Oral Therapies

Oral acne treatments are chosen for more severe forms of acne. More severe acne is acne with large inflammatory lesions, acne that leads to scarring, acne unresponsive to other types of treatments or forms of acne that causes the sufferer social discomfort.

Basically three oral treatments against acne are at our disposal: antibiotics, retinoids and certain birth control pills.

Antibiotics

In general, antibiotics are used in inflammatory juvenile acne. In adult type acne they are often not of sustained efficacy. Because of side effects and antibiotic resistance they should not be used continuously for more than three months.

Isotretinoin

Isotretinoin (Roaccutan^® and generics) is an oral retinoid that has been successfully used in acne and rosacea treatment for more than 25 years. A treatment with isotretinoin is typically indicated in severe forms of acne.

Isotretinoin influences all aspects of acne and rosacea: hyperactivity of sebaceous glands (the site of acne), prevents comedones (blackheads and whiteheads) and is highly anti-inflammatory. The effect of the isotretinoin treatment is usually sustained after cessation of therapy.

We have a long-standing experience with low-dose isotretinoin therapy. Contrary to higher dosage treatments, the common side-effects (dryness of the skin and mucosa) are much less pronounced. Before and during isotretinoin therapy, blood tests are performed. Changes of blood chemistry during treatment with low dose isotretinoin are extremely rare.  Women in child-bearing age must not get pregnant during this regimen and one month after cessation of therapy, because isotretinoin is teratogenic.

Common side- effects of isotretinoin

For various reasons, some people consider an isotretinoin therapy a risky way to treat acne. In the right hands and in the right dosage, however, isotretinoin is a reliable therapy for acne, with a limited risk-profile. Side-effects that always occur are:

• dryness of skin and mucosa: isotretinoin lessens the production of sebaceous glands. The intensity of dryness people experience from isotretinoin depends on various factors: the dosage, time of the year and factors specific to the individual. At times wearing contact lenses during the treatment can be a problem. To lessen dryness, daily cleansing and moisturising routines should be adopted. Our cosmetician will show you how.
• enhanced liability to sunburn: During isotretinoin therapy the uppermost layer of the skin is thinned, hence UV rays may penetrate more easily into your skin. You should adapt sun-protective measures accordingly.
•  pregnancy: isotretinoin in women in child-bearing age may only be taken if they agree not to get pregnant during the entire course of the therapy and one month upon cessation of isotretinoin. It is a teratogenic drug which would necessitate a medically-indicated abortion. In men isotretinoin does not have teratogenic effects.
•  enhanced vulnerability of the skin: During isotretinoin therapy the upper layer of the skin is temporarily thinner. Your skin may be more prone to trauma — for example when waxing hair — which is not recommended during the treatment.
•  isotretinoin and other drugs: Should you be taking other medication during isotretinoin therapy you should inform your doctor. Some antibiotics should not be combined with isotretinoin; also some birth control pills may not be effective during isotretinoin intake. Should you notice any mood changes, you should stop isotretinoin therapy and contact us immediately.

Duration of isotretinoin therapy

Until some years ago it was thought that a higher daily and cumulative doses of isotretinoin would be necessary to obtain a sustained effect. Sometimes it is necessary to repeat isotretinoin therapy in stubborn forms of adult type acne.

Whether or not an isotretinoin treatment is an option for you does not only depend on your form of acne, but also from your determined intention to follow the whole course of the treatment.

We can also offer you anti-acne treatments on the basis of laser und other light sources.