This patient presented with very severe acne. We had some trouble getting retinoids approved in the beginning, but got them through after submitting for authorizations. The parents do not want to use accutane, so I’m trying to get her clear with extractions and other medications. Sometimes you have to adjust your treatment protocols when your first or second line treatments are not available to use. This is not uncommon, luckily we have many options when treating acne. More extraction sessions coming soon! Thanks to the patient for sharing her journey! MrPopZit