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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic Acne. Treated With Proactiv, Accutane. Stayed Clear For Some Time, Recurring. How Can I Reduce It Permanently?

Hi, I had suffered with severe acne for about 5 years, tried different products such as proactiv and other skin treatments. My doctor suggested accutane, and so, last year i took the drug and for about 4 months after, my skin stayed clear. But, my acne has come back, not as severe as it was but it still flares up. I am currently on antibotics and trying murad, a cleanser that my beauty therapist thought would do the trick. Do you have any idea of why im getting my acne back? and, what steps should i take from here? Go back on accutane and try again? Thanks.
Thu, 5 Jul 2012
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Internal Medicine Specialist 's  Response
Hu,
Welcome to HCM,
Have read your query, the surest route to success in treating acne vulgaris follows 3 steps. First, establish the type and severity of acne. Second, select medication appropriate for the patient’s condition and skin type. In general, patients with oily skin benefit from solutions or gels, while those with dry skin do better with creams, lotions, or ointments. Third, educate yourself about the disease, the different types of medications and their side effects, and expectations for improvement that are realistic. Realistic expectations should enhance compliance and lead to the successful resolution of a chronic debilitating disease. All of which result from a multifactorial pathophysiologic process in the
pilosebaceous unit: sebum production, follicular hyperkeratinization, proliferation and colonization
by Propionibacterium acnes, and the release of inflammatory mediators. The resulting lesions include noninflammatory open (blackheads) and closed (whiteheads) comedones, as well as inflammatory papules, pustules, and nodules. A variety of medications are available for the treatment of acne vulgaris. Note that most treatment regimens should be used for at least 6 to 8 weeks to judge their effectiveness before considering alternative treatments or adding other agents. Will recommend to visit your clinician or dermatologist before switching or trying any medications. Thanks
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Chronic Acne. Treated With Proactiv, Accutane. Stayed Clear For Some Time, Recurring. How Can I Reduce It Permanently?

Hu, Welcome to HCM, Have read your query, the surest route to success in treating acne vulgaris follows 3 steps. First, establish the type and severity of acne. Second, select medication appropriate for the patient’s condition and skin type. In general, patients with oily skin benefit from solutions or gels, while those with dry skin do better with creams, lotions, or ointments. Third, educate yourself about the disease, the different types of medications and their side effects, and expectations for improvement that are realistic. Realistic expectations should enhance compliance and lead to the successful resolution of a chronic debilitating disease. All of which result from a multifactorial pathophysiologic process in the pilosebaceous unit: sebum production, follicular hyperkeratinization, proliferation and colonization by Propionibacterium acnes, and the release of inflammatory mediators. The resulting lesions include noninflammatory open (blackheads) and closed (whiteheads) comedones, as well as inflammatory papules, pustules, and nodules. A variety of medications are available for the treatment of acne vulgaris. Note that most treatment regimens should be used for at least 6 to 8 weeks to judge their effectiveness before considering alternative treatments or adding other agents. Will recommend to visit your clinician or dermatologist before switching or trying any medications. Thanks