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Suggest treatment for acne and pimples

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Posted on Tue, 2 Sep 2014
Question: Hello Doctor,

Ive started developing acne and pimples(severe) from the age of 14 and Im 30 now. Im still getting them but are mild(2-3 pmiples) now. Ive been to dermatologists for chemical peels (glycolic/salysilic) and recently I had taken a few sittings of RF micro needling however the acne comes back if I start discontinuing it. Also when ever i squeze my nose, i get some semi solid yellow stuff out of the pores and ive black heads too. Ive a very oily face. If i use toner(neutrogena) regularly, my skin gets dried out and darkens a bit. I use suncreen too in the morning and cetaphil os twice a day. clarithromycin gel n the pimples. My doctor is sggesting micro dermabrasion now and he says Ive sebaceous hyperplasia. Can you help me how i can take care of my skin and from acne worsening.
Another dermatologist suggested isotretinion pills but Im planning to have kids so i opted out.
Kindly help.
doctor
Answered by Dr. Hardik Pitroda (8 minutes later)
Brief Answer:
Pictures required for grading.

Detailed Answer:
Hello,
Thank you for posting on HCM.

Acne, as you must be aware 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 and scarring, thus mandates proper treatment at the earliest.

I can see that you have tried lots of treatment without much effect.

Treatment usually depends on severity of of acne and for the accurate grading you need a proper examination or atleast you can share your pictures , so i can advise you in a better way.
You can mail pictures to YYYY@YYYY with subject titled: ATTN Dr Hardik Pitroda.

Once I will review your pictures I will formulate a proper treatment regimen for you.
Hope you will revert soon.
Thanks
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hardik Pitroda (31 hours later)
As requested, please find the pics attached for further reference.
Also, when i have acne breakout i use azithromycin 500 for 3 days along with clarithromycin gel in the night and clindamycin gel in the morning over the pimples.

When i go out in the sun(to office), i apply faceguard 30spf gel on the face.
I generally dont like the sunscreens that leave white residue on the face.
Faceguard 30 spf doesnt leave a white layer.

Please suggest any treatment or any procedure for the same.
doctor
Answered by Dr. Hardik Pitroda (1 hour later)
Brief Answer:
Oral isotretinoin, chemical peels

Detailed Answer:
Hello,
Thank you for the images.
I have reviewed your pictures and as there are few inflammed lesions of acne with scarring I would consider it as grade 3 acne,which is the most severe form of acne.
Nothing to worry as you will be fine.
After review of your treatment history, I have formulated the management regimen for you as highlighted below.
1. Oral isotretinoin is a must for better control of acne. Isotretinoin is very safe in males and there are no reports of its use in male affecting the pregnancy and fetus.
Thus relax and start Isotreinoin as advised by your dermatologist. In my patients I generally advise 30 mg alternate day for few months.
2. Take oral clarithromycin 250 mg in pulse therapy i.e one tablet of 250 mg twice a day for 6 days and then repeat such cycle after a gap of 10-15 days and total of 4 such cycles would be sufficient.
3. Apply clarithromycin gel twice a day over full face and a gel containing benzoyl peroxide and adapalene (EPIDUO gel) over full face at night.
4. Apart from these home- based treatment, i would strongly recommend clinic based procedures like chemical peeling. Many peels are available in market for acne but in your case I think some strong peel like Jessner peel or a cocktail peel of salicylic acid, mandelic acid and azelaic acid will do really good.
For sebaceous hyperplasia you can get a few sessions of dermabrasion or I would prefer abrading it with a radiocautery.
5. Continue using the facewash and sunscreen.
I am sure with the above regimen, you will be fine in few months.
I would insist you to keep me posted about your condition so that I can help you further along the management.
Let me know i you require any more assistance from my side.
Thanks
Take care
Dr Hardik Pitroda
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Hardik Pitroda

Dermatologist

Practicing since :2010

Answered : 1489 Questions

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Suggest treatment for acne and pimples

Brief Answer: Pictures required for grading. Detailed Answer: Hello, Thank you for posting on HCM. Acne, as you must be aware 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 and scarring, thus mandates proper treatment at the earliest. I can see that you have tried lots of treatment without much effect. Treatment usually depends on severity of of acne and for the accurate grading you need a proper examination or atleast you can share your pictures , so i can advise you in a better way. You can mail pictures to YYYY@YYYY with subject titled: ATTN Dr Hardik Pitroda. Once I will review your pictures I will formulate a proper treatment regimen for you. Hope you will revert soon. Thanks Dr Hardik Pitroda