Oral treatment is indicated in subjects with moderate and severe acne. It is also used in  those patients with mild acne who are psychologically very depressed and in those for whom employment is difficult because of their acne, even if the acne is relatively mild.

Patients who require oral therapy. Patients with moderate or severe acne Patients who are depressed, even if the acne is mild Dysmorphophobic patients Patients with hyperpigmented macules (particularly patients with coloured skin) Patients with acne excoriee Patients with Gram-negative folliculitis develop postinflammatory macules which may last for many months; therapy with oral therapies is indicated in such patients - again even if the acne is mild.

 

  Once initiated, oral  therapy  must  be given for  a minimum of 6-8 months and this  should be emphasized  to the patient. Surveys have shown very clearly that  60 per cent of patients  may be  given  totally inadequate  oral   therapy, such  as  a  course for one month.

  The three main groups of oral therapy in acne are antibiotics,  hormones  and  retinoids.  Antibiotics are usually the first line of oral therapy.