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Dr. Andrew Rynne

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Chronic cocaine user. Have ache and oily skin. Used retin A and benzoyl peroxide. Any advice?

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Dr. Sudarshan

Dermatologist

Practicing since :2005

Answered : 1391 Questions

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Posted on Tue, 18 Dec 2012 in Drug Abuse
Question: Hi Doc, I've been a chronic cocaine user for a year now. I would like to know if it really causes bad skin. My face isn't really breaking out with acne but I always have these whiteheads and my skin is so oily eversince. Ive used retin A and benzoyl peroxide but I still get them and my skin is constantly super oily. I hope you can help with my queries and offer advise. Thank you
doctor
Answered by Dr. Sudarshan 16 hours later
Hi XXXXXXX,

Thanks for writing in.
Acne and oily skin are related to each other.
The excessive oil secretion by sebaceous glands causes acne and white heads.

You can use retin and benzyl peroxide.
The most effective drug in your case can be Isotretinoin.It will reduce acne as well as oily skin.It has good effects even in low dosage like 10mg per day.You can discuss the option of isotretinoin with your dermatologist.

Also chemical peeling with salicylic acid can be a good option.
You can use antiacne face wash twice or thrice per day.Cetaphil oily skin cleanser is excellent option for acne prone skin.

Hope this helps.

I will be available for any further follow up.

Regards.
Dr Sudarshan.
MD dermatology.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 4 hours later
I have always had oily skin and was occassionally getting blackheads on my nose and able to extract them to clear the pores. Haven't had severe acne since I was a teenager. Since years I have been using Stieva-A Forte Tretinoin Cream (.1%) and occasionally benzoyl peroxide when I get pimples but generally my skin had always been clear. But the tretinoin and benzoyl peroxide didn't stop my face from being too oily.

Lately since I started using cocaine my skin became bad--pimples and a lot of whiteheads that I cannot extract. mostly on my forehead, below my eyebrows, all over the nose even on my nose bridge and chin. Could cocaine cause these? Are there other harmful effects of cocaine on the skin? How does cocaine age you? I have noticed and people have noticed I have aged. If I stop cocaine will the ageing be reversed and my skin to clear up?

With these whiteheads (no red pimples or pus filled pimples) and blackheads only do you still recommend isotretinoin? How long shall I take it and it is once a day? How long will it take for my skin to clear up?
doctor
Answered by Dr. Sudarshan 5 hours later
Hi again,

Cocaine use does not cause acne or ageing skin,It can cause decrease immune system and cause increase susceptibility to different skin infections.
Also majority of times cocaine contains number of impurities these may cause depressed immunity,hormonal changes and ageing.
Some of these changes are reversible after stopping the drug.

You can take Isotretinoin in low dosage and it will help in oily skin and whiteheads.
Atleast 3 months course is essential.You will notice visible results within 2-3 weeks of starting the drug.

Hope this answers your questions.

Regards
drSudarshan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 3 days later
Thank you and I am relieved to know ageing can be reversible after stopping cocaine. How long will I see the result after stopping cocaine?

My dermatologist said I am not a candidate for Oral Isotretinoin because it is for nodule cystic acne and not for whiteheads and blackheads :( She said to keep using Stieva A tretinoin but I have been using it for years and still oily :( It just make my skin peels occasionally.

Doc, since 2 days my nail on my left pinky finger felt loose so I removed the nail polish to see what's going on. There is dark yellowish/brownish thickened nail on the center and the half top layer of my nail came off. I think this is nail fungal infection underneath the nailbed. What could have caused this and will it go away on its own once the nail grows? Or it can spread? Or it has to be treated? What kind of treatment to make this go away?

And if I pick my nose using that pinky can the fungus underneath my nailbed spread inside my nose? I will attach a photo of my pinky. I hope you can help.

doctor
Answered by Dr. Sudarshan 49 minutes later
HI again,

The description of nail suits the diagnosis of fungal infection or onychomycosis.

It occur due to contact with water and having wet work.Caused by fungi known as dermatophytes.
Its better to get it treated as it can spread to other nails or body parts.
It will not spread to nose but can spread to the skin of the body.

Antifungal drugs should be taken for it for 3 months for cure.
They can be fluconazole 1 /week or terbinafine for 7days per month.
Topical antifungal like ciclopirox oleamine should be applied daily.

Hope this helps.

Regards
DrSudarshan
MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 2 days later
thank you doc,


I filed the swollen yellowis/browshih lump on my nails and seems gone except for one line in the center with brown color. does this mean it has gone away and I dont need to take medications? or i can skip the oral medication and just apply antifungal cream?


secondly, is steiprox shampoo advised by my dermatologist few months ago will help with my face?
doctor
Answered by Dr. Sudarshan 2 hours later
Hi again XXXXXXX,

You can apply antigungal cream and skip oral medication if only single brown line is remaining.

Steiprox shampoo is useful for dandruff and seborrheic dermatitis will not be helpful in oily face.

You can use Cetaphil oily skin cleanser by Galderma it will be helpful for you.


Regards
DrSudarshan


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 43 hours later
ok I read that Stieprox shampoo has ciclopirox oleamine. can i use this for my nail fungus?
doctor
Answered by Dr. Sudarshan 1 hour later
Hi XXXXXXX,

Ciclopirox oleamine is a antifungal and can be used on nail fungus.Only it would be difficult for application over the nail.The nail lacquer is a better option.

Hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 22 hours later
thank you. I shall apply the cicliplirox oleamine then. will it be faster to get rid of the nail fungal infection by filing it to make it thin and reduce the bulk?
doctor
Answered by Dr. Sudarshan 7 hours later
Hi again,

You can apply Ciclopirox oleamine over nails.
The turn over time for fingernails is 3 months so the application must be continued for atleast 3 months.It will slowly make it thin and reduce the bulk.

Hope this helps.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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