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ACNE Page 3 BY BRUCE MIRKEN © Copyright 1997 by Parents' Press ANTIBIOTICS Antibiotics may be used as well. Sometimes these bacteria-fighting agents are applied to the skin in cream or lotion form ­ one common treatment plan involves applying an antibiotic cream in the morning and tretinoin at night. For more severe cases the doctor may recommend an oral antibiotic, typically either tetracycline, erythromycin, or minocycline. Minocycline is often preferred because it is potent and can have fewer side effects than the others, but it is also more expensive. DRAWBACKS The downside of antibiotic use is that bacteria can become resistant to the drugs over time. The emergence of such resistant strains is becoming more of a concern in medicine across the board, and for that reason some argue that these drugs shouldn't be used routinely but should be reserved for use only when truly needed. That's a debate that will no doubt continue for some time. When nothing else works, you dermatologist may recommend isotretinoin (brand name Accutane), another vitamin A derivative that is taken orally. The good news is that isotretinoin is the closest thing to a cure yet developed for severe acne: Improvement can be dramatic and is usually long-lasting. The bad news is that this is a potent, tricky drug with a host of potentially serious side effects which can include headaches, dry skin, loss of night vision, and hair loss. Blood tests are required before, during, and after treatment to check for potentially dangerous effects. Because of the dangers, isotretinoin is only used in the severest cases. Most importantly, isotretinoin can cause severe birth defects if taken during pregnancy and should never be used when pregnancy is even a remote possibility. Female patients are required to sign a special consent form and are instructed to use two forms of birth control starting at least one month prior to treatment. This can be an awkward subject ­ sexually active teens may be reluctant to tell either their parents or their doctor ­ but it must be taken extremely seriously But overall the bottom line is basically a happy one: Today's teens have far more effective acne treatment options than their parents did. "Times may be rough," Tom Plummer says, "but things really do start to look up. And don't be afraid to go to a dermatologist." Comments about this article? Send us an e-mail and we'll add your remarks to the feedback page.