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Have severe acne on face. Suggest treatment?

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Practicing since : 2005
Answered : 1919 Questions
Hi doctor,

I have sever acne on my face ..consulted doctors but no use.
please advice me some skincare specialists or treatments.
Posted Sat, 22 Jun 2013 in Beauty
Answered by Dr. Johny Chacko 45 minutes later
Welcome to healthcare magic
I need some more details from you about the duration of acne, what all treatments you have already taken for it and what are you taking at present.

You have a feature to upload the photo of your acne lesions at the right side of the query page, please utilize that so that I can assess the severity and answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'.

Acne is due to adolescent hormones and it may continue till that hormonal influence is over. It might be 28 yrs or 30 yrs or even 32. We need to control the severity till then so that it would not leave behind any scars.

Avoid creams on your face. Avoid oil on your scalp. Diet is important. Avoid milk and milk products like cheese, chocolates, sweets, sugary foods and drinks, french fries, pizzas etc. Eat a lot of fruits XXXXXXX in vitamin A ( anything which has lot of yellow, orange or red color).

Waiting for further details from you so that I can plan a good treatment regime.
If you have any further questions I will be happy to help.
Wish you good health

Above answer was peer-reviewed by
Follow-up: Have severe acne on face. Suggest treatment? 3 minutes later
Thanks for the reply doctor.
Here are the few details about my treatment.
I have consulted dermatologist in XXXXXXX skin clinic and went through harmonal tests and all,results were pretty fine.
so doctor suggested me to take Acne management treatment and prescribed DOXT tablets and Aziderm ointment on active pimples.
following that have taken 4 salsylic and 1 glycolic peel.
but occurence of pimples havent reduced .

hope information is helpful.
Answered by Dr. Johny Chacko 39 minutes later
Welcome back XXXXXX,

The treatments you have taken are approved treatments for acne. But the results are subjective. In some the above treatment will be adequate, in some it would not work. But do not be disheartened, because there are a lot of other treatments which can be tried.

You have not uploaded the photo, I need not see the entire face, only one side of cheek with acne lesions will do if you are worried about privacy.

Do you have pus filled lesions, cysts, nodules or only small black heads and white heads ?

Salicylic acid peels are good adjuvant treatments which can be continued along with medications and gels.

I would recommend a gel containing Benzoyl peroxide 2.5% and adapalene 0.1% (Epiduo gel) which give very good results. Apply this in the evening for 4 hours and wash it off. Get this prescribed by your dermatologist. I will advice about oral tablets once I have the details.
Waiting to hear from you.
Take care
Above answer was peer-reviewed by
Follow-up: Have severe acne on face. Suggest treatment? 12 minutes later
Hi doctor,

I have uploaded very recent pic of mine and you can see the acne scars on my cheeks and fore head.
and major problem lies with marks on my face.
I do have pus filled lesions .

If you need any more details I can provide you.

Answered by Dr. Johny Chacko 15 hours later
Thanks for uploading the picture.
More than active pimples what looks prominent is the pigmentation left behind by pimples, we call it post inflammatory hyper-pigmentation. You also have few active nodules and comedones.

If you can afford salicylic acid peel you may continue it every 2 weeks. It will reduce oiliness and reduce new break outs. It will also help to lighten the pigmentation.

As doxycycline can make your skin more sensitive to sunlight and can worsen the pigmentation, I will recommend Tablet Azithromycin 500 mg once a day for 3 consecutive days. Repeat it the same three days the next week. Continue this treatment for at least 2-3 months.

Avoid excessive sunlight exposure. I will recommend you to use a sunscreen in a gel form, not lotion or cream. Eg (Ansolar gel cream or Suncote gel) . Apply it half an hour before you leave for work and re-apply every 3 to 4 hours.

Please do not touch the pimples as it will make it darker.

A combination of Adapalene 0.1% and Benzoyl peroxide 2.5% is available( Epiduo gel) which you can apply over pimple prone areas in the evening for 4 hours and wash it off. In my experience this gives better results than Aziderm.

A face wash containing 2 % salicylic acid (eg: Speelac face wash) can be used twice a day to wash your face.

A lightening gel containing kojic acid (eg:Kojivit gel) can be applied at night over marks and not active pimples before you go to sleep.
Get all these prescribed by your Dermatologist.

Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health.
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