Severe pustular acne is mainly characterized by nodules and cysts, and requires systemic medication combined with topical medication, supplemented by physical therapy if necessary. 1. Systemic medication: Severe acne requires oral isotretinoin, and those with strong inflammatory reactions can first take minocycline and doxycycline orally, and then use isotretinoin after the inflammation is reduced. Prednisone can be used in moderation for severe polymerized acne and fulminant acne. 2. Topical medication: antibiotics such as fusidic acid cream and erythromycin ointment can be used topically, or benzoyl peroxide and retinoic acid can be used topically. 3. Physical therapy: For patients who are not satisfied with the efficacy of topical and oral medications, photodynamic therapy can be combined. Specifically need to go to the hospital, medication should be used under the guidance of the doctor, avoid self-medication.