If proper cleansing and topical treatment are not enough, an oral antibiotic may be prescribed. Oral antibiotics such as tetracycline (Achromycin V), erythromycin (ERYC, Ilotycin, and others), minocycline (Dynacin, Minocin), doxycycline (Doryx, Vibramycin, and others), ampicillin (Omnipen, Polycillin, and others), cephalosporins, and sulfa drugs are often prescribed by dermatologists for more severe acne with many papules and/or pustules. These are often very helpful, but one cannot stay on antibiotics forever.
For women who have acne and also need birth control, hormonal therapy may be useful, especially if the acne is thought to be driven by a hormonal imbalance. Birth control pills with 50 micrograms of estrogen and low progesterone can help to control acne and are sometimes prescribed for just that purpose in women. Examples include Demulen 1/50, Demulen 1/35, Loestrin 1/20, Ortho-Novum 7-7-7, Triphasil, and TriNorinyl. In more severe cases in older women, antiandrogens such as spironolactone are sometimes used.
Isotretinoin (Accutane) is frequently used for severe acne. It usually yields great results that can markedly improve a person's self-image and self-esteem. Isotretinoin is a strong derivative of vitamin A
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