5 Ways to Combat Severe Acne


For many people, acne doesn’t just affect their skin; it shatters their confidence. Breakouts can be anxiety-inducing, making it hard to interact with those around you.

If you suffer from acne, you’ve probably tried numerous products in an attempt to keep blemishes at bay. Unfortunately, not all products work for all types of breakouts. People who suffer from more severe types of acne will need a different treatment plan than those with mild skin inflammation.


Severe acne most often appears in two forms, nodular and cystic. Nodular acne stays deep under the skin, hardening into stubborn bumps. Like nodular acne, cystic acne also resides deep under the skin. However, cystic acne is often softer and typically bursts open, leading to further infection. Both nodular and cystic breakouts need to be treated with something stronger than Clearasil or other over-the-counter topicals.

For those suffering from severe acne, searching for an effective acne treatment can feel overwhelming. Luckily there are plenty of options to help you on your way to clear skin. Keep reading to learn about five treatment options to improve your skin when OTC products aren’t cutting it.

Hormonal Birth Control


If you’re a woman dealing with hormone imbalances, birth control pills could be a viable acne treatment option. High levels of hormones called androgens cause hormonal acne by stimulating your skin to produce excess oil called sebum. This sebum makes your skin a cozy home for bacteria while also clogging your pores. Hormonal birth control lowers the amount of androgens in the body, reducing sebum production and thus controlling acne flare-ups.

As with any medication, there are a few considerations to take into account before getting on birth control. Needless to say, if you’re trying to conceive, hormonal birth control isn’t going to be the right acne treatment for you. Additionally, some women report experiencing side effects like mood swings, decreased libido, and nausea once starting the pill.

Oral Antibiotics

Mild acne is sometimes treated with topical antibiotics, but something stronger is often needed for severe breakouts. When dealing with cystic or nodular acne, doctors will often prescribe oral antibiotics in pill or liquid form. This medication works by killing the excess bacteria trapped inside your pores, which could otherwise cause breakouts. Oral antibiotics can also reduce the painful inflammation that accompanies severe acne.

When taking oral antibiotics, make sure you follow your doctor’s directions and don’t skip doses. It’s important to finish the entire course, even if your acne is improving. You’ll also want to make sure you aren’t taking antibiotics for longer than three months. If you take antibiotics for extended periods of time, it can lead to antibiotic resistance.

Cortisone Shots

Referred to by dermatologists as intralesional corticosteroid injections, cortisone shots can reduce inflammation and shrink active breakouts. Cysts and nodules usually take up to a month or more to resolve on their own. However, a cortisone shot injected directly into the acne-ridden area can help breakouts clear up in just a few days. The procedure itself is fast and painless, using a small microneedle to perform the injection.

With this quick fix comes a few side effects. After receiving a shot, patients may experience hyperpigmentation, which is a discoloration of the skin. Additional complications could include thinning of the skin at the injection site. These side effects are usually temporary and will go away over time.


Spironolactone was originally designed to help prevent high blood pressure and heart failure. Today, it’s becoming an increasingly popular treatment for hormonal acne. Like birth control, spironolactone reduces oil-producing androgens in the body, helping to curb breakouts. This medication is taken once daily in tablet form and is often prescribed along with other treatments for maximum results.

Although spironolactone is a safe and effective acne treatment, it isn’t suitable for everyone. Doctors usually won’t prescribe this medication to men since it lowers testosterone. This can lead to unwanted side effects such as reduced libido, erectile dysfunction, depressed mood, and fatigue.

On the other hand, women who are pregnant or trying to get pregnant should not take spironolactone because it leads to birth defects. Many physicians prescribe birth control in conjunction with spironolactone to prevent pregnancy and provide additional acne-fighting support.


Isotretinoin, often referred to by the brand name Accutane, is a prescription medication created from vitamin A. For many people, this medication gets rid of acne for good by shrinking their oil glands and killing bacteria.

Although isotretinoin effectively fights acne, it gets a lot of attention for its uncomfortable side effects. If you choose this treatment plan, you may experience dry skin, depressed mood, and joint pain. The good news is these ill effects tend to subside after stopping the medication.

Before starting isotretinoin, you need to make sure you're fully committed to this treatment option. The medication requires monthly visits with your doctor to have blood work done. Like spironolactone, isotretinoin causes birth defects, so women need to be on birth control while taking this medication.

If over-the-counter acne products aren’t improving your breakouts, don’t give up. There are multiple treatment options for those suffering from severe acne. To learn what treatment option is right for you, consult your healthcare provider.