Isotretinoin
Isotretinoin is a potent drug reserved for treating severe cystic acne and acne that has proven itself resistant to other medications. Isotretinoin is a synthetic (man-made) retinoid (form of vitamin A) that comes in pill form. It is usually taken once or twice a day for 16 to 20 weeks.
Today, it is the most effective acne treatment available because it is the only acne treatment that works on all four factors that predispose a person to acne – excess oil production, clogged skin pores, P. acnes and inflammation. The remissions achieved with isotretinoin usually last for many months to many years. For many patients, only one course of isotretinoin therapy is needed
Oral Antibiotics
For patients with moderate to severe and persistent acne, oral antibiotics have been a mainstay of therapy for years. Like topical antimicrobials, oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation. Treatment with oral antibiotics usually begins with a higher dosage, which is reduced as acne resolves. Generally, antibiotics are prescribed for six months or less.
Oral Contraceptives
Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands and can be used as long-term acne therapy. However, oral contraceptives should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches—without the advice of a gynaecologist.