Brief Answer:
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Detailed Answer:
Hi XXXXXXX
Thanks for writing to us.
I can totally understand your concern.
I know how frustrating it is when you have tried almost everything available to treat your skin condition.
I have seen the images attached.

Now to treat your skin condition, I would advise that you take single step at a time ie firstly control your active acne lesions and then start treatment for marks and scars. Now the treatment needs to be continued for long. So have patience and be compliant to advised treatment.

Firstly to treat acne,
Use cetaphil cleanser to wash face twice daily.
Use a mild moisturiser meant for acne prone skin- cetaphil or physiogel or acne moist in morning or whenever skin feels dry
Use any anti acne soap to bathe like acnex or dermadew acne or Azac etc
Orally start tablet azithromycin and isotretinoin. Isotretinoin is a wonder drug for acne, helping in resolution of lesions and preventing further flare ups but has to be taken cautiously. One should not get pregnant while being on it and avoid pregnancy even after two months of stopping the drug. So for married females it is mandatory, to maintain strict contraception. As these are prescription drugs, so please consult your dermatologist for its prescription. Isotretinoin reduces acne, reduces oiliness and improves skin texture. it induces dryness as its common side effect.
Also get a blood work done to check your hormonal profile and rule out polycystic ovarian disease. If in case, any hormonal disorder is there oral contraceptives can be started. OCPs too help in control of acne.

Topically apply clindamycin gel in morning and adapalene gel in night.

Hopefully with these steps, your acne will improve in one or two months time.


Now once acne resolves for marks and scars start microdermabrasion with or without peels. Topically many pigmentation reducing medicines are available to reduce marks like Kojic acid, Azelaic acid etc.


Hope this would help you out.
Take care

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Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing back.
Please accept my apology for delayed response
Now with the details you have provided and after looking at the images, you may start with these
Use cetaphil os cleanser to wash face. Apply cetaphil moisturiser to tackle dryness.
take doxycycline 100 mg two times in a day
apply adapalene benzoyl peroxide gel in night, only over acne lesions( deriva BPO/ epiduo/ peroduo)

Follow these atleast for three to four weeks. Once lesions clear, apply tretinoin cream full face for one hour every night to prevent recurrence.

Hope this would help you out. Once acne clears you may take treatment for scars and marks.
Take care

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