How do I get rid of clogged pores and cystic acne on my face?

Hi,

Welcome to icliniq.com

Thank you for writing in, and I completely understand how exhausting it can be to deal with stubborn acne for years. You are not alone in this. Let us go over your concerns and find a way forward together.

You are experiencing chronic comedonal and cystic acne (Acne vulgaris), a condition that leads to:

1. Clogged pores (closed comedones) that feel like small bumps.

2. Inflamed, cystic pimples mainly on your cheeks and sometimes on the chin and forehead.

3. Persistent breakouts despite treatment, which points to hormonal influence (especially since you are already on Spironolactone and birth control).

While you are doing many things right, your skin may need a gentler, long-term plan with better tolerability.

I would suggest this skincare routine for you, which is gentle and straightforward:

1. Use a gentle benzoyl peroxide cleanser (2.5 to 4 percent) once daily at night.

2. In the morning, use a foaming cleanser.

3. At night, replace Tretinoin with Adapalene 0.1percent gel; it is gentle but still effective.

4. Add Azelaic acid 10 percent if tolerated, which helps with bumps and pigmentation.

5. Use a good moisturizer.

6. Start with a sunscreen with a sun protection factor (SPF) 50 every morning.

7. Optional medical treatment: If the cystic acne worsens, consider a short course of Doxycycline 100 mg once or twice daily for six to eight weeks. Consult your specialist doctor before starting any medication.

8. Avoid:

   1. Over-washing or scrubbing the skin.

   2. Using physical exfoliators.

   3. Using high-fragrance or comedogenic makeup.

Acne treatment takes at least six to 12 weeks to show improvement. Be patient and consistent. You are doing great by seeking help; do not give up.

Wishing you calm, clear skin soon! Please feel free to follow up with any new symptoms or questions.

I hope this answers your query.

Thank you.