral medications and topical treatments (creams, lotions, and gels) to reduce pain and redness and help treat acne. Although using steroids to treat acne is not common practice, there are some instances where it may be indicated to aid in treatment. 

One such steroid is prednisone. Here, Curology’s dermatology providers will explain what prednisone is, how it can help fight acne, and its potential side effects. When used under the supervision of your licensed dermatology provider, prednisone can work hand-in-hand with personalized skincare products to weaken acne’s hold on your skin. That said, prednisone is usually reserved for severe inflammation.

What is prednisone?

Prednisone is a Food and Drug Administration (FDA) approved prescription medication used to manage many different health conditions.¹ While there may be some exceptions, it is generally not prescribed for acne vulgaris as a first-line treatment, but rather for more serious conditions like: 

• Acne fulminans:² A severe form of acne characterized by sudden painful, ulcerating nodules.

• Acne conglobata:³ A chronic form of acne characterized by interconnected nodules and abscesses that commonly lead to scarring.

Prednisone belongs to a class of medications known as corticosteroids. Corticosteroids are synthetic substances designed to mimic the naturally occurring steroids produced by your body in the adrenal glands. 

These substances are used throughout the body for many different processes, including regulating metabolism, suppressing inflammation, and maintaining balanced levels of water and electrolytes.⁴

As a medication, corticosteroids like prednisone have anti-inflammatory properties that are used to reduce pain and swelling.⁵ They’re also sometimes used to reduce vomiting and nausea caused by cancer treatments.⁶ 

At other times, corticosteroids are used to suppress the immune system when the immune system is too active, like in the case of some autoimmune conditions.⁷ 

This versatile and potent group of medications is prescribed for everything from asthma and COPD to rheumatoid arthritis and leukemia.⁸ 

When is prednisone used for acne?

By reducing skin inflammation, prednisone treatment can provide powerful relief from the redness and pain of severe breakouts.⁹ 

Steroids aren’t needed for every case of acne, though. Prednisone is reserved for severe cases, and it’s not typically used alone or as a first-line treatment. Severe acne requires an inside-out approach. Oral treatments, like corticosteroids, hormonal contraceptives, or oral antibiotics, can be used alongside creams and gels with ingredients like benzoyl peroxide or tretinoin. Together, they reduce inflammation and attack acne-causing bacteria with a multi-pronged approach.¹⁰

Prednisone for acne vulgaris

Acne vulgaris is the medical term for the most common type of acne that many of us experience—particularly in our teenage years. Blackheads, whiteheads, or cysts on your face, neck, or trunk are the hallmark signs of acne vulgaris.¹¹⁻¹²

First-line treatments for acne vulgaris are topical treatments like benzoyl peroxide, a topical antibiotic, or a retinoid cream. If those aren’t effective, your healthcare provider might consider adding in oral medications such as antibiotics, hormonal contraceptives, or isotretinoin. For most people, these combinations of treatments will be effective.¹³⁻¹⁴

However, up to 20% of people with acne vulgaris can experience severe acne.¹⁵ Research shows that a temporary course of low-dose prednisone can help people with severe inflammatory acne get their symptoms under control while they wait for standard acne therapies to take effect.¹⁶

Prednisone for other types of acne

While acne vulgaris is the type of acne you’re most likely to experience, there are also other less common forms. Acne fulminans and acne conglobata are both rare, severe forms of acne that are treated, in part, with prednisone.¹⁷⁻¹⁸ Both of these uncommon acne conditions involve severe, deep, painful inflammation that is often resistant to the usual types of acne treatments.¹⁹⁻²⁰

Acne fulminans and acne conglobata also share similar treatments. The recommended treatment for these types of acne is a course of prednisone followed by isotretinoin.²¹⁻²² Your medical provider will gradually taper off the dose of the prednisone over time as the isotretinoin begins to take effect in order to prevent any relapses and minimize side effects.²³

Benefits and side effects of prednisone for acne

Every medication comes with its benefits and downsides, and prednisone is no exception. We’ve listed its pros and cons below, but make sure to go over them in detail with your healthcare provider. They can help you decide if the cons outweigh the pros in your case. 

Benefits of using prednisone

We’ve gone over many of the benefits of prednisone already—but here’s a quick reminder of what prednisone can do for severe acne:²⁴

• Reduce swelling and inflammation.

• May help reduce pain and redness.

Keep in mind that prednisone is typically used after mild acne treatments—such as oral antibiotics and progressively potent topical treatments—haven’t worked. And as acne is not listed as one of the conditions it treats; it is considered off-label use. Still, prednisone may work on acne that’s non-responsive to other treatments. 

Prednisone is also rarely used alone. It’s most commonly used alongside topical treatments that include acne-fighting ingredients like salicylic acid or benzoyl peroxide. 

Curology can help you find the right complementary topical treatments through one-on-one consultations with our licensed dermatology professionals. We factor in your medications and medical conditions to create personalized skincare products, like moisturizers, spot treatments, and sunscreens, among others.

Prednisone side effects

The severity of prednisone’s side effects can depend on how much you’re taking and how long you’ve been taking it. The longer and higher the dose, the more likely you are to see side effects, which can include:²⁵

• Worsening acne.²⁶

• Bone loss.

• Reduced natural cortisol production.

• Weight gain.

• Insulin resistance.

• Eyesight changes.

• Increased anxiety, irritability, insomnia, and mood swings.²⁷

• High blood sugar.²⁸

• High blood pressure.

• Delayed wound healing.

Oddly enough, prednisone can cause breakouts, much like anabolic steroids. However, when prednisone is prescribed for acne, it’s often used alongside isotretinoin and topical treatments, which may help with rebound acne flares. 

Your body can also become used to prednisone in your system so that when you stop taking it, you may experience withdrawal symptoms or a spike in acne.²⁹⁻³⁰ To prevent increased acne in response to stopping prednisone, healthcare providers typically taper prednisone use to reduce side effects and complications.³¹ 

Personalized skincare solutions for you

Prednisone is an FDA-approved corticosteroid medication used to manage various health conditions. It works by reducing inflammation, swelling, and pain. Prednisone is typically reserved for severe cases and is often used in combination with other acne treatments, such as benzoyl peroxide or tretinoin. 

While primarily used for acne vulgaris (the most common type of acne), prednisone can also treat rare, severe forms like acne fulminans and acne conglobata. 

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The benefits of prednisone include reduced swelling and inflammation, pain relief, and efficacy on treatment-resistant acne. However, it can have a lot of side effects. These can include high blood sugar, bone loss, weight gain, and high blood pressure. Your healthcare provider will work to minimize these adverse effects by using the lowest effective dose and tapering your prednisone over time. Only a medical provider can determine whether or not prednisone may be a good treatment choice for you. 

Curology’s licensed dermatology providers are ready to provide personalized formulas to complement oral medications you’re taking for acne, and to answer any questions you may have about your skin. Click here to learn more. 

P.S. We did the homework so you don’t have to:

1.  Puckett, Y., et al. Prednisone. StatPearls. (2022, May 8).

2.  Zito, P.M. and Badri, T. Acne Fulminans. StatPearls. (2023, March 7). 

3.  Hafsi, W., et al. Acne Conglobata. StatPearls. (2023, January 13).

4.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. (2022, July 26).

5.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid.

6.  Barbour, S.Y. Corticosteroids in the treatment of chemotherapy-induced nausea and vomiting. Journal of the National Comprehensive Cancer Network. (April 2012).

7.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid

8.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid.

9.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid.

10.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016, February 17).

11.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

12.  Sutaria, A. H., et al. Acne Vulgaris. StatPearls. (2023, February 16).

13.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

14.  Sutaria, A. H., et al. Acne Vulgaris. StatPearls. Ibid.

15.  Sutaria, A. H., et al. Acne Vulgaris. StatPearls. Ibid.

16.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

17.  Zito, P.M. and Badri, T. Acne Fulminans. StatPearls. Ibid.

18.  Hafsi, W., et al. Acne Conglobata. StatPearls. Ibid.

19.  Zito, P.M. and Badri, T. Acne Fulminans. StatPearls. Ibid.

20.  Hafsi W, et al. Acne Conglobata. StatPearls. Ibid.

21.  Zito, P.M. and Badri, T. Acne Fulminans. StatPearls. Ibid. 

22.   Hafsi, W., et al. Acne Conglobata. StatPearls. Ibid.

23.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

24.  U.S. Food & Drug Administration. RAYOS (prednisone) Prescribing Information. (July 2012).

25.  Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid.

26.  Kazandjieva, J. and Tsankov, N. Drug-induced acne. Clinics in Dermatology. (March 2017). 

27.  Kenna, H.A., et al. Psychiatric complications of treatment with corticosteroids: Review with case report. Psychiatry and Clinical Neurosciences. (2011, October 17). 

28.  Puckett, Y., et al. Prednisone. StatPearls. (Ibid).

29.  Greywal, T., et al. Evidence-based recommendations for the management of acne fulminans and its variants. Journal of the American Academy of Dermatology. Ibid.

30.  Kazandjieva, J. and Tsankov, N. Drug-induced acne. Clinics in Dermatology. Ibid.

31. Greywal, T., et al. Evidence-based recommendations for the management of acne fulminans and its variants. Journal of the American Academy of Dermatology. Ibid.

32. Kazandjieva, J. and Tsankov, N. Drug-induced acne. Clinics in Dermatology. Ibid.

33.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (Ibid).

34.  Fox, L., et al. Treatment Modalities for Acne. Molecules. (August 2016).

35.  Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (Ibid).

Meredith Hartle is a board-certified Family Medicine physician at Curology. She earned her medical degree at Kirksville College of Osteopathic Medicine in Kirksville, MO. *Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Meredith Hartle, DO