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The most common side effects with isotretinoin mimic the symptoms of hypervitaminosis A (Zaenglein et al. 2016). With the standard dose, these side effects disappear after treatment discontinuation (Zaenglein et al. 2016). The evaluation of each acne patient should include a complete medical history and a physical examination.

For mild to moderate to severe acne, it generally starts with a combination of local treatments or antibiotic tablets combined with topical treatments. Antibiotics usually start to remove the skin within four weeks and the treatment can take months. However, there is a risk that acne bacteria will develop antibiotic resistance and imperfections will reappear.

However, there are additional considerations that you should consider during the treatment. Women over 25 often have a high percentage of failed treatments . About 80% of women fail in multiple cycles of systemic antibiotic medication and about 30% to 40% fail after one cycle of isotretinoin (Blasiak et al., 2013, Goulden et al., 1997a, Goulden et al., 1997b, Rademaker, 2016). The suspicion of an underlying endocrine disorder should be increased if acne repeat occurs shortly after treatment with isotretinoin . Generally avoid overly aggressive and hard cleaning agents, especially if you are already using a topical prescription ingredient. With dry, sensitive skin, a creamy cleanser may be a better option.

Salicylic acid increases anti-inflammatory and peeling activity, while benzoyl peroxide kills bacteria and is known to cause drying and mild peeling. Benzoyl peroxide-based cleaners and creams are available externally at concentrations of 5 percent or Acne Treatment less, or at higher prescription concentrations. Regardless of what you are trying to do, you should continue treatment for a few months before you see the difference. Visit your doctor if you don’t notice any improvement within six to eight weeks.

Current antibiotics are believed to accumulate in the follicle and can act through anti-inflammatory and antibacterial effects (Mills et al. 2002). Due to increased antibiotic resistance, monotherapy with local antibiotics is not recommended in the treatment of acne. Topical antibiotics are best used in combination with BP (Zaenglein et al. 2016). Hormonal, cystical, stress-induced – forget all the terminology you’ve heard.

Minocycline has been shown to be safe and effective at a dose of 1 mg / kg, but no dose response was found for efficacy (Fleischer Jr. et al., 2006, Zaenglein et al. 2016). For practical purposes, minocycline is generally dosed at 50 to 100 mg twice daily. Azelaic acid should also be used with caution in patients with Fitzpatrick type IV or higher skin due to the potential lightning strike (Cunliffe and Holland, 1989, Katsambas et al., 1989, Kircik, 2011). However, this side effect makes azelaic acid a useful supplement in the treatment of acne because it helps treat post-inflammatory dyspigmentation.

Expect your doctor to also prescribe local retinoids, benzoyl peroxide or other topical treatments. In addition to oral antibiotics, some dermatologists prescribe topical antibiotic creams and gels to treat and prevent acne. Topical antibiotics have fewer possible side effects than oral antibiotics and are generally prescribed for less severe and persistent acne cases.