Which medication class is typically used for treating severe acne vulgaris?

Oral isotretinoin is a medication class that is primarily used for treating severe acne vulgaris, particularly in cases that have not responded to other treatments. It is a powerful oral retinoid derived from vitamin A and works by targeting several key factors involved in acne pathogenesis. These factors include the reduction of sebum production, normalization of hyperkeratinization, anti-inflammatory effects, and antibacterial activity against Propionibacterium acnes, the bacteria primarily responsible for acne development.

Oral isotretinoin is typically reserved for patients with nodular cystic acne or when acne has led to scarring or significant psychological distress. Due to its efficacy, it can often lead to long-term remission of acne, distinguishing it from other treatments that may only provide temporary improvement. While other options, like topical retinoids, systemic antibiotics, and hormonal therapy, can effectively treat acne, they are generally more suited for milder cases or specific types of acne, or used in conjunction with other therapies rather than being the first-line approach for severe cases.