Suggest treatment for acne on back, shoulders and chest

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Posted on Thu, 30 Oct 2014 in Acne
Question: I m suffering from Acne problem as per doctor has diagnosed. Acne started at my back, then on shoulders, then on my neck and chest and at last (current) on my face. These are small boils some red and some with whitish puss. These boils dry up after few days. This problem is from about last 45 days. Another important problem i have is of Tenia Versicolor (White or Pinkish Patches) on my back and shoulder. This problem of Tinea versicolor is from last 8 years for which doctor suggested several Gells and One cream - Fourderm of Cipla Company. This was fruitful only till i was using that. After that it again started. I continued this treatment for almost 1 yr. In previous month i again started using same fourderm cream for patches. Now very minor patches but problem of Acne started on different organs as mentioned above. I m 23 Yrs old
Height: 165 cm
Weight: 85 Kg
Diet: Veg

As per Doctor's suggestion

1. Its going to take very long time (Several courses) to get complete treatment.

2. 1st Course (for 4 days)
a. Blood test for sugar level (Report NIL)
b. Azithral 500
c. Dexamethasone tablets IP
d. Aquasol A

(Next 4 days)
a. Levofloxacin Tablets IP 750 mg
b.Cefixime Dispersible Tablets 200 mg
c. Prednisolone Dispersible Tablets
d. Vitamin C Chewable tablets

3. 2nd Course (Homeopathic medicines) for 3 months -
a XXXXXXX Mur
b.Thuja
c.Antim Crud
d.Acid Nit
(Continued these medicines only for 7 days )

4. 3rd course (for 8 days)
Consulted another specialized dermatologist on recommendation of my family Doc.
a. Fluconazole Capsules I.P. (Syscan 200)
b. Minocycline Hydrochloride Modified release Capsules(Minoz OD 100)
c. Clindamycin nicotinamide gel
d. Adapalene gel

5. 4th Course (For 7 days)
a. Lynx (250 Mg)
b. Flexon ibuprofen paracetamol tablets
c. Acnesol Gel
d. Calamine+aloe vera+light liquid paraffin lotion

(For next 7 days)
a. Ibuflamar P ibuprofen paracetamol tablets
b. doxycycline and lactic acid bacillus capsules
c. Acnesol Gel
d. Calamine+aloe vera+light liquid paraffin lotion
e. Levocetirizine tablets ip 5mg
f. Glintra (benzoyl peroxide 2.5% Anti Acne cleanser Bar)

Called after 3 days(Thursday)

Please Help...
doctor
Answered by Dr. Suresh Heijebu 1 hour later
Brief Answer:
Drug modification needed strongly.

Detailed Answer:
Hi Sir,

I have carefully read your query and understand your concern.

To begin I would like to appreciate truly for the way you have presented your query. This is most arguably the best presentation by a user on this portal I witnessed so far.

You seem to have Severe resistant/recalcitrant nodulo cystic acne. For a better clinical response, I would like to advise the following;

Instead of adaplene, Isotretinoin a systemic steroid can be supplemented. This is highly effective in severe recalcitrant acne vulgaris. Retinoids should always be the part of the treatment.

Isotretinoin should be initiated in doses of 0.5mg/kg/d for 4 weeks and increased as tolerated until a cummulative dose of 120-150 mg is achieved.

Continue using Oint Glintra, Calamine, aloe vera lotion and Fourderm ointment without fail.

Antibiotics like Daptomycin can be substituted for the above antibiotics you earlier used but only after culture results.

Antifungal antibiotics like terbinafine 250 mg twice a day for 14 days to prevent relapse of Tinea versicolor.

Note - All the drugs mentioned should be used only under strict medical supervision.

Also avoid junk foods and strictly follow low glycemic food.

Skin lesion cultures are needed to rule out gram negative folliculitis are warranted if the patient does not respond to treatment or if the improvement is not maintained.

This can help to institute specific and the required antibiotic which is the vital step in the overall management of your case.

I hope this info is helpful to you,
Post your further queries if any,
Thank you
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
Dr.
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3657 Questions

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