Isotretinoin Treatment for Severe Acne Cases



Acne is caused when pores in the skin are clogged with oil (called sebum) and dead skin cells.

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Blackheads are clogs that reach the skin's surface. Whiteheads are clogs that stay beneath the surface of the skin.

Bacteria can also become trapped in pores and cause an infection. This may cause small red bumps, pimples, and cysts.

Risk Factors

Acne is most common in teenagers. Adults and children can have it too. Things that may raise the risk are:

  • Changes in hormone levels due to:
    • Puberty
    • Pregnancy
    • The time before a menstrual period
    • Polycystic ovarian syndrome (PCOS)
  • Emotional stress
  • Certain skin products
  • Sweating
  • Drugs such as:
    • Anabolic steroids
    • Drugs to treat epilepsy
    • Lithium
    • EGRF inhibitors to treat cancer
  • Family history



Acne symptoms vary from person to person. They can range from mild to severe. A person may have:

  • Excess oil in the skin
  • Blackheads—small black dots
  • Whiteheads—small, white, raised bumps
  • Papules—small, pink bumps that may be tender
  • Pimples—inflamed, pus-filled bumps that may have a red base
  • Nodules—large, painful, solid lumps deep in the skin
  • Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring


The doctor can make a diagnosis based on a physical exam. People with severe acne may need to see a skin doctor.



The goals of treatment are to reduce the acne and treat any infection. A combination of treatments works best. Options are:


Acne may be treated with:

  • Medicines to reduce oil and bacteria in pores, such as
    • Over the counter cleansers, creams, lotions, and gels
    • Prescription antibiotic or retinoid ointments
    • Antibiotic pills
  • Medicines to control certain hormone levels
  • Oral retinoids to reduce the size of oil glands—for severe cystic acne.


Procedures to treat acne may be:

  • Corticosteroid injections—mostly for large, cystic acne lesions
  • Acne surgery
  • Chemical peels—to loosen blackheads and reduce papules
  • Dermabrasion—to treat deep acne scars
  • Scar excision—to help how the acne scars look
  • Collagen fillers—to make acne scars look smoother
  • Light and laser therapies

Skin Care

Good skin care can help reduce irritation of acne. This includes gentle washing and using skin products that do not clog the pores.


It can be hard to prevent acne. For some, reducing emotional stress may help.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.