You are quite right that genetic and hormonal reasons are the 2 more common causes for acne. At the same time, there are also other possible causes that may have aggravated your conditions, making your treatment less effective.
While Isotretinion and hormonal treatments are both highly effective, these 2 treatments are often done in combinations. First to prevent pregnancy while on isotretinion, second to potentiate the result. Once the acne is under control, I may remove the isotretinoin once it achieve the targeted dosage based on your weight.
Since both treatments have their own risks and benefits, it is important to consider them carefully before starting the treatment and also to monitor potential side effects. It is also possible to add in certain gentle light therapy or even light chemical peel, depending on your skin condition after starting the treatment. It has to be monitor carefully to prevent unwanted side effects. Excessive treatment may increase the risk of complication.
Do go through your skincare regime with your doctor as it is an important component of the treatment. While some cleanser may help to reduce the clots in oily skin, excessive treatment may dry the skin and trigger more production of the oil(sebum) as a protective mechanism. It is also crucial to have the right moisturiser to keep the skin moist but not clot the skin. Please use lots of sunblock while on isotretinoin now. Your skin is now more sensitive than before.
Just because you are now on isotretinoin, you should not abandon the topical treatment. Do continue with a appropriate topical treatment like differin for better result.
In case you are wondering, diet may also affect the outcome of your treatment. While diet is not the cause of acne, some studies notice that taking a diet with high gylcaemic index (e.g. sugar, cake, soft drink) often aggravates the acne. Some also notice that diary products, especially skim milk, may have similar bad effect.
By taking care the various possible causation and aggravating factors, hopefully, you can achieve better control and be acne free. Cheers!
Regards,
Dr Elias Tam
