Brief Answer:
Treatment options of acne, seborrhea and dark spots

Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic

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

Acne and oily skin go hand in hand.
Oily skin/ seborrhea is due to bigger sized sebaceous glands presenting as a wider pore size.
These bigger sized sebaceous glands naturally produce more sebum/ oil as compared to smaller sized sebaceous glands thereby causing oily skin.

Acne is a result of an interplay of factors like:
-Sebum overproduction,
-Sticky epidermal cells thus causing the lining epidermal cells of follicles/pores to shed in clumps thereby causing blockage
-A bacterium, Propionibacterium acnes which acts on pent up sebum or oil thus causing inflammation.

Treatment of oily skin and acne is related.

Oral retinoids e.g Isotretinoin are effective in both, seborrhea as well as acne.

Oral Isotretinoin is antiinflammatory, comedolytic as well as sebostatic i.e inhibits sebum production, therefore, has multipronged mechanism of action in acne.

The most important reason for efficacy of Isotretinoin in acne is due to that fact that they are sebostatic. They reduce the size of sebeceous glands (shrinks) by almost 90% within a month.

Apart from Oral retinoids, Oral antibiotics may also be started if your acne is inflammatory i.e red, painful and pus filled.

Topical treatment is an essential part of the overall treatment of acne and includes topical antibacterial antiacne preparations like clindamycin gel, benzoyl peroxide gel.
Either of them can be used as a spot treatment only for active acne, during days time.
At night, I usually ask my patients to use a topical retinoid e.g adapalene gel, once daily, over the whole affected area, not just active acne.
Topical retinoids are antiinflammatory and comedolytic, therefore prevent new acne formation apart from resolving existing ones.

Retinoids also help lighten the dark spots resulting from acne. Specifically, for dark spots I usually suggest my patients to use either kojic acid or hydroquinone once active acne has resolved.

Since you have sensitive skin, therefore, I would suggest you to use a gentle cleanser for face wash e.g cetaphil cleansing lotion, twice daily

I suggest you to visit a dermatologist. Your dermatologist will assess the severity of your acne and advice accordingly.

You may also opt for a few sessions of chemical peeling from your treating dermatologist.
Salicylic acid chemical peel is quite useful for acne and seborrhea whereas glycolic acid peel is for post acne hyperpigmentation.

Regards

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Brief Answer:
I suggest you to visit a dermatologist for a thorough assessment

Detailed Answer:
Hi.

Treatment of acne is individualized and guided by the severity of acne.
While topical treatment alone may suffice for mild acne, Oral treatment is usually required for moderately severe to sever grade of acne.
Therefore I suggest you to visit a dermatologist in your vicinity. Your dermatologist will be able to assess the exact condition and advice accordingly.

You may use a gentle cleanser e.g cetaphil cleansing lotion, twice daily.
Topically you may use Clindamycin 1% in lotion form, over the acne affected area during Day time.
For Night application you may use Adapalene 0.1% gel, to be applied over the whole affected area.
Oral Retinoids i.e Isotretinoin and Oral Antibiotics e.g Azithromycin Or Lymecycline or Doxycycline etc can be started only after a thorough assessment of the severity of your acne.


Your dermatologist might also ask you to take a few sessions of chemical peeling along with topical and oral treatment.

A point I want to make about Oral Isotretinoin is that it should be avoided during pregnancy or in females who can get pregnant during Isotretinoin treatment because it can cause severe fetal malformations.

Regards

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