What is better for a long term acne management for me - low dose of Accutane or birth control? (photos)

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

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

Thanks for your question and photos.  It's frustrating to still be dealing with acne at your age!  You might want to consider a few months of accutane and birth control to get the active acne under control and prevent future scarring, but after that improves, I would still recommend staying on birth control unless you are wanting to become pregnant.  There are a lot of adjunctive, or complimentary, treatment options you can also pursue.  Ask your dermatologist about a series of microneedling, perhaps some chemical peels, or other aesthetic options.  There are also some good non-prescription topicals that can keep you relatively clear, including those with glycolic acid, salicylic acid, or retinoids in them. Best of luck and work with your dermatologist for a balance that works right for you.