7 Major Treatment Considerations for Nodulocystic Acne 

One of the most initial treatments that one may think of after coming across the term “cystic acne” is Accutane. This Accutane happens to be an oral vitamin A byproduct that has been recognized since 1982 for acute nodulocystic acne. But it is available with several conditions as well as challenges, that patients must be conscious of. Only a recognized allure skin & laser center like ours, comprising a board-certified dermatologist, has the authority to advise on a few of the most common questions when it is related to Accutane, apart from the alternative therapies. 

How do I Start Accutane? 

The initial step is to fix an appointment with our dermatologist who has thorough knowledge regarding allure skin and laser. You need to consult whether this medication will suit you. You need to realize that Accutane is unlike other medications. As it may lead to birth defects in babies born to patients who are impregnated on the medication, it can’t begin on the very day of the first dermatology appointment. There is a nationwide regulatory program called iPLEDGE that mandates certain conditions to be fulfilled before they can be prescribed. 

Am I Eligible for Accutane? 

In medical science, the theory of “one size fits all” is inapplicable, especially when it comes to Accutane as it is most frequently used for acute nodulocystic acne. But some of our dermatologists have applied it to patients with less intense acne who have gone through all standard therapies. 

How Fast Do I Expect Results with Accutane? 

Results differ from one patient to another. Some patients will observe significant development within the first month of therapy. Others may have to wait a couple of months to feel the progress of the treatment. A few patients are there whose acne deteriorates at the beginning with Accutane for 1-2 months before it begins improving. 

What Are the Expected Side Effects of Accutane? 

Side effects could be wide-ranging and vary from one patient to another. But most patients will experience some sort of dryness of the eyes, lips, nose, and skin. A few people with more sensitive skin can suffer from eczema or rashes. Additionally, there are less common, but significant instances, of mood disorders, reported in our skin and laser center including suicidal/homicidal ideation and depression. These issues were immediately taken care of with utmost priority and 100% success. On extremely rare occasions, a few patients may experience hair, eye, and nail problems. Liver enzymes and cholesterol levels can get worse with pancreatitis being the most serious issue. But all were within control. 

How Long Do I Need to be Treated? 

Everything depends on how well a patient tolerates the medication. A course in Accutane can consume around four months to a year. Entire medication intake is mostly determined by the weight of the patient, which is normally (120-150) mg/kg. 

Does Accutane Guarantee that My Acne will be Gone Forever? 

Usually, acne is much better after Accutane. However, it has the propensity to recur in a less acute and more manageable form nearly 6-12 months post-completion of a treatment. But some patients will need 1 or 2 more courses of Accutane to regulate their acne. Hardly, there are patients whose acne doesn’t improve at all with Accutane. 

Are There Any Other Options Instead of Accutane? 

Several other options are there to heal your acne. There are two in particular. 

The first is a medication called spironolactone. It happens to be a blood pressure medication that is also utilized quite frequently and effectively for hormonally flared moderate and nodulocystic acne. Potentially rare side effects are elevated potassium levels and reduced libido apart from breast tenderness. The commonest side-effect observed is menstrual irregularity. Some patients need to urinate more than usual. Nevertheless, 90% of patients on spironolactone do extremely well and are satisfied with the control of their acne. Being a hormone blocker, you would not wish to avail yourself of it if you were contemplating pregnancy. 

For cystic acne, oral clindamycin is an amazing short-term antibiotic to control acne in a much better way. An uncommon side effect is C. difficile colitis which manifests as profuse watery diarrhea. Yet, the medication seems to be well tolerated. 


Last but not least, acne is a common condition that we can mostly manage, but can’t eliminate. At our skin care clinic in California, we come across patients who do the best but the happiest are those who realize everything and set practical and manageable treatment goals. 

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