In a word, no. Cystic acne has shown us that its treatment goes beyond what we use topically to treat the normal papules and occasional pustules and comedones (blackheads and whiteheads). Once you have cystic acne, it’s very difficult to treat that with any kind of topical therapy.
I’ll usually start patients with an oral therapy with minocycline or doxycycline agents for acne. If these don’t work, then we go up from there. We also address the hormonal component in women, which we can’t really impact in guys. Ultimately, you may have heard of the medication called Isotretinoin or Accutane, which is our standard of care for severe recalcitrant cystic acne, We’ll prescribe these medications when scarring is getting worse and worse.
