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Dr. Andrew Rynne

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Suggest treatment for severe acne and hair fall

Answered by
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Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2015 Questions

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Posted on Thu, 28 Aug 2014 in Skin Hair and Nails
Question: Hello, Im seriously effected by using Melacare.Knowing it is not good unable to overcome use of it, bcoz of its adverse results of skin irritation, pimples, boils. I've been asked to continue Melacare along with Resticline 500mg tablets daily. If I stop it, my skin is not all showing good. My marriage is falling shortly in a month, and I wish to get rid of my skin problem. I lost my skin glow, color, also recently started serious hair fall, it became very very thin & pathetic. Pls suggest me best medicine. I tried the other medicines doctor advised but nothing is suiting, but giving me allergic reactions. I want to get back by skin color, with good volume of hair. If possible, pls help me with you appointment to visit you. Thanks, XXXXXXX Vizag. Mob# 0000
doctor
Answered by Dr. Kalpana Pathak 1 hour later
Brief Answer:
these are side effects of steroid abuse

Detailed Answer:
Hi XXXXXXX
I can understand your concern and would truly love to help you as much as possible. These are common side effects of prolonged use of any steroid based cream.

Before I could answer your query, I would appreciate if you could send me a good resolution pic of your face and scalp.
You can upload the pic by clicking on upload report/image icon which is on right side of query page.
Send me the pics so that we can take this discussion further.
Hoping to hear from you soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak 16 hours later
I've uploaded current pics of my face & scalpe.Face is jus washed by scalpe shampoo as advised by doctor. If u notice clearly small boils kind pimples started up d lips, since I cleaned with shampoo it was clear a bit. For these boil kind pimples im using Resticlin 500mg tabs, with Melacare night apply. No cream or tabs suiting to me now, if I try they're giving adverse reactions. Doctor has scared me that these pimples w'd become large, n make holes on face if I dont use the said tablets daily which cannot b cured unless a costly lazer treatment taken. Im so worried now abt my skin & hair. Entire body became dark n dry, hair is falling very very badly, n became pathetic thin in volume. Im also using Teczine to control allergy in blood. Ive been advised to use Resochin tabs & Hostacycline 500 tabs before for a while, n now too, which I did not start yet now to consult you for remedy. Let me know if I need to visit your clinic. Id be glad to show improvement at d soon bcoz of my marriage shortly. Pls help me.

Thanks. XXXXXXX
doctor
Answered by Dr. Kalpana Pathak 2 days later
Brief Answer:
details below

Detailed Answer:
Hi XXXXXXX
Apologies for the delay in response from my side.
I have gone through the attached image and I could male out that yo uare a beautiful girl. However the pic is not so clear to appreciate your skin lesions.
I would request you to send a better resolution pic so that I can examine your skin lesions. Also send me a pic of you scalp as requested.
My suggestion in your case would be
To stop using melacare instantly
Use a mild cleanser like cetaphil to wash your face
Apply a mild moisturiser and sun screen daily( cetaphil moisturiser and suncote sunscreen)
Apply clindamycin gel( Dacne plus/cliface/ clindac a gel) full face four to five times a day
Start oral vitamin c 500 mg twice in a day(tab celin)
Start oral tablet ciprofloxacin 500 mg twice in a day( only if not allergic to this antibiotic).
You may stop all other medicines except for your antiallergic.
Follow the treatment for a week and then get back for follow up as after a week I would like to start retinoids( oral and/or topical as per the response) or peels.
This treatment is advised to reduce your boils. Further treatment would be to improve your skin.

Should there be a query,please write back.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak 21 hours later
Hi, I was surprised on the compliment, and understood all pics which were uploaded did not go to you. Looks like this page is not accepting multi pics upload. I tried attaching 10 pics now but failed, pls give ur email to send all my pics of my face & hair. I'm feeling very tense on current situation of skin & hair. I'm taking a challenge on getting recovered with this problem with your assistance. Pls look into the pics & advise me. Since I've used Retino A (for 1hr at bed time, later) Melacare cream (all night), skin in pics might show a little better, but my face skin is showing rough with little holes, dry, pain, itchy, red rashes. If I miss applying Melacare, or when I go out in Sun, my skin would show absolute allergetic, pimples like boils, itchy skin. I'd feel shy to face anyone with ugly skin tone. Also, my eyebrow hair & scalpe hair if you see in pics, it is pathetic, pls help me to improve hair growth at the fast. Hair fall on scalpe is very high on daily. I'd appreciate we speaking on phone or skype to give a brief show of face for you to observe more in live. I'd be gald with your suggestion, and provide me best treatment. Let me know if I need to go through any tests..Thanks, XXXXXXX
doctor
Answered by Dr. Kalpana Pathak 11 hours later
Brief Answer:
details below

Detailed Answer:
Hi XXXXXXX
Thanks for uploading the pics.
Now I can appreciate the redness, roughness and bumps over your face.
My treatment plan still remains the same as I mentioned in my previous post. To the treatment prescribed, I would just add that you use a calamine lotion(calosoft lotion) once in a day. This would soothe your skin.
As far as hair fall is concerned, you seem to have androgenetic alopecia. You need to start a hair supplement like keraglow XXXXXXX once daily. Also apply minoxidil 2 percent solution 1ml twice in a day over scalp. Hair growth needs atleast six to twelve months. So the treatment is gonna be long. However in a month's time, your hair fall should reduce.
I know your are a bit sceptical, but you need to stop melacare once and for all.
Whatever side effects you have over your face should improve in a month.
Check my previous post, I have mentioned treatment plan in detail, please start the same and get back to me for follow up.
Also please let me know
if your periods are regular
if your scalp is oily itchy and if you get dandruff often
if you have increased hair growth over chin, chest areas etc
if your face is oily and you get acne otherwise also.

You can have my phone number from my profile page. Should there be a need, you may call me.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak 11 hours later
Thank you, Doctor! I understand to use the following medicines. Could you elaborate the method of daily use of it, and its the dosage little briefly to follow in right way, as I work in night shifts between 6pm to 3am IST, and rest in morning until 12pm IST, and happens to go out in sun in afternoons.

1) Cetaphil Daily Facial Cleanser
2) Cetaphil Daily Facial Moisturizer, Spf 15, Fragrance Free - 4 Fl Oz
3) Suncote sunscreen
4) clindamycin gel( Dacne plus/cliface/ clindac a gel) -- check with doctor on this
5) vitamin c 500 mg twice in a day(tab celin)
6) ciprofloxacin 500 mg twice in a day ( only if not allergic to this antibiotic).
7) calamine lotion(calosoft lotion)
8) keraglow XXXXXXX
9) minoxidil 2 percent solution 1ml

For your Q., I've replied in line:
if your periods are regular- Answer: Every month it was regular, but this month I had it for long for 6 days instead of 3 days, the reason I doubt, may be, bcoz of the use of Promonet N at the starting days of periods for not to trouble in journey.
if your scalp is oily itchy and if you get dandruff often: Answer: My scalpe is oily, dull, turns dizzyness if not washed daily &, also may cause dandruff, hair color too faded from being black.
if you have increased hair growth over chin, chest areas etc: Answer: I've little hair on upper lips, on the forhead just right above the edge of eyes, and cheeks edge. No hair on chest. 2 or 3 thick hair on chin, as how my mom has.
if your face is oily and you get acne otherwise also: Answer: My face part skin is very oily, and feel like these acnes are bcoz of it. Also, sometimes feel very dry, itcy, skin break. I didnt find ur no., on ur profile. However, will check it again.
Also, please advise if I use "swiss skin whitening pills" along with your suggested medicines. I've read few skin cases on this website where some of the doctors advised patients to use it along with the medicines. I want to improve my over all body color, as it was badly effected in the recent yrs bcoz of incorrect sterioid skin medicines I used in past. I felt it is good to check your word for good, instead of taking own decisions which might result in adverse reactions.

Waiting for your reply, Thanks, XXXXXXX
Hello, I've a concern to be informed you. During my teenage I used Lacto calamine lotion which caused an allergic features at that time. The calamine lotion which you've advised, does it belongs to something like to Lacto calamine lotion..?

Now since 2 days I stopped Melacare, I notice my face skin turned black with unconditional dull appearance, being rough & allergetic. Will the use of above suggested medicines Can bring a quick healing to this problem..? I'm very depressed on my skin condition as it is not suiting to any new medicine application, and seeing the adverse reactions, I'm very much worrying, and wish to know if I need to undergo skin analysis test prior I use new medicines, to know if the new ones suits me, after stopping the steroids creams of Melacare..Pls advise me here..

Also I tried asking for Cetaphil Cleanser & Moisturizer in my local area Apollo medical shops, and their distributers for, and came to know this Cetaphil based ones are not available in Vizag. Please advise on it, or suggest me a best one as its alternate.

For hair, do you suggest any best shampoo, as I use Mintop 2%..

Also, since my entire body color turned XXXXXXX and showing dark complexion, I would request you suggest me best pills for improving the color.

Let me know if I need to take skin tests, and attach the reports..? It might help you to read, and understand more about my skin. I want to be very careful & take proper treatment without any problems, as I can not have any further leaves now to take rest for recovery. Hope you understand me, and advise me the best.

Please read the sent 3 messages, and kindly respond me with the best solution.
Thanks, XXXXXXX            
doctor
Answered by Dr. Kalpana Pathak 24 hours later
Brief Answer:
details below

Detailed Answer:
Hi XXXXXXX
Thanks for writing back.
Regarding your prescription-
1) Cetaphil Daily Facial Cleanser- face cleansers should be used whenever you wash your face. Face should be washed atleast twice daily but not more than three to four times. So use the cleanser as and when required. Obviously after getting up in morning and prior to sleeping the face should be washed clean and moisturiser should be applied. If this is not available at your leading chemist store, then look for alternatives like episoft/ moiz/cutirinz etc
2) Cetaphil moisturiser- again should be used twice in a day. However if your skin feels dry in between can be used multiple times. Use it once you get up ie around 12 in afternoon and in evening prior to going to your office.
3) Suncote sunscreen- half an hour prior to stepping out in sun
4) clindamycin gel( Dacne plus/cliface/ clindac a gel) - Should be used two to three times in a day. You may apply it and even go to your office as its gel based. You may also use it twice in between 12 to six and then apply it prior to sleeping. You can keep a gap of half an hour or more in between your moisturiser and clindamycin gel
5) vitamin c 500 mg twice in a day(tab celin)- take morning and evening
6) ciprofloxacin 500 mg twice in a day ( only if not allergic to this antibiotic)- take morning and evening.
7) calamine lotion(calosoft lotion). its just like lactocalamine. People rarely show allergy to it. However if you think you are allergic, you may avoid.
8) keraglow eva- once in a day anytime after meal
9) minoxidil 2 percent solution 1ml- twice in a day. You may apply it once you get up around 12 and in evening(6 pm) or post midnight(3 am) as per your convenience and job schedule.

Regarding swiss skin whitening pills- it must be a glutathione based supplement. you may take a glutathione based antioxidant which supposedly has generalised whitening effect over body( pinodin g one tab twice in a day, empty stomach. Along with vitamin c supplement). However I am not a keen supporter of such whitening medicines. Moreover melacare cannot have generalised effect over your body skin color. So actually its your choice. Just to even out your body skin tone, you may use a lightening soap like dermadew lite soap and should use sunscreen liberally over all exposed areas.

Apart fro mall these suggestions, mention a healthy nutritious diet rich in protein, fruits nuts and green vegetables. Also exercise regularly.

Hope this answered all your queries.
Regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak 12 days later
Hi, I've been using Clyindamycin gel at bed times & in morning after wasing face with Cetaphil cleanser. Also while using Suncote gel suncreen, my skin is good, but showing dark color with dullness. When I use moisturiser & clindamycin, d color of skin is little Ok, but it is worst dark after suncote. Last day I tried applying Melaguard spf 50 to just see if it is better, but notice it is fine but giving so much oilyness & sweat on face. Pls see the latest pics of mine attached in below, and advise me better medicines for skin color improvement. I've got so much of XXXXXXX on my exposed body. I could not find Pinodin tablets anywhere here. Pls suggest some alternate whitening pills of safe one, n best treatment to improve facial skin color & texture. After stopping Melacare, looks like my skin condition is good, but seriously need to improve color, as b4. Pls give ur direct no., as i couldnt find it on ur profile.
doctor
Answered by Dr. Kalpana Pathak 22 hours later
Brief Answer:
details below

Detailed Answer:
Hi XXXXXXX
Thanks for following up with me.
Firstly I would like to know, if your acne due to continuous melacare use has resolved with medicines I prescribed. If it has, I will prescribe medicines to improve your skin color.
If acne eruptions are still there, you need to continue with cetaphil cleanser,moisturiser and clindamycin till the lesions resolve. Also please take ciprofloxacin for faster resolution.
Suncote or any other sunscreen may sometimes make face look dull. As far as I understand, your sun exposure is less. So use suncote or any sunscreen of your choice prior to stepping out in sun. I suggested suncote as its non greasy.
Please upload a recent pic of your face. I have checked your uploaded pics but I couldn't find any new attachment.Pinodin G is the most commonly available whitening pill. If you cant procure it in your city, then please arrange it from any bigger city nearby.
You may contact me on 0000.
Regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak 19 hours later
Really I feel happy doctor, my acne is curing by using ur advised medicines. Thank u so much for it :) I w'd be more glad if u can help me recover with d darkness of my skin now. Im unlucky to loose my match bcoz of my skin condition. But keeping hope on ur treatment using d medicines for quick recovery. I attached 3 latest pics once again. Pls advise d best skin tone improver medicines. I will call u sometime shortly. Thanks! XXXXXXX
doctor
Answered by Dr. Kalpana Pathak 25 hours later
Brief Answer:
details below

Detailed Answer:
Hi XXXXXXX
Thanks for providing the pics and details.
You need to continue with oral ciprofloxacin, topical clindamycin, cetaphil cleanser and moisturiser till the acne clears completely. That might take another one or two week.
Also continue using a sunscreen. If suncote doesn't suit you well, you may try any sunscreen of your choice. You may use melaguard sunscreen too. Apply it and after half an hour may dab extra oil by using a wipe tissue.

Once the acne is gone, start using kojic acid based cream twice in day like kojvit/carofit max/kojiglo/cosglo etc. Some mild peels like lactic acid peel or Kojic acid ,arginine- pyruvic acid peel can also be added to improve color.

Do not be in haste as things wont improve overnight.
If pinodin G is not available take any other antioxidant like antoxid Hc or exerge Hc. The aim is to improve your skin tone. You may use any skin lightening soap like dermadew lite or glyaha koj. Also use a sunscreen over exposed body areas.
Cetaphil is available at leading chemist stores. Do not order online as cetaphil moisturiser or sunscreen doesn't cost 5000 rs as you have mentioned in mail.
In nutshell continue with acne treatment till lesions subside then start antoxid Hc, continue sunscreen, apply kojic acid cream twice in a day , take peels.
Cetaphil moisturiser and cleanser should be continued too,
Hope this helped
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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