What is the best method to get rid of severe acne permanently?

There are many good treatments for acne vulgaris. These include topical treatment, oral antibiotics and oral isotretinoin.

Among these treatments, oral isotretinoin is probably the most effective treatment for controlling severe acne and the majority of cases of severe acne can be well controlled.

The recurrence risk of acne upon discontinuation of isotretinoin is also generally lower than with other treatments.

It does have some side effects including dryness of the lips, teratogenicity, photosensitivity and can affect the liver enzymes and lipids.

It is best for you to see your dermatologist/doctor for assessment to determine your suitability for the treatment.

You definitely sound like you need a combination of oral and topical therapies.

Oral isotretinoin is definitely something to consider, although it has side effects. Your doctor can better discuss the risk-benefit issues with you.

Topical chemical peels in light concentrations regularly should help you dry the pimples. Do consider applying some topical antibiotics as well.

Some doctors also consider adding oral erythromycin to reduce the "purge" of isotretinoin in the initial stages.

Severe acne usually involves pus filled lesions and angry red bumps. There is also sometimes involvement of the chest and back.

Acne prone skin occurs when the oil glands over-react to normal stimulli. I advise a few cardinal rules to follow.

Your diet can influence how much your acne flares up. Caffeine (in coffee and tea) stimulates your oil glands. The more caffeine you take, the worse your flare-ups will be.

Exposure to extreme hot or cold environments means that blood flow to the skin increases. This will also cause your acne to flare up.

Taking excessively hot or spicy food or drinking alcohol, again, increases blood flow to the skin and can lead to flare ups.

Smoking impairs your healing and prolongs your recovery time post-acne flare-up.

I would consider starting on oral isotretinoin. This will effectively re-programme your oil glands permanently. You can expect to be on this treatment for between 6 to 9 months. This will also help to improve some of the scars. This method however can be costly and is associated with side effects such as dry and peeling lips. Consult your doctor first before starting on any treatment.