Brief Answer:
oral retinoid would be the next option

Detailed Answer:
HI, thanks for using healthcare magic

Acne is due to four factors: (1) plugging of the hair follicles due to some skin changes within the follicle
(2)excess sebum production- sebum is an oily waxy substance made in the glands of the skin
(3)presence of a particular bacteria linked with acne
(4)inflammation

The best treatments address most of these factors to get rid of the acne.

Antibiotics are part of effective therapy. Since you have already used these then the next option , since it is severe would be retinoids.

Retinoids can be oral or topical. In the case where it is severe, your doctor may opt for oral retinoids.
They would decrease sebum production, reduce inflammation and also have an effect on the bacteria. Accutane is the oral retinoid used.

You may want to discuss this option with your doctor.

I hope this helps, feel free to ask any other questions

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Brief Answer:
may be able to get generic

Detailed Answer:
HI

Instead of using the brand name version of the medication, you can see if it is possible to obtain the generic isotretinoin. Generics are usually cheaper than the brand products.

If this is not possible then you may have to use other types of medications.

There are some topical agents that may work for you.

You can try to see if they have a positive effect, it can take 2 to 3 weeks for any significant effect to be seen.

The names are (1) clindoxyl or you can use (2) epiduo gel

Clindoxyl is a combination of clindamycin and benzoyl peroxide

Epiduo is a combination of adapalene and benzoyl peroxide.

Only one is needed. These are applied in small pea sized amounts to the face and other affected areas at night

Please feel free to ask any additional questions

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