Extremely severe acne does not always respond to treatment. Medicines such as antibiotics cannot safely be used for months on end and often stopping the medicine results in the spots coming back and the user can become resistant to the antibiotic so over time it does not work anymore. Over the counter creams are often caustic and very harsh to the skin which may irritate the acne and can cause premature lines. If the acne is very extreme it needs aggressive treatment, some of these treatments can contain retinoids and or birth control pills, side effects are likely and taking these medications long term can be harmful and again, the spots can return if the treatment is stopped. One treatment that is very effective is laser acne treatment.
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