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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Dermatology
Satisfied Customers: 17555
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have cystic acne. I have consulted the doctor he has

Customer Question

Hi i have cystic acne. I have consulted the doctor he has prescribed me doxcycline its been 20 days on it first week it helped me little bit..but 2 nd week there was no improvemet in the mid of 2nd week i started using 5% benzole peroxide cream after that it has helped me little bit ..but I still get the bumps on my fore head every day
JA: How long have you been dealing with this? Is there anything in particular that makes your head feel worse or better?
Customer: i have acne from last 3 years i am 25 year old.. i get the painfull bumps..bezole peroxide actually helping to take off the bumps over night...but it makes my skin dry...and next i get few more
JA: Anything else in your medical history you think the doctor should know?
Customer: i was tetramycline oral antibiotic..before this..when i took ythis medication my acne was gone for 1 and half year but now its back ..and its worse...now I just took this medication for a month
Submitted: 1 month ago.
Category: Dermatology
Expert:  Dr. D. Love replied 1 month ago.

Hello from JustAnswer. This is Dr. Love and I will be assisting you today.

Both the doxycycline and the benzoyl peroxide are common medicines used for treatment of acne, including cystic acne. The next medicine that is typically considered if the benzoyl peroxide plus doxycycline is not sufficient would be the addition of a topical retinoid, particularly Retin-A (tretinoin) gel.

It also would be an option to use a topical antibiotic to augment the oral antibiotic, such as topical erythromycin or clindamycin.

There also are some treatments that can be considered for each gender (I realize that you would have stated your gender when registering for the site, but the personal information is hidden to maintain privacy). An oral retinoid, isotretinoin, can be used for males. It is generally avoided in females unless there is very strong avoidance of pregnancy. Females can be treated with an anti-androgen, such as spironolactone, or with certain birth control pills that also help to control acne.

Most of these medicines are only available by prescription. Certain retinoids can be obtained over the counter in some countries, some of which are weaker than the Retin-A gel, such as Retinol. Otherwise, you wold need to discuss the other medicines with your doctor.

If I can provide any additional information, please let me know.

Expert:  Dr. D. Love replied 1 month ago.

Please let me know if I can provide any further assistance.

Customer: replied 1 month ago.
Thanks for help..I am 25 year old male so which one of these medications will be better for me ...and how can i obtain the prescription
Expert:  Dr. D. Love replied 1 month ago.

We typically treats acne oin a step-wise fashion, which is why the usual next step would be a retinoid. Of the retinoids, the Retin-A gel would be the best option. However, this is only available by prescription, so you would need to see your doctor to obtain a prescription. If you are in a situation in which you cannot readily get to your doctor, you can try an over the counter retinoid initially, such as retinol.

The "best" medicine for stubborn acne is the oral isotretinoin, but it is also the treatment regimen that has the highest rate of side effects, so we usually reserve the isotretinoin for people (primarily male) in whom other medicines have failed. We almost never start the isotretinoin early in the course of treatment using the argument that it is the best medicine. It would need to be particularly severe acne to even be considered.