Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments. One to two months use is typically adequate to see improvement. Acne often resolves completely or is much milder after a 4–6 month course of oral isotretinoin. After a single course, about 80% of people report an improvement, with more than 50% reporting complete remission. About 20% of patients require a second course. Concerns have emerged that isotretinoin use is linked with an increased risk of adverse effects, like depression, suicidality, anemia, although there is no clear evidence to support some of these claims. Isotretinoin is superior to antibiotics or placebo in reducing acne lesions. The frequency of adverse events was about twice as high with isotretinoin, although these were mostly dryness-related events. No increased risk of suicide or depression was conclusively found. Isotretinoin use in women of childbearing age is regulated due to its known harmful effects in pregnancy. For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control. In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy. iPledge requires the woman under consideration for isotretinoin therapy to have two negative pregnancy tests and mandates the use of two types of birth control for at least one month before therapy begins and one month after therapy is complete. The effectiveness of the iPledge program has been questioned due to continued instances of contraception nonadherence.
Baby acne almost always goes away on its own with no intervention. But bring it to your pediatrician's attention if the bumps look like they might be infected (for example, skin appears extra red, you notice swelling or discharge, or your child spikes a fever or has other symptoms) or if you suspect an allergic reaction or eczema (which may require a cream to keep the rash from spreading).
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
Baby acne generally lasts longer with breast-fed babies, since the same residual, oil-triggering hormones that the baby was exposed to in the uterus can come through the mother's milk, too. As a result, it often begins clearing up as your baby is weened off of breast-milk. It may even clear up sooner if your baby's oil glands have matured enough to handle the hormones before then.
Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.