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Cystic acne is the most rare and most severe form of acne, which can
become disfiguring and leave permanent scarring on the skin. One of the
more tragic outcomes of this form acne is that it develops during
adolescence, an emotionally vulnerable stage in life anyway. There is
an unfounded social stigma associated with this condition and many
people who suffer from it withdraw from normal social activities and
even develop clinical depression that has been known, in some cases, to
lead to suicide.
There is a series of accepted cystic acne
treatments that are recommended in the United States, starting with the
mildest medications first, followed by more aggressive treatments if
the first fails. Each phase of treatment is associated with more
expense and stronger side effects to the patient.
Cleanliness
is always the first step to a clear complexion but nodulocystic acne
(cystic acne) is not related to hygiene. The blemishes develop at a far
deeper layer of the epidermis than cleanliness can affect.
Topical
ointments and lotions are the next line of treatment but they often
prove ineffective with this deep-seated form of acne. Antibiotics are
the next stage and they often prove effective initially. Their
effectiveness diminishes over time, however, and long-term use of
antibiotics is not safe.
When these milder cystic acne
treatments fail, there are highly effective prescription medications
that can be taken, both topically and orally, but they are extremely
dangerous and are considered the drug of last resort.
These
drugs contain a medication called isotretinoin, which is a vitamin A
derivative known to cause many severe side effects, including a flare
up of acne. Some of these side effects will go away once the body
adjusts to the medication and others will go away once the medication
is discontinued. Unfortunately, some of them are permanent.
Cystic
acne treatments containing isotretinoin are known to cause a very high
number of severe defects in a developing fetus. For this reason, it
should never be taken by any woman pregnant or likely to become so
during treatment.
The chances of birth defects caused by this
medication are so extremely high that men taking this medication are
not allowed to donate blood on the chance the blood recipient may be,
or become, pregnant after transfusion. This restriction on blood
donation applies even for a period of time after treatment has been
discontinued.
There are rigid restrictions in the United
States for the prescribing and dispensing of these
isotretinoin-containing cystic acne treatments. Before prescribing
these medications, doctors are required by federal law to register the
patient on a national database and pharmacists must check this registry
before filling and releasing the medication to the patient.
Prescribing
physicians are restricted to a 30-day supply of this medication and
patients must pick it up from the pharmacy within a restricted period
of time. If the pick-up time is missed, the patient must wait 30 days
before obtaining a new prescription.
Cystic acne treatments
containing isotretinoin are formulated based upon the patient’s weight
and severity of condition. For these reasons especially, it is never a
good idea to share this medication with another person or to take
another person’s prescription.
Med-Help is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendations.