Acne. Possibly one of the most hated words in the English language. Almost everyone has had acne at some point in their lives, but what if you have more than just a small breakout here and there? What if you constantly have to deal with the discomfort of a red, inflamed face? Having worked with people who have gone through years of different acne-taming regimens, we’re here to tell you that though it can be difficult, there are severe acne treatment options available that work.

How Do I Get Acne?

Many people believe that taking good care of their skin by eating right, drinking enough water, and washing their face at night will be enough to prevent acne. Though these methods are important and do benefit certain people, they aren’t always effective on their own.

Sadly, there seems to be stigma around acne as a symptom of someone being “unclean”. That, simply put, is false. Most people who suffer from acne – and not exclusively severe acne either – are genetically predispositioned to have it. So, when you read about or hear people recommend making a simple lifestyle change to treat your blemishes, know that:

  1. For many people, it’s not that easy and…
  2. You ARE NOT “unclean”; you just need a medically guided treatment to help you clear your skin.

In addition, men tend to be more likely to have severe acne than women during adolescence. However, women are more likely to develop adult-onset acne. Other than the face, acne is commonly located on the neck, back, or buttocks.

What Kinds of Acne Are There and How Do I Know if Mine is Severe?

Generally speaking, there are 6 kinds of acne of increasing severity which are:

  1. Blackheads
  2. Whiteheads
  3. Papules
  4. Pustules
  5. Nodules
  6. Cysts

Most people have had a blackhead or a whitehead in their time. Most people have even had a papule or pustule thrown in, much to their annoyance. However, severe acne is classified as nodulocystic acne or severe inflammatory acne. These kinds of outbreaks tend to last much longer than the average blackhead or pustule. A single pimple of this category, either nodules or cysts, can stay on your skin for weeks or months at a time.

A nodule is a hard, swollen lesion that unlike simpler pimples, develops deep within the skin and can last as long as a couple of months. A simple pimple begins when an infected hair follicle wall (commonly called a pore) ruptures. When this happens, bacteria has free access to the dermis, which is the deepest layer of the skin. That’s how your average whitehead develops.

In the case of a nodules, the follicle wall in question ruptures deep within the dermis, not just near the top. This causes the follicle bacteria to infect follicles next to it. The result is a deep, painful, hard nodule on the skin. They are often described as feeling like a knot. A nodule can be filled with pus, much like an average pimple, but the fluid will be located deep under you skin and unlikely to make a whitehead.

Nodules can last anywhere from a few weeks to months at a time. Because of the extensive underground damage, they are much more likely to scar than a regular pimple. In addition, over the counter topicals will not help this type of acne. You must see a dermatologist to prescribe you an oral medication that fights the acne from the inside.

A cyst, on the other hand, is essentially an elevated nodule blemish. Cystic acne obliterates the originally infected follicle and slowly works its way to the surface, often filled with pus or blood. These pimples can be incredibly swollen and can measure up to a couple inches long or wide. Because they are essentially a more infected nodule, they typically last longer and the likelihood of scarring is very high.

Nodule and cystic acne can only be treated by a professional and under no circumstance should you try to pop either of these kinds of blemishes.

What Are My Severe Acne Treatment Options?

For those of you who have determined that you do have severe acne, there are many medications and regimens you can try to tame your breakouts. The most effective medication on the market for severe acne treatment is Isotretinoin, more commonly known as Accutane. However, this medication requires that you have a dermatologist or doctor whose credentials allow them to prescribe it to you.

Isotretinoin is a retinoid taken orally twice a day with a meal. The treatment generally lasts 15-20 weeks, depending on the severity of your acne. This medication is highly controlled because of its lasting effects and possibly detrimental effects on the body. In fact, the only way a person can take Accutane is if they also agree to participate in a program set up by the Food and Drug Administration called iPledge.

Women and Accutane

iPledge is set up primarily for women who want to take Accutane because of the severe birth defects it can cause if the woman were to be pregnant. In fact, two months before starting the therapy, women must have two blood tests done to ensure that they are not pregnant. During the course of treatment, women must have a blood test done each month to continually ensure that they are not pregnant.

Each month, the medication must be re-prescribed only after bloodwork comes back negative and the female patient has taken an online quiz through iPledge stating that they are on at least two methods of birth control.

Men have it much easier, as they do not have to go through the process of proving that they are not with child each month.

How Accutane Works

Put simply, Accutane permanently shrinks your oil glands. Because people with acne produce more sebum than necessary, the elimination of the excess causes your skin to stay clear because your pores no longer get clogged.

The pill works from the inside and essentially dries out the body (see side effects below). While on this medication, your skin is likely to get worse before it gets better. It may not be until month two or three that you start notice a significant difference in your skin.

Because it shrinks your oil glands, a wonderful side benefit of this medication is that, even when you’re done with it, your hair will never get as greasy as fast. How nice is that?!

Common (Not Serious!) Side Effects

Now, we know this description of Accutane can scare some people. It is a serious medication! Though it’s more of a process than using a simple topical cream, the difference is that it will work as a severe acne treatment, when over the counter medications just don’t cut it.

Whether male or female, while on Isotretinoin, you’ll have to take a little better care of yourself. The most common side effects include:

  • Dry skin (especially your lips)
  • Nosebleeds
  • Dry eyes
  • Joint pain
  • Sun sensitivity

Because Accutane is actively shrinking your oil glands, while taking the medication, your skin will be extremely dry. Your lips and nose in particular will be extra dry. Below, we’ve highlighted some extremely helpful products to keep your skin comfortable and moisturized.

  1. Aquaphor or Vaseline – exclusively!
    • Most brands for dry lips actually don’t help you – including Chapstick. Aquaphor and Vaseline are essentially the ONLY brands you should trust on your precious lips.
  2. Non-Comedogenic Products
    • Check the labels on any makeup or moisturizer you want to buy for the word “non-comedogenic”. This means that it’s specifically formulated to not clog pores and cause oil backups.
  3. Cetaphil or CeraVe Moisturizers/Lotions
    • These brands are excellent choices for acne prone, sensitive, and extra dry skin. There are many different kinds to choose from, but these brands are guaranteed to nourish your dry skin.

Though it may sound intimidating, Isotretinoin is the most effective way to rid your skin of severe acne. Acne can is frustrating and embarrassing to deal with, and for those of you who feel like you’ve tried everything under the sun, Accutane may be the best option for you. If you have severe acne, Camas Swale Medical Clinic offers Accutane treatments. For more information, contact us here.