01/06/2014

Acne 101: How to Get Rid of Severe Acne

Miley Cyrus with acne

Following on from my post on How to Get Rid of Moderate Acne this post focuses on therapies for the worst kind of acne - Severe acne.

You know when you've got severe acne if you have many large cysts and nodules on your face also affecting your chest and back. This acne is most prone to scarring and should be treated early. Make sure you see a Dermatologist if you've got this.

After all the measures for treating mild acne and moderate acne have failed, its perhaps time to consider treatments for severe acne.


Oral Antibiotics

This means antibiotics in tablet or capsule form. The most common ones we prescribe are the class of tetracyclines which include doxycycline, minocycline and lymecycline. These work by reducing inflammation and combatting the acnegenic bacteria P. acnes. These antibiotics should be avoided in pregnant women and young children as they can cause birth defects and discolouration of teeth. They also risk photosensitivity which means you need to wear sunscreen when out as you have increased susceptibility to sun damage. Use of these should be limited to 12 weeks at a time to reduce antibiotic resistance that reduces effectiveness of this treatment.


Isotretinoin

Now these are oral retinoids. The big guns. The most effective treatment of severe acne and usually if acne is very severe, this becomes the first line treatment. It targets all four causes of acne. Patients usually complete a course of 16-24 weeks and what's unusual about this therapy is that it has a target total dose of 120-150mg spread throughout the course. The dose is usually started at 0.5-1.0mg per day and increased as tolerated. While it is a very effective treatment, the use of this is tightly controlled due to its terrible side effects: It brings a very high risk of causing birth defects so pregnant women cannot take this, women of child-bearing age should also be using at least two modes of contraception. There is also a link of this causing depression, dry skin, dry eyes and liver damage, which are reversible on stopping therapy. Studies have shown that 50% of patients who take this are permanently cured after one course and 20% of patients need further treatment.


So that wraps up this week's series on Acne 101. I hope you've taken away something from these posts and do share these with your friends so we can all benefit from this. If you have any suggestions on further skin topics you would like me to write about, please let me know!

Livia | The Skin and Beauty Blog

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