Isotretinoin

• A commonly prescribed aggressive form of oral treatment is Isotretinoin. Isotretinoin is an extremely potent chemical that is used as a last resort treatment for individuals suffering from moderate to acute acne that is not improving through other treatments. While Isotretinoin has a reputation for not only clearing current outbreaks but also eliminating outbreaks for life, the drug has several serious side effects that require individuals who are taking it to remain under careful physician care. These side effects include raising triglyceride and cholesterol levels, raising liver enzyme levels and triggering irritable bowel syndrome. There have also been some accusations that Isotretinoin causes depression and suicidal thoughts, though studies have not proven this. The recognizable brand name associated with Isotretinoin is Accutane.
  
  

Microdermabrasion

• Some rigorous dermatological procedures, such as microdermabrasion, are an option many who suffer from stubborn or severe acne entertain. Microdermabrasion buffs the skin's surface with microscopic crystals to polish away the top layers and remove them with a small vacuum. The idea is that by removing the layers that are affected with acne will remove the infection all together. Microdermabrasion can be harsh and irritating for sensitive skin, and typically leaves patients of all skin types red, oily and even swollen for several days after the procedure.
  
  

Chemical Peels

• Chemical peels are also employed to combat acne aggressively. Strong substances, such as glycolic acid or salicylic acid, are brushed onto the skin to burn away the top layers of skin, eradicate impurities and deeply unclog pores. To replace the burned top layers, the dermis must grow new skin cells and thus replace the acne ridden old cells with fresh, clean skin. However, chemical peels are extremely abrasive and commonly cause painful side effects including skin blistering, scaling, infection, redness, scabbing, scarring and discoloration.
  
  

Resurfacing

• Skin resurfacing uses laser light to demolish the top skin layer and raise the temperature of mid-level skin layers to a sterilization point. Like chemical peels and microdermabrasion, resurfacing removes the upper layers to encourage the healthy and clean growth of new skin cells. However, unlike the other two treatments, resurfacing works to eliminate deep rooted acne infections by warming the skin to a point where it can eradicate the bacteria itself. For resurfacing to be effective it must be repeated several times over a short time span and is an expensive procedure.
  
  

Surgery

• In extreme cases, surgery may be used to treat acne. Some surgery treatments, such as a punch biopsy, are minimal outpatient procedures that are used to remove small portions of severely affected areas. Stitches are used to close cover the portions and encourage the healthy regrowth of skin. Another rare but aggressive form of surgical treatment is skin grafting, where a dermatologist removes infected and scarred facial tissue and replaces it with skin from behind the ear, back of the neck or abdomen. Depending on the extensiveness of the grafting, this procedure may require inpatient care.