A Guide to Severe Acne Treatment (2024)

You don't have to put up with severe acne and run the risk of getting scars on your face. There are lots of treatments that can bring your breakouts under control. The key is to work with your dermatologist to tailor a treatment plan to your specific needs.

Isotretinoin for Severe Acne

Isotretinoin is a powerful drug that's used to treat the most severe cases of acne. Your doctor may recommend this drug if you have severe acne that doesn't get better with other medications, including antibiotics.

The drug is derived from vitamin A. It targets your acne by stopping the production of oil and decreasing inflammation that can lead to scarring.

Isotretinoin may be able to control your acne long-term and typically needs to be taken for 15 to 20 weeks.

Side Effects of Isotretinoin

While it can be an effective acne treatment, isotretinoin has some potential side effects that you should know about.

One serious side effect is that it can cause severe birth defects. The FDA requires women of childbearing age to agree in writing to use birth control before, during, and for a month after therapy.

The FDA also warns that using isotretinoin may be linked to depression, psychosis, and in rare cases, suicidal thoughts or suicide attempts.

While taking isotretinoin, you will be checked by your doctor for side effects through at least monthly follow-up visits.

In 8 out of 10 people, isotretinoin clears up severe acne. But one-third of people may develop acne again after successful isotretinoin treatment. If this happens to you, usually you'll spot the return of your acne in the first year after you finish the treatment. Your doctor may recommend another round of isotretinoin or another treatment, depending on how severe your acne is.

Other Severe Acne Treatment Options

Besides isotretinoin, you may also treat your severe acne with a procedure that drains and removes large acne cysts. This procedure may reduce the risk of scarring.

Your doctor may also recommend an anti-inflammatory steroid injection to treat inflamed acne cysts. Your cysts may shrink 2 to 5 days after the injection.

Another option you can consider is photodynamic therapy (PDT). PDT uses light treatments to destroy bacteria that cause acne breakouts.

Tips for Weighing Your Treatment Options

There is a tendency for acne to run in families. If you have symptoms of acne and have a parent or sibling who had severe acne with scarring, you may want to see your dermatologist to discuss treatments for severe acne.

Watch for signs that your acne is turning severe. For instance, you may notice you have deep, painful, or tender cysts. You may also have inflammation and signs of scarring.

Follow these tips as you make your treatment plan:

Don't wait. If you have signs of acne, set up an appointment with your doctor or dermatologist. The sooner you start treatment, the sooner you will start to see results.

Don't ignore side effects. If you're experiencing side effects from prescribed medications, speak up to your dermatologist. Individuals react to drugs differently; your treatment plan must work for you.

Watch your mood. Acne is associated with higher rates of anxiety and depression. If you are experiencing any symptoms, talk to your doctor and seek treatment.

A Guide to Severe Acne Treatment (2024)

FAQs

What's the strongest acne medication? ›

Isotretinoin: This is a potent medicine that attacks all four causes of acne—bacteria, clogged pores, excess oil, and inflammation (redness and swelling). About 85% of patients see permanent clearing after one course of isotretinoin.

What are the top 3 best acne treatments? ›

Rankings: Acne Treatments and Creams
RankBrandActive/Key Ingredients (sample product)
#1 Score: 100DifferinAdapalene
#2 Score: 60NeutrogenaBenzoyl Peroxide (10%)
#3 Score: 56ClearasilSalicylic Acid (2%)
#4 Score: 56CeraVeSalicylic Acid (2%)
2 more rows

What is the most extreme acne treatment? ›

Isotretinoin: An oral retinoid known by its brand name, Accutane, this option is "a much more drastic treatment than a topical retinoid," Sachs says. As such, it's mainly appropriate for patients with deep and painful nodulocystic acne and people whose acne hasn't responded to other methods.

What age is acne the worst? ›

Some have mild symptoms, while others can have very severe issues. Acne effects around 90% of adolescents with the prime age across all genders being the teenage years of 14-19 years old.

What is the hardest type of acne to treat? ›

Nodules and cysts are the most severe form of acne. You have to see a dermatologist to clear up severe acne. Picking or popping nodules and cysts can lead to scars.

Is there a pill for severe acne? ›

Isotretinoin is a treatment for severe acne that comes in capsules. It has a number of beneficial effects: it helps normalise sebum and reduce how much is produced. it helps prevent follicles becoming clogged.

What is the number one thing that gets rid of acne? ›

Benzoyl peroxide.

This ingredient kills bacteria that cause acne, helps remove excess oil from the skin and removes dead skin cells, which can clog pores. Benzoyl peroxide products that you can buy without a prescription are available in strengths from 2.5% to 10%.

What is the number one treatment for hormonal acne? ›

Spironolactone is the most common treatment for hormonal acne that is provided by Dermatologists.

How to clear acne fast? ›

  1. Apply Ice to the Pimple:
  2. Apply a Paste of Crushed Aspirin to the Pimple.
  3. Use An Over-the-Counter Acne Spot Treatment.
  4. Use Makeup with Salicylic Acid to Conceal Pimples.
  5. Apply a Face Mask for Acne.
  6. Get a Cortisone Injection to Quickly Get Rid of a Pimple.
Jul 31, 2023

What is the first line treatment of severe acne? ›

Antibiotics. For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin).

What is the last resort treatment for acne? ›

Both types of acne require treatment by a dermatologist; over-the-counter potions and creams simply can't do the job. That's where isotretinoin/Accutane comes in. Prescribers refer to it as the drug of last resort. This is because it clears up nodular and cystic acne when nothing else can.

How to shrink a cystic pimple overnight? ›

How to get rid of cystic pimples
  1. Warm compress. A green tea bag or other compress soaked in warm water may help soothe your cyst. ...
  2. Cold compress. A cold compress may help decrease inflammation, but avoid putting ice directly on your skin. ...
  3. Advil. ...
  4. Cortisone. ...
  5. Prescription skincare (like Curology!).
Jan 27, 2020

What does B12 acne look like? ›

The clinical appearance of acneiform exanthema occurring during treatment with vitamin B6 or B12 consists of loosely disseminated small papules or papulopustules on the face (especially on the forehead and chin), on the upper parts of the back and chest and spreading to the upper arm.

How to tell if acne is hormonal or bacterial? ›

Location: Bacterial acne is more frequently found on oily skin regions like the forehead, nose, and chin, while hormonal acne is typically found on the lower face and jawline. Timing: Before menstruation or during ovulation are two times of the menstrual cycle when hormonal acne tends to worsen.

What is the root cause of acne? ›

Acne develops when sebum — an oily substance that lubricates your hair and skin — and dead skin cells plug hair follicles. Bacteria can trigger inflammation and infection resulting in more severe acne.

Is Accutane the strongest acne medication? ›

Isotretinoin is the single most effective drug for treating severe acne that hasn't responded to other treatments. 1 It treats all types of acne, including cystic and nodular acne, along with the pain and inflammation that come with them. Isotretinoin may also prevent acne scars.

What can cure acne fast? ›

If you notice a breakout, here are seven ways to get rid of pimples fast.
  1. Dab on some benzoyl peroxide. ...
  2. Apply a little ice. ...
  3. Use products with salicylic acid. ...
  4. Apply some hydrocortisone cream. ...
  5. Use a pimple patch. ...
  6. Try a little tea tree oil. ...
  7. Visit your dermatologist.
Nov 20, 2023

Which is the most severe form of acne? ›

Cystic acne — the most severe form of acne — occurs when oil and dead skin cells build up deep within hair follicles. The resulting rupture within your skin may form boil-like inflammation. Acne signs vary depending on the severity of your condition: Whiteheads (closed plugged pores)

What if my acne won't go away? ›

If pimples are deep and long lasting, it may be a good idea to see a dermatologist. The dermatologist may prescribe antibiotics to reduce inflammation and kill bacteria that could be causing pimples. In some cases, they might prescribe birth control pills to adjust hormone levels.

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