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Retinoids are a form of vitamin A which will reduce the amount of hypertrophy to your sebaceous glands. You can find over-the-counter acne preparations with lower doses of retinoids than you'll get from a prescription.  However, many people respond to the over-the-counter strength products well and do not need prescriptions. Ask your doctor if you need a prescription or if over the counter is a better option for you. Women with bad acne have the option to use oral contraceptives to control their hormonal levels. This also has the advantage helping to balance other secondary effects of the hormones, such as irritability and water weight gain.  You need a prescription to get contraceptives that affect your hormones. Don't use oral contraceptives if you are pregnant or trying to get pregnant. Accutane is an anti-acne medication for treatment of severe acne and requires a prescription. If you have sebaceous gland hypertrophy or severe acne, ask your doctor if Accutane is right for you.  You will need to have your blood monitored every month while taking the medication and may experience side effects for several months after using it. Do not use Accutane unless you fully understand the risks of the medication. Accutane can have long-term effects on your health and wellness. You cannot take Accutane if you are pregnant or planning to become pregnant. Phototherapy is a treatment option you can perform at home by purchasing special equipment, or you can choose to ask your dermatologist.  Research supports this treatment, which is simple and easy to perform. Technically, exposure to sunlight is phototherapy. However, in climates where the sun doesn't shine enough hours or you can't get outside when the sun is out, you can purchase a phototherapy unit. Use the unit to treat your acne as directed and using the safety precautions listed on the unit. Possible side effects from using these units include skin that becomes red, peels or changes skin tone.  Your doctor may also perform photodynamic therapy in the office. This involves applying a medication to the skin, which is then activated by a special light. This is more effective than a light treatment alone. Oral and topical antibiotics may be used to treat acne, especially when reinfection is a concern. Topical antibiotics can be used long-term, usually along with benzoyl peroxide or retinoids. Oral antibiotics are usually used short-term to get a bad breakout under control. Antibiotics are especially useful for inflammatory acne, which is acne with a lot of red bumps, pimples, or cysts.
Consider prescription retinoids. Consider oral contraceptives. Ask about Accutane. Ask about phototherapy. Talk to your doctor about antibiotics.