Is there any alternative for isotetrinoin /accutane in nodular acne ?

Maybe: Aggressive combinations of oral antibiotics and topical medicines are sometimes effective, but you risk developing more scarring during that time if they fail. Accutane is the most reliable option.

Yes: Hello, Traditional texts speak of the failure and risk of topical methods for deeper cysts and nodules. However, new amplified approaches of topicals can predictably, and reproducibly inactivate nodular acne without accutane. A strategic approach requires a great patient/practitioner relationship. Cortisone injections during the treatment can minimize scarring from large individual lesions.