Brief Answer:
Continue Krimson-35, clinical pictures required

Detailed Answer:
Hello XXXX,
Thank you for posting on HealthcareMagic.

I can understand your concern regarding Acne and i will try to answer your queries in best possible way.

Acne, as you must be aware is a pretty common condition affecting majority of teenagers and young adults.
It is caused chiefly due to hormonal influence and clogging of pores and followed by infection and inflammation.

It has tendency for recurrence and complications like pigmentation(dark spots) and scarring, thus mandates proper treatment at the earliest.

I can see the routine medications of acne has not helped you much and
since you are having PCOD which actually worsens the situation as it makes your hormonal profile unstable and thus contributes to your acne.
Acne due to PCOD is little difficult to treat compared to people with normal hormonal profile.
Thus I will have to figure out a treatment layout keeping in consideration your PCOD.

Treatment usually depends on severity of acne and the accurate grading is not possible until actual examination. Therefore I insist you to post some good clinical pictures so that I can gauge the severity and thus plan a treatment.
You can send pictures to YYYY@YYYY with the subject titled 'ATTN Dr Hardik Pitroda'.

As you are already taking KRIMSON-35 which contains ethinyl estradiol which will help in controlling your hormonal imbalance, I will suggest you to keep continuing the medications.

Hope you will revert soon with the photographs.
Thanking you
Dr Hardik Pitroda
M.D Dermatology

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Brief Answer:
Oral isotretinoin, topical retinoids, Peeling

Detailed Answer:
Hello XXXX,
I have reviewed your clinical pictures.
You have got pretty higher grade of acne with pigmentation and scarring.
I would recommend you to consult a certified dermatologist for proper management.
If I was your treating dermatologist, I would treatment you in following manner.
I would prescribe you with oral isotretinoin, starting with 20g once daily for 4 weeks and then consider tapering to thrice or twice a week for another 4-8 weeks.(Note: While on this drug conception should be strictly avoided till 3-6 months after stopping of drug)
I would also give you oral clarithromycin 250 mg twice a day for 6 days and repeat the such 3-4 cycles/pulses every 15 days.
For local application, I will prescribe you antibiotic cream like Clarithromycin or clindamycin or nadifloxacin twice a day over full face.
Also at night time I would advise a very effective and novel combination of benzoyl peroxide and adapalene (EPIDUO gel)over full face.
Make sure you take one pea-size amount of any topical cream/gel and apply over full face very gently without rubbing.
Apart from these home-based treatment, I would strongly recommend some clinic -based treatment.
At clinic, you can get series of chemical peels by a certified dermatologist. Chemical peels will improve your acne, pigmentation and scars and thus provide you good aesthetic look. In your particular case, I would go for Jessner peel and glycolic peel alternately for 6-8 sessions, though the choice of peel and sessions varies from dermatologist to dermatologist.
Use a good gentle cleanser like Cetaphil cleansin lotion to rinse the face.
These medications can occasionally dry up your skin and lips thus I would suggest use of good quality moisturizer like Cetaphil DAM or Hymos moisturizing lotion for face and some good lip balm like NMFE lipcare for lips.
Use gel based sunscreen like Suncote sunscreen gel before going out in sun.
Avoid use of oil-based make up and foundation.

Also keep continuing KRINSON35 for control of hormonal imbalance.

Take plently of fruits and vegetables and try to limit intake of refined sugars/ carbohydrates and fatty food.

I am very sure with this regimen you will be fine but with active follow up. Thus I would insist you to follow up with your status after 3 weeks. You can reach me directly via my profile page.

Let me know if you require any assistance from my side.

Thank you and take care
Dr Hardik Pitroda

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