How to treat acne, whiteheads, and redness on the face?

Hi,

Welcome to icliniq.com.

I understand your concern.

Going through the history provided from your end, it is acne vulgaris with post-inflammatory pigmentation. It is essential to understand the various causes of acne and the triggers that lead to the formation of acne. Acne vulgaris is caused due to multiple factors, including genetic susceptibility, wherein the chances of acne are transmitted from parents and ancestors due to hormonal imbalances, which occur due to multiple reasons, of which the most common reason is PCOS which is a polycystic ovarian syndrome. PCOS causes hormonal imbalances, which lead to the formation of acne regularly and maybe on and off, along with other symptoms, including unwanted excess hair growth on the face and chin area and scalp hair loss. Due to the possibility of PCOS being common, it is always suggested to seek a gynecologist consultation to rule out the possibility of PCOS. The other causes of acne include dietary changes when there is increased consumption of oily and fried food, red meat, sweets, milk, and dairy products and due to climate changes, due to excess sweating, due to stress, in case of using skin care products with unusual ingredients. Most skincare products are not suggested for individuals with active acne as they may trigger and exacerbate the formation of acne. Altering the sebum production and causing changes in the outer layer of the skin, called the keratin, triggers the buildup of bacteria which is a part of the normal commensal of our body, leading to the formation of acne.

It is also important to understand that in the presence of the above factors, be it external or internal, there would be a recurrence in the acne formation, but it may be manageable, especially in case of external triggers with the usage of medication as well as procedures when done together.

My suggestion for the treatment of current acne,

1. Ahaglow foaming face wash (Glycolic and Lactic acids) may be used externally in the morning and at night. Apply, massage in gentle circular motions for a minute on the affected area, and wash off. This helps reduce sebum secretion and oil formation within the skin. They will reduce the formation of acne and, therefore, may be continued for months together.

2. Peroclin gel 2.5 % gel (Clindamycin and Benzoyl peroxide 2.5 gel) to be applied every morning after cleansing the face with the above cleanser and on alternate nights on the affected area only. It is suggested to avoid the unaffected areas. This antibiotic combination helps treat bacterial buildup, which is caused due to changes in the sebum production due to multiple factors, as mentioned above. Benzoyl peroxide is a strong agent. In case of sensitivity to benzoyl peroxide or in case of a history of allergy to benzoyl peroxide, I am also including an alternate gel which would be less strong compared to this gel but would help when treating the current acne as well. Clinmiskin gel (Clindamycin and Niacinamide gel) This is an alternate treatment to the above gel in case of sensitivity alone. They may be continued in the absence of sensitivity to the above gel.

3. Aziderm 10 % (Azelaic acid) cream is to be applied externally. This cream may be applied on alternate nights on the affected lesions, only avoiding the unaffected area. This medication is extremely strong and therefore needs to be used with caution. I suggest you use the smallest quantity possible in a very thin layer to be applied on the affected areas only. This medication needs to be applied on alternate days, and the gel mentioned in the second point needs to be used on the rest of the days, which are alternate to the days when this cream is applied. In case of sensitive skin, I request you avoid this medication. However, this cream effectively reduces the formation of acne and post-inflammatory pigmentations. They may be continued for about three months. Once your skin gets accustomed to their application on alternate days, they maybe increased in frequency and be used every night instead.

4. Tablet Limcee 500 mg (vitamin C) chewable tablet to be taken once daily at night orally after food. They are to be chewed and eaten rather than taken with water. It is suggested to avoid extremely hot drinks and extremely hot food items 30 minutes before and 30 minutes after the intake of this tablet. Avoid the usage of milk during the consumption of the tablet, as well as some individuals may experience abdominal discomfort. They help in the healing of acne faster and prevent frequent recurrences.

5. As I have mentioned above, medication usage and procedures would yield the best result. Glycolic acid chemical peels, which may be done in a session of at least six every two weeks, would help reduce the formation of acne by stabilizing the sebum production and correcting the keratin layer of the skin. They are relatively inexpensive and may be continued even after six sessions till the skin feels better and there is the required result.

6. Apart from the above, laser techniques wherein the laser beams are directed on the acne lesions, which are actively present and are also done in sessions of at least six every three weeks to four weeks, may be done. They are relatively expensive. Carbon lasers, erbium lasers, and Q switch lasers are the different types of laser techniques available and can be used in combination. They help reduce acne due to their antibacterial effect and by causing a mild peeling of the skin, thereby helping to correct the keratinization of the skin. A professional does both the procedures mentioned earlier at the dermatologist clinic. Therefore, I suggest you consult a dermatologist directly to undergo the procedure.

7. I would also like to request you provide an image of the affected area by attaching it in the image option provided in the query section for further assessment of the severity of acne and providing more management options. In the absence of an image, there is difficulty in assessing the grade of the acne, therefore providing the necessary medications in the form of oral antibiotics and other medications necessary for reducing the formation of acne. In addition, there are different types of acne, grading system, and post-acne pigmentation of different types, which can only be assessed by inspecting an image provided.

In severe cases of acne and post-acne erythema, oral antibiotics may be prescribed for the same reason.

8. Avoid oily and fried food, red meat, milk and dairy products, and sweets, as they may trigger the formation of acne due to changes in sebum production. Instead, I suggest you consume more fruits, vegetables, fiber, and at least ten glasses of water daily in a 250 mL glass size.

9. I would also like to suggest you avoid using any skin care products as they may not help reduce acne and instead may increase and trigger the formation of acne. In addition, the current moisturizer that has been mentioned needs to be avoided, as moisturizing the face and using other products are only advised once the current acne lesions subside.

Acne, as mentioned above, may be recurrent depending on external and internal factors. However, external factors may be controlled and managed. In contrast, the internal factors may be difficult to be controlled unless they are due to hormonal imbalances caused due to gynecological conditions. Therefore, I suggest you consult a gynecologist to rule out other conditions.

I hope you find it helpful.

Kind regards.