Why do I still have acne and scars despite treatment?

Question

Hello doctor,

I have acne and acne scars, and I have tried many skincare products. About a month ago, I visited a dermatologist who prescribed a Sebo cleanser for acne-prone and oily skin. I do have oily skin, especially on my nose, which becomes quite oily when I wake up; however, I do not get acne there.

Most of my acne appears on my cheeks, where the skin is currently red and has developed pitted scars. I also maintain a healthy diet, including fruits, and drink plenty of water, but I have not seen significant improvement so far.

Please help.

Thank you for your guidance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Thank you for contacting iCliniq and expressing your concerns.

I realize how upsetting it may be to live with acne and acne scars at such a young age. Your description suggests that you have post-inflammatory erythema and pitted acne scars. Because you have previously taken Isotretinoin and other drugs, your acne was probably moderate to severe. When such treatments are stopped, acne might return if a good maintenance plan is not followed.

At this point, the major goal is to keep new acne from emerging, as scars cannot heal well while acne is active. I will develop a treatment strategy to help you control both active acne and acne scars.

Skincare routines:

Use a mild, non-foaming cleanser twice daily (morning and night).
Apply a non-comedogenic moisturizer such as Physiogel AI Sensitive.
To prevent pigmentation, use a broad-spectrum sunscreen with an SPF(sun protection factor) of 60 or higher every day.

For aggressive acne or marks:

In the afternoon, apply 1 percent clindamycin gel to the afflicted regions.
Apply a pea-sized amount of Adapalene 0.1 percent gel to the entire face in the evening, followed by a moisturizer, five days per week.
On the other two evenings of the week, apply a pea-sized dollop of Azelaic Acid 20% cream in the same way.
Adapalene and Azelaic Acid should not be used on the same night since they can cause dryness. Adapalene, as a topical retinoid, will help reduce active acne, but Azelaic Acid will help improve pigmentation and acne scars.
Please stick to this regimen for three to five weeks, and you should see a considerable change in your skin.

I hope this alleviates your fears. Your opinion is much appreciated and allows us to provide better patient care.