Options For Acne Control of Non Responsive Condition

Suffering acne for 6 years;oily face with 2-4 moderate pustular lesions daily.Was prescribed BP and adapalene (6 months) but to no avail. Next tried antibiotics such as doxycycline and cotrimoxazole together with tretinoin (6 months each)and yet failed. Completed isotretinoin 30MG for six months, but broke out 1 month after stopping. Now on 2nd course of isotret 30mg OM and halfway of my cumulative dosage but still consistent oily face and daily breakouts of small pustular lesions.What can i do?

Doctor Answers 2

Difficult to control acne

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  It sounds like you have done everything right and that you have gotten appropriate treatment.  Your history illustrates how difficult it can be to bring this condition under control.  Certainly, you might consider treatment with IPL or photodynamic therapy in the future.

Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Durable Remission with Accutane

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Accutane provides a durable remission in most patients but it is very dose sensitive.  Typically, a patient is prescribed a dose at 1mg per kg of their body weight per day with a total cumulative dose goal of 120mg -150mg per kg over the entire 5-8 month treatment course.  A low dose of 20mg per day can resolve a patient's acne during the treatment course but usually does not "cure" the acne.  Additionally, I counsel my patients that once they complete their course of accutane they may not be "acne free" but the acne they do experience will be less intense with a decreased number of lesions and much easier to manage with topical treatments and oral antibiotics.  As always, I recommend consulting a board certified dermatologist for evaluation and treatment of your specific condition.

Anthony Perri, MD
Houston Dermatologist

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