There are several drugs used in the treatment of cystic acne, including those that battle the acne itself and those that work to diminish the scarring that can result from cystic acne. Finding the drug that is right for you can be challenging, as first -ine treatments aren't always effective, and stronger medications often have serious side effects.

First-line Treatments 

There are several prescription medications available to fight cystic acne. A dermatologist will likely start you on a regimen of oral antibiotics such tetracycline, minocycline, or doxycycline. Less commonly prescribed antibiotics include clindamycin, erythromycin, or sulfonamides. Any of these treatments can cause mild side effects such as dizziness, upset stomach, and light sensitivity. Newer treatments such as laser therapies and chemical peels have been shown to be effective, especially when used simultaneously with other acne treatments. These treatments can cause temporary discomfort, redness, and burning of the skin. 

Stronger Medications

If oral antibiotics don't work, your dermatologist may prescribe Isotretinoin, more commonly known as Accutane. Accutane is effective against even the most severe cystic acne, but it does carry the danger of severe side effects, the most dangerous of which is the potential for severe fetal birth defects if taken by the mother during pregnancy. The risk is so serious that female patients taking Accutane in the US are required to be monitored by the Food and Drug Administration to reduce the risk of pregnancy. Other side effects include drying of the mucus membranes and skin, muscle tenderness, photosensitivity, and decreased night vision. Accutane may also cause an increase in triglycerides, cholesterol, and liver enzymes. A link to increased depression and suicidality has been suggested, but not proven. 

Treatment for Cystic Acne Scarring

There are several treatment available to reduce the scarring that can result from cystic acne. Collagen or fat can be injected into the site of the scar to fill in missing tissue and make the scar less noticeable. The effect of these injections is only temporary however. For more severe scarring, dermabrasion can be used to remove the top layers of skin. This can erase shallow scars and reduce the appearance of deeper scars. Laser resurfacing can also be used to remove the top layers of skin to achieve the same effect. The heat involved also induces the skin to regenerate more quickly. Several treatments may be necessary to achieve the desired results.