What is the next recommended treatment for an 18-year-old with persistent acne despite using topical treatments?

In cases of persistent acne in adolescents, particularly when topical treatments have not yielded satisfactory results, the next step often involves systemic treatment options. Isotretinoin, or Accutane, is a powerful oral retinoid used for severe acne, especially when other treatments fail, but it has significant side effects and is typically reserved for cases that meet specific criteria, such as severe cystic acne or when a patient's quality of life is significantly impacted.

Tetracycline, specifically oral antibiotics like doxycycline or minocycline, is a common choice for treating moderate to severe acne due to its anti-inflammatory properties and ability to reduce acne-causing bacteria. This makes it a logical option for an 18-year-old experiencing persistent acne. While it can take several weeks to see improvements and is often used in conjunction with topical treatments, its effectiveness in addressing the underlying bacteria and inflammation associated with acne makes it a strong contender for further management.

Clindamycin topical solution is effective for some acne cases but may not provide the systemic relief that is sometimes necessary for persistent acne. Minoxidil is primarily used for hair growth and is not a treatment for acne, making it an unsuitable choice in this context.

Therefore, the appropriate escalation of treatment in this case