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    Navigate: FAQ Home Page > Acne & Skin Concerns > Q&A
    Posted on: 11/17/2006

    Question

    I've had acne since the 6th grade. I've tried everything to get rid of it: almost every kind of wash, scrub, cream, soap, Proactiv, and I've even been to the doctor about it. He prescribed the antibiotics and cream. But after about 6 1/2 months, it's only worse. The next step is the stronger medicine, which my doctor doesn't want to try if he doesn't have to because of the side effects. I recently talked to a lady that said she had acne that wouldn't go away like me, but when she started birth control, it cleared up. Do you think birth control will work?

    Answer

    Birth control pills might work, but they don't always do the job. In my practice, I see plenty of women for acne who are already on birth control pills and still break out. I ususally don't recommend birth control pills for acne unless the person wants to actually take it for birth control itself. The reason I don't do this is because 1)birth control pills don't always work, 2)they can have side effects and are not risk-free, 3)they usually take several months to start to work for acne, and 4)once you go off of them, the acne comes back.

    I think antibiotics are a safer alternative, because there are usually no serious side effects and they can be tapered to low doses. If one antibiotic doesn't help, there are several other ones to choose from. If you have tried multiple antibiotics with no effect, I would probably go to isotretinoin (Accutane). Despite the bad press this medication has received lately, it has several advantages: 1)it almost always works, 2)the treatment course is usually 5 months, and 3)the side effects are known and controllable.

    The biggest problem is that if you become pregnant while on Accutane, your baby might have birth defects, so you have to avoid pregnancy while you're on it. I'm not saying that this is the treatment for you, but you should at least discuss the pros and cons with someone who is comfortable prescribing it. One last thing to mention: I see many young women who have polycystic ovarian disease, and this can be manifested by difficult to treat acne as well as very irregular periods (like skipping a month). If this sounds like you, a simple blood test to check your hormone levels can diagnose it. Good luck!!


    Answered By:
    Renata Mullen , M.D.


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