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Home: Diseases & Conditions: Acne: Treatments: Severe Acne

Acne: Treating Severe Acne

Acne Treatment: Treatment Of Cysts And Nodules-

Cysts and nodules form at the third stage of acne and are known as severe acne. Inflamed nodules and cysts cause pain and scarring. The treatment regimen for severe acne includes physical, oral and topical treatments. The options may include: oral isotretinoin, oral antibiotics, injecting corticosteroid in the lesions, surgical procedures, and for women options may also include oral contraceptives. Let us find out more about what treatment options are available for cysts and nodules.

Most of the common topical treatments such as Benzoyl Peroxide, Salicylic Acid etc. may not be very useful to treat cysts and nodules. It is preferred to use oral medication to treat this acne.


Isotretinoin is one of the most potent medicines for acne. Isotretinoin is a retinoid (a compound of vitamin A). Isotretinoin helps treat all the following four causes of acne:

  • Excess oil,
  • Clogged pores,
  • Inflammation, and
  • The bacteria P.acnes.

The normal dose of isotretinoin is one or two pills a day for up to twenty weeks. Your dermatologist will decide the dose. Please don't take Isotretinoin without medical supervision.

Side Effects Of Isotretinoin:

The common side effects of isotretinoin are: joint pain, headache, nausea, and depression. For women, it is very important to be in regular contact with their doctor because isotretinoin can cause damage to the development of a fetus. Isotretinoin is not prescribed during pregnancy. Before the treatment begins, any possibility of pregnancy is ruled out. Talk to your doctor in detail about this and follow instructions strictly. Learn more about Isotretinoin.

Oral Antibiotics:

Antibiotics can be used topically as well as orally. For severe acne oral antibiotics are preferred as they produce faster results. Broad-spectrum antibiotics kill the bacteria P.acnes. With reduction in the population of this bacterium, infection and inflammation reduces. Antibiotics commonly used include: tetracycline, erythromycin and doxycycline. Excessive use of antibiotics can cause resistance to the antibiotic and gastro-intestinal problems. For more details about oral antibiotics, click here.

Injecting Corticosteroid In The Lesion:

In this treatment, a mild steroid solution is injected in the cyst. The steroid dries the acne within a few days. This treatment may prevent scarring as it reduces the infection quickly.

Surgical procedure:

Sometimes the lesion is cut open and drained. This procedure needs skill and patients should not try this themselves. Popping a cyst can lead to more infection.

Oral Contraceptives For Women:

Hormones are responsible for overactive sebaceous glands. These glands produce more of the sebum that causes acne. In women the hormonal activity can be corrected with oral contraceptives. These drugs should be taken only under medical supervision.


Spironolactone is a steroid. It is prescribed along with oral contraceptives to women. Spironolactone controls the production of Androgens (a group of hormones). Androgens are responsible for overactive sebaceous glands. By controlling androgens, the sebum production is reduced and acne is treated in women.

Article created on: June 14, 2006

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