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Suggest treatment for acute acne problems

DOCTOR OF THE MONTH - Jan 2014
Jan 2014
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Dermatologist
Practicing since : 2002
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Question
Hi, This is XXXXXXX and Im 24. I'm suffering from acute acne on my face and back. For my face I've been using the gels Clinmiskin and Deriva CMS for the past 8years and it used to give me results then. But now my face, neck and back are full of scars from acne. I use Deriva CMS to get rid of the scars but of late skin is drying up and is quite flaky. Cos it's flaky I get tempted to peel it off my face. I have dandruff problem too. Some say that dandruff give rise to pimples and acne. Kindly let me know if I can continue with the above mentioned gels or is there a quicker cure available?
Coming to back acne, I started using Bio-oil about a month ago after a friend suggested it. As the area affected is large, Im confused as to whether I'll get the intended results. Is Bio-oil worth it?
I also happened to hear about the peeling technique to get rid of the acne scars. How effective is peeling and by when will the scars go away? Will there be any side effects? What if pimples start re-appearing again? Can this be done on face too?

Note: I live in XXXXXXX and at the moment we have an arid climate here which adds up to the skin dryness.
Posted Sat, 23 Aug 2014 in Acne
 
 
Answered by Dr. Kakkar S. 57 minutes later
Brief Answer:
Acne and dandruff treatment

Detailed Answer:
Hello and welcome to healthcaremagic

I have gone through your concern and I have understood it.

You have been on the right kind of treatment. However, for Acne, there is no one time solution. Treatment if often long. Moreover once your acne is under control, you need to use a maintenance gel, commonly a topical retinoid (deriva gel/adapalene gel), to prevent the new lesions/comedones from developing.

-I usually start my patients of acne on topical benzoyl peroxide gel (e.g Microbenz 3.5 % gel, marketed by Sunpharma in India) OR Clindamycin gel (e.g clin 3 gel or clindac -A gel or clinmiskin gel which you have already using) for day time use.

-At night I as my patients to apply a topical retinoid e.g either Adapalene OR Adapalene+clindamycin combination. e.g Deriva-cms gel contains topical clindamycin along with adapalene in a gel formulation. While it is mainly used for acne, the retinoid component i.e adapalene increases the skin turnover and consequently decreases the contact time of keratinocytes with melanocytes, therefore it does has a lightening effect on post-inflammatory hyperpigmentation.

-I also decide to start my patients on oral antibiotics if they have inflammatory acne e.g doxycycline 100mg once or twice daily.

-Use a gentle cleanser for face wash e.g cetaphil cleansing lotion rather than using a soap or face wash.

-bio-oil has an oil base and is not recommended for oily and acne prone skin. I would suggest that you discontinue with it.

You could also opt for chemical peeling sessions from a dermatologist for both acne as well as postinflammatory hyperpigmentation/acne scars. While salicylic acid peel is mainly used for acne, glycolic acid peel is for post inflammatory hyperpigmentation/scars.

Dandruff and acne frequently co-exist. Treating dandruff effectively would aid in better control of acne.

I would suggest you to use an antidandruff lotion/shampoo. My choice is 2% ketoconazole shampoo(Scalpe lotion), thrice weekly OR even daily, for 2-4 weeks.

However sometimes a shampoo alone seems insufficient. In such a case dermatologists choose to prescribe a topical steroid lotion (Mometasone lotion e.g Elocon lotion), to be applied once daily at night, at the scalp skin for 2 weeks.

The topical steroid lotion can be stopped once the dandruff is well controlled and thereafter the improvement can be sustained with just an anti-dandruff lotion/shampoo, twice weekly

Hope this information helps
Regards
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for acute acne problems 8 hours later
Thank you for your response. I have couple more queries.
1. I have a very sensitive skin. Post waxing my arms, I get rashes and my upper arm gets itchy after few hours. I try not to get my nails on it but during sleep its not under my control. Though the rashes disappear by next morning, the itch persists 3-4 days more. I deal with this by applying talcum powder or prickly heat powder. Is this okay? Can you please suggest some means to avoid the itch post waxing?

2. Is there something (a specific nutrient/tablet) that I can supplement with my daily food intake that will help my skin become less sensitive ? Cos of my long work hours and as I live alone, I'm unable to follow a balanced healthy diet and this, I think, is one of the reasons my skin is sensitive and prone to acne. What should I consume for a healthy skin?
Don't know if this has anything to do with skin, but I have a low b.p and lesser than normal hemoglobin count. I don't have a thyroid condition.
 
 
Answered by Dr. Kakkar S. 23 hours later
Brief Answer:
Healthy skin advice

Detailed Answer:
Hi.

Sorry for the delay in my reply

1) Post waxing the skin becomes dry. That could be one reason for itching. I would suggest you a soothing moisturiser post waxing e.g Ritch creamy lotion would be ideal for you arms (It is marketed by curatio pharmaceuticals in India)

2) Work stress, lack of adequate sleep can take a toll on your skin health. Rather than a multivitamin tablet, I would suggest you to take a healthy nutrient rich diet composed of cereals and pulses, green leafy vegetables, lots of fruits and salads as well. Avoid Tea/coffee, chocolates, coke, sweets, Pizzas, burgers etc.

3) 8-10 Glasses of water per day.

4) Half an hour of brisk walking/jogging.

5) 6-8 hours of regular sleep.

Regards
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