Cystic and nodular acne are arguably the most serious types of acne and can be the most difficult to treat. According to the Nemours Foundation, a children’s health organization, both cystic and nodular acne are the result of clogged pores that open very deep in the skin. These clogged pores can produce nodules, which are solid lesions lodged deep beneath the skin’s surface that are painful to the touch. Cysts are located deep in the skin as well and are filled with pus. Both nodules and cysts can lead to permanent acne scarring.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, cystic and nodular acne are not types of acne you should try to treat yourself since they both require the skill of a trained dermatologist.

A dermatologist may initiate a treatment regimen that includes a topical ointment and/or antibiotics. However, cystic and nodular acne do not always respond to these more conventional treatments.

In cases where other treatments are not successful, a dermatologist may prescribe Accutane to fight the bacteria that is causing the acne. Accutane, the brand name for isotretinoin, is manufactured in capsule form by Roche Pharmaceuticals. The product is manufactured in dosages ranging from 10 mg. to 40 mg., according to Roche. A typical course of treatment lasts 15 to 20 weeks and the drug has proven remarkably effective at clearing acne within that time frame.

Accutane is not for everyone. It carries the risk of psychological side effects, such as depression and psychosis, and also has been linked to bowel and liver problems. Pregnant women also can not take Accutane, as it has been linked to birth defects.

Accutane can be remarkably effective at treating acne that resisted other treatment plans. If you or a loved one begin taking the drug, be attentive for any emotional changes or mood swings and notify your doctor if any of these changes are noted.

Accutane comes with a certain level of risk, but the severity of some patients’ acne can make the risk medically acceptable in many circumstances.