Brief Answer:
Acne and scars

Detailed Answer:
Hello and Welcome to Healthcaremagic.

I am Dr. Kakkar and I have understood your concern.

ACNE TREATMENT:

You need to understand that for acne there is no one time solution. Treatment if often long. Once your acne is under control, you need to use a maintenance gel, commonly a topical retinoid (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) for day time use.

-At night I ask my patients to apply a topical retinoid e.g either Adapalene alone OR Adapalene+clindamycin combination. e.g Deriva-cms gel (contains topical clindamycin along with adapalene in a gel formulation). Adalene nano gel contains Adapalene, however it should not be used twice daily as it may cause severe irritation.

Topical retinoids i.e adapalene increases the skin turnover and consequently decreases the contact time of keratinocytes with melanocytes, therefore it also 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 for 4 weeks OR Azithromycin (Azithral 500 mg) 3 consequtive days in a week for 4 weeks

-Use a gentle cleanser for face wash e.g cetaphil cleansing lotion rather than using a soap or face wash (neutrogena acne oil free face wash contains 2% salicylic acid and might cause severe irritation on your skin since you are already using adapalene and that too not once as recommended, but twice daily!!)

Once your acne activity is controlled, I would suggest that you should still continue with topical retinoid (Adalene gel) for maintenance (every alternate days) as retinoids are comedolytic and antiinflammatory and thus prevent new acne.

You could also opt for chemical peeling sessions of salicylic peel, from a dermatologist for acne.

Drinking 8-10 glasses of water and having lots of fruits and vegetables is good for your skin

ACNE SCARS:

Post acne marks can be just post-inflammatory hyperpigmentation Or they could be acne scars.

For post-inflammatory hyperpigmentation, you could use a topical skin lightening agent, once your acne activity is under control e.g kojic acid or hydroquinone or azaleic acid.

However, post acne scars are most commonly managed by some surgical means like either chemical peeling, dermabrasion, Fractional CO2 Laser, Microneedling/dermaroller etc.


Hope this helps
regards

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