Due to the severity of cystic acne, over-the-counter (OTC) treatments for acne aren’t strong enough. This means you’ll need to see a dermatologist for prescription medications. Depending on the type of treatment used, you may not see full results for up to eight weeks.
Talk to your doctor about the following methods used to treat cystic acne. Some cases require combination therapies.
IsotretinoinIsotretinoin (Accutane), a powerful prescription medication, is considered the most effective treatment measure for cystic acne. It’s derived from a powerful form of vitamin A, taken in tablet form every day.
About 85 percent of people who take it experience improvements within four to six months. Despite the efficacy, there are some serious risks associated with isotretinoin.
Talk to your doctor if you experience any of the following:
new or worsening mood disordersinflammatory bowel diseasepersistent headaches or nosebleedsbruisingskin inflammationblood in your urinemuscle and joint painOral antibioticsOral antibiotics may be used to treat cystic acne if it covers a large area of your skin. These work by decreasing bacteria and inflammation that could be contributing to cystic acne formation. However, antibiotics don’t alleviate excess oil and dead skin cells.
Antibiotics should only be used in the short term, due to concerns over bacterial resistance. If antibiotics aren’t effective, then your doctor will likely recommend you start taking isotretinoin.
Possible side effects of oral antibiotics may include:
abdominal paindiarrheanauseasun sensitivityvomitingLearn more: The myth of antibiotics and birth control »
Topical retinoidsTopical retinoids are also derived from vitamin A. However, these don’t he quite the strength of isotretinoin. These work by unplugging hair follicles to remove and prevent severe acne.
Retinoids are sometimes used in conjunction with topical antibiotics to make them more effective. Topical retinoids can be used on a daily basis and come in the form of creams, gels, and lotions.
While one OTC retinoid (adapalene) is currently ailable, cystic acne is usually only responsive to prescription-strength formulas.
These include:
AvageAvitaDifferinRetin-ATazoracUsing topical retinoids can make your skin red and can also cause it to peel. These side effects are usually temporary as your skin gets used to the medication. Retinoids can also make you more susceptible to sunburn, so be sure to wear sunscreen.
SpironolactoneSpironolactone (Aldactone) is another possible prescription treatment measure for cystic acne. Traditionally, it’s used as a diuretic to help treat edema and high blood pressure. In terms of acne, this medication can work by managing excess androgen levels that could be contributing to inflammatory acne. It’s typically only effective in women with acne on their jawline or lower face.
Spironolactone may cause birth defects, so you shouldn’t take it if you’re planning a pregnancy. People with kidney disease also shouldn’t use this medication.
Researchers in one 2012 study found that doses of 50 to 100 milligrams (mg) per day work best. However, it isn’t uncommon to go as high as 200 mg daily.
This also reduces the risk of side effects, such as:
breast tendernessdizzinessfatigueheadacheshigh blood potassium (hyperkalemia)menstrual irregularitiesOral contraceptivesOral contraceptives are a viable option for cystic acne in some women. This method is especially effective if you tend to develop acne cysts during hormone fluctuations related to your menstrual cycle.
Birth control pills contain estrogen, which can help regulate overall hormone levels and possibly reduce acne.
Still, oral contraceptives aren’t for everyone. These medications may not be appropriate for you if you smoke, he blood clots, or are trying to get pregnant.
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