Do I have severe acne? Am I candidate for Accutane? (photos)

I share your concern about the use of a systemic medication, such as Accutane. I have been treating acne of all degrees of severity successfully for decades without the need for systemic medications, such as oral antibiotics or Accutane (and the problems that these can cause). Most cases of acne can be treated, even severe cases (and from the photos, this is at most a moderate case of acne with a whole lot of post inflammatory redness), via a combination of at-home, diligently applied appropriate topical medications and in-office acne cleaning, intralesional injections for persistent or resistent nodules, and superficial peels, at least until the topical medications kick in (usually between eight to sixteen weeks after starting their diligent use). So, to prevent any permanent scarring, you would be wise to consult with a board certified dermatologist as soon as possible. Hope this helps.

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

​Acne requires a combination approach to get long-term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling with PRP, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with an expert. Best, Dr. Emer​

Thank you for your question and photographs. It's difficult to evaluate your skin through this type of forum, but from what I can see, it looks like you have combination acne: inflammatory lesions and comedones. There are a variety treatment options such as oral and topical antibiotics, Accutane, light therapy, peels, etc. With Accutane, there are a lot of side effects, so I highly recommend you consult with a board certified dermatologist in your area to have your skin evaluated and to discuss appropriate treatment options that best suit your needs. Take care and good luck.