Hi. Thanks for posting your concern at HCM For severe acne OR for acne unresponsive to traditional anti-acne medications, Isotretinoin can be started. It the only drug which offers any chance of long term cure and after a full course of isotretinoin significant number of people never have a recurrence of there acne. It should be taken under the supervision of a dermatologist because of certain lab tests which are to be done before and during treatment with isotretinoin. Topicals like clindamycin gel and benzoyl peroxide gel should be continued nevertheless. An oral antibiotic, preferably Azithromycin would help in controlling inflammatory pus filled acne take care regards