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Look into oral antibiotics. Consider using retinoid topicals. Talk to your doctor about topical antibiotics. Ask your doctor about oral contraceptives. Discuss anti-androgen agents. Consider isotretinoin.
While topical antibiotics are effective for mild to moderate acne, oral antibiotics are typically prescribed for more moderate to severe acne outbreaks across the body. Oral antibiotics are usually only given for a predetermined length of time, after which you will need to taper off your use of the medication.  Commonly prescribed oral antibiotics for treating acne include minocycline and doxycycline, which are both tetracyclines. Side effects include increased sensitivity to the sun, so make sure to wear sunscreen. Do not use in children under age of 9 or in pregnant women as there is an increased risk of reduced bone growth or permanent teeth discoloration. Ask your doctor if oral antibiotics are right for you. Much like the over-the-counter topicals available at most pharmacies, prescription-strength retinoids help reduce acne outbreaks by preventing pores from becoming clogged. Retinoids are derived from vitamin A and come in many prescription-strength forms, including tretinoin (Avita), adapalene (Differin), and tazarotene (Tazorac).  Use retinoids topically on the skin. Apply it in the evening, and allow your skin to grow accustomed to its use. You only need a pea-sized amount to cover the face. For best results, begin using retinoids three times each week, then increasing your use to a daily schedule as your skin gets used to the medication. Retinoids commonly cause skin irritation, flaky skin and dryness. You can minimize these side effects by starting with the lowest concentration of medication available. If your skin can tolerate these lower concentrations, you may start increasing the strength. Avoid using retinoids at the same time as over-the-counter acne medication. Retinoids can also increase your sensitivity to the sun. Wear sunscreen, and cover your skin with protective clothing, such as hats and jackets. . Prescription-strength topical antibiotics can help kill excess bacteria on the surface of your skin, which may otherwise result in clogged pores and outbreaks. Topical antibiotics may also reduce redness in acne-prone skin. Many topical antibiotics are also combined with benzoyl peroxide, which can help reduce the chances of developing antibiotic-resistant bacteria on your skin.  Common topical antibiotics combined with benzoyl peroxide include clindamycin (Benzaclin) and erythromycin (Benzamycin). Dapsone is a topical gel that is often prescribed to treat acne. It is usually combined with a topical retinoid component to maximize its effectiveness. Dapsone may cause skin irritation, redness, and dryness Combined oral contraceptives may be useful in treating acne for women and adolescent girls. These specialized pills often combine estrogen with progestin, and are available in three different forms: Ortho Tri-Cyclen, Estrostep, and Yaz.  Common side effects include headache, nausea, weight gain, breast tenderness, and periodic bleeding, though more serious side effects could include a risk of blood clots. Ask your doctor if a combined oral contraceptive is right for you. Anti-androgen agents like spironolactone (Aldactone) can help block sebaceous glands from being affected by androgen hormones. These medications are typically prescribed to women and adolescent girls who have not had success with oral antibiotics in treating acne. Commonly reported side effects include breast tenderness, painful periods, and the body's retention of potassium. Isotretinoin is a very strong oral medication that is usually reserved for people who have not responded to other acne treatments. The side effects of isotretinoin include ulcerative colitis, an elevated risk of depression and depression-related suicide, and severe birth defects in pregnant women. Taking isotretinoin requires continued monitoring by your doctor to prevent or detect these side effects before they become problematic. Common forms of isotretinoin include Amnesteem, Claravis, and Sotret.