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    Suggest treatment for adult acne

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Posted on Tue, 2 Dec 2014 in Skin Hair and Nails
Question: Yes,thank you. My gyn prescribed Osphena for me. Soon afterward, I was suddenly sprouting a horrid case of cystic acne. I'm 63 and haven't Had real acne in many years- just occasional blackheads. This looks like some kind of pox and I'm embarrassed to go out in public. I can't find anything online about it. It seems to improve and then worsens. My FP gave me an rx for metrodinazole gel to use once qd. And to see a dermatologist if it didn't work. It keeps tricking me by appearing to be clearing, so I don't call a dermatologist. I can feel new cysts forming, especially when I palpate my mandible. Then they pop out red and angry overnight. The only other piece of info is that I received a shingles vaccine about the time I started Osphena.
doctor
Answered by Dr. Geetika Paul 1 hour later
Brief Answer:
Need to look for the exact cause

Detailed Answer:
Hi

You seem to be developing adult acne .
Acne in your age group can occur due to various reasons like hormonal alterations in the body,due to drug drugs which induce acne or they can be due to certain infections .
The most important thing is that adult acne definitely need to be evaluated in detail to look for the exact cause .
Now since you have noticed some improvement with metronidazole but the lesions keep coming back ,I would surely recommend that you see a dermatologist who can evaluate and look for the exact cause .
I would like to know if you have achieved menopause or are Peri menopausal or if you have any excess facial hair or loss of scalp hair or any excess weight gain recently .All these can point towards a hormonal cause .
Also osphena is not known to cause acne in patients .

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Geetika Paul 44 minutes later
Hello. I have finished menopause and have none of the symptoms you quoted. Do you feel that there is no connection with the shingles vaccine taken a week before lesions ?
Sorry- I forgot to tell you that I had a long lasting case of histoplasmosis last summer and found "rash" as a side affect online. This did look rashy in the beginning, and were sore. Now they are just cystic with as many as 30 lesions on my face, throat, and two on legs, with a few on upper arms. My FP treated the histoplasmosis with one Z-Pak and it only occurred to me recently that these lesions might be connected. Should I be worried about deposits forming in my eyes? My brother is fighting to save his vision from a case of histo years ago after being around an old chicken house. I've had histo before with the telltale calcifications on X-ray. I was told that most Arkansans have Histoplasmosis due to the huge chicken and turkey industry in the north of the state. I had taken up bird watching and was feeding and cleaning the feeders and droppings regularly. Should I see an opthomologist now?
I've already stopped feeding the birds. Thank you
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Follow up: Dr. Geetika Paul 8 minutes later
Sorry but in the first question, I stated my family practice doctor put me on diclophenac gel. That was INCORRECT. HE PRESCRIBED (Flagyl) METRODINAZOLE GEL x1 QD for the rash/ lesions. I guess my mind was wandering !!
doctor
Answered by Dr. Geetika Paul 12 minutes later
Brief Answer:
Kindly provide close up pictures

Detailed Answer:
Hi again

Thanks for the information .
The rash you have developed does not appear to be related to shingles vaccine .
Now since you have a past infection with histoplasmosis, so that is the most important possibility that is coming to my mind .
If I were your treating doctor, I would have surely evaluated the facial lesions to rule out a recurrent histoplasmosis rash first before considering other possibilities.
Also since eye lesions are an important part of histoplasmosis and are symptom less in the initial stages, so a regular eye check up is mandatory in your case .
Also I would like to have a look at the exact skin condition so that we can look for other possibilities as well .
Please click some close up pictures of the affected area and upload them here on this page .

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Geetika Paul 7 days later
All right. I have some pics of the lesions from a month ago and will take more now. I'm on my third 60 gram tube of Flagyl gel. Also 1% hydrocortisone per my FP
doctor
Answered by Dr. Geetika Paul 4 hours later
Brief Answer:
Kindly provide pictures

Detailed Answer:
Please click some close up pictures of the affected area and upload them here on this page .

Dr Geetika Paul
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Geetika Paul

Dermatologist

Practicing since :2008

Answered : 2606 Questions

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