Brief Answer: Topical antiacne gels+Oral antibiotics/retinoids Detailed Answer: Hi. Thanks for posting your concern at HCM You have mentioned 2 concerns over here: Acne and Post-acne Hyperpigmentation/black spots Acne is a very common problem in young. Acne commonly involves face, trunk, chest and shoulders (all these areas are rich in sebaceous glands). Treatment of acne required diligence and patience both on the part of the patient and the doctor. I advice the following general measures to my patients of acne: --Use a mild cleanser like cetaphil twice daily. Harsh cleansing causes the skin to become excessively dry which in turn causes rebound oiliness. --Avoid all the regular use creams, moisturisers, sunscreens that you may be using for the time being till you are on anti-acne treatment. --Avoid taking facials. --Avoid picking your acne. Since Acne and seborrheic dermatitis/dandruff are usually associated it is advisable to use an Anti-dandruff shampoo since acne is worsened by dandruff. Specific treatment for acne: --Oral Antibiotics: For inflammatory acne(papules and pustules) I usually advice my patients to start with one of the oral antibiotics like Azithromycin/ Doxycycline/ Minocycline. --Oral Retinoids: For severe acne OR for acne unresponsive to traditional anti-acne medications, Isotretinoin can be started. It the only drug which offers any chance of long term cure and after a full course of isotretinoin significant number of people never have a recurrence of there acne. It should be taken under the supervision of a dermatologist because of certain lab tests which are to be done before and during treatment with isotretinoin. --Topical treatment: Is a valuable adjunct to any form of acne treatment. Mainly two classes of drugs are used topically 1)Topical Antibacterials: Dermatologists around the world prescribe topical gels/creams containing topical antibiotics like either clindamycin 1%/ benzoyl peroxide 2.5% OR Nadifloxacin during the day time. 2)Topical Retinoids: Either Adapalene 0.1%/ Tretinoin 0.025% OR Azaleic acid (10%/20%) at bed time. Regarding your second concern i.e Post-Acne Hyperpigmentation, Azaleic acid (10%/20%), in addition to being beneficial in Acne, can be very effective in lightening Post-Acne Pigmentation as well. I would advice you to see a dermatologist and get a prescription out for your problem after having a discussion with him keeping all these points in mind. I am here to help you with any clarifications you desire. take care regards

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