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I started taking Minocycline (an oral antibiotic that kills bacteria infecting clogged skin pores) around April of last year. As you may or may not know, Minocycline is derived from Tetracycline and is a member of the Tetracycline family of antibiotics including doxycycline, tetracycline and oxytetracycline which all have a similar antimicrobial spectrum of activity against a wide range of gram-positive and gram-negative organisms. All of them are simply modified versions of the Tetracycline antibiotic created to overcome bacterial resistance. The problem arises when an antibiotic manufacturer modifies an existing antibiotic to overcome resistant bacteria, that resistant bacteria already possess the gene to resist and or destroy the antibiotic thus making it easier for the bacteria to gain mastery over the new antibiotic. This, in the case of Tetracyclines, doesn't necessarily render them totally ineffective; However, it does significantly reduce their effectiveness. Once resistance develops all offspring (daughter cells) of that bacterium inherit that resistance. Once the resistant strain is made, everybody who is infected with it will have a resistance problem. Basically it just gets worse. This is known as cross-resistance and it is frequent with the Tetracyclines. For the first 9 months the antibiotic worked wonders, it cleared my skin 100%; However, I became resistant to it around month 10 and everything came back. I'm now taking doxcycline (Member of the tetracycline family) and it's working; However, I am debating whether or not it's worth it to take this medication until my body becomes resistant to it and start back at step 1 with a face that looks like a pizza.

I have two choices: Accutane or another systematic approach using topical ointments and antibiotics

Accutane Pros:
Clears skin completely for years and is considered a cure.
Not an antibiotic
Convenient, 2 pills a day. No need for topicals.

Accutane Cons:
Very expensive
Possible, but not probable serious side effects such as depression, increased pressure in the brain leading to loss of hearing/vision (less than 1% of people experience these effects)

Antibiotics Pros:
Less expensive
Less serious side effects
Can clear acne for a given amount of time

Antibiotics Cons:
Bacterial resistance
Cross resistance to other antibiotics
When you become resistant it's basically useless

So what should I go on?

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