What is the treatment for both sun damage and acne scars in my skin?

Question

Hello doctor,

I have a couple of skin issues. I have some sun damage on my skin and a good amount of acne scars as well. I have been trying to get rid of those stubborn areas for a long time. They are mainly on the sides of my face. I also had a horrible case of folliculitis. It has recently cleared up because of not shaving too close to the skin. I do not have much-ingrown hairs anymore.

But, I am now left with all the skin damage that has taken place throughout the years. The razor bumps that I had has also considerably darkened my neck area. I have been to a dermatologist recently. I was first given Retin A prescription (0.05 %) and told to use a Hydroquinone cream along with it. I did not see much results from it.

I was then given a Retin A prescription for the dark areas on my face again (the first Retin A medication was too strong % 0.05, and so I was given 0.025 % this time). However, I do not see any change in my dark areas. Along with my Retin A prescription, I was also given Hydrocortisone for the area of folliculitis too. There has not been a reversal in any of my skin condition, not in the areas where I had folliculitis or the dark areas on my face. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area.

Answer 2

Hello,

Welcome back to icliniq.com.

Thanks for sharing the pictures (attachment removed to protect patient identity). Yes, I can appreciate some post-acne scarring on cheeks as well as pigmentation in the areas you mentioned. As you have said, there is currently no active folliculitis or acne, so I will not be prescribing medications for that. Follow the habit of not cutting your hair too close to the skin.There are a lot of treatments for acne scars (talking about the pitted scars), including tretinoin cream you already using.

But the thing with tretinoin is you need to apply it for more than three to four months regularly to see some results. Better treatment for pitted scars would be Co2 laser, which is more effective. Regarding the pigmentation part, I am prescribing a few medications below. Sun protection and regular use of sunscreens is a necessary step in any case of hyperpigmentation.

1. Glyco 6 cream (Glycolic acid) apply once at night. Increase time sequentially. Eg. Start with one hour, gradually increasing one hour per day, and if no burning or redness can apply overnight, apply only on hyperpigmented areas and do not rub it too much.

2. Aziderm (Azelaic acid) cream 20 % apply once in the morning only on hyperpigmented areas, again do not rub it too much.

3. Photostable sunscreen gel apply all over the face for 15 minutes before going in the sun.

What is the treatment for both sun damage and acne scars in my skin?

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