I am a 27-year-old female. Why does my acne keep returning?

Question

Hi doctor,

I am a 27-year-old female, weighing 136.6 pounds, and my height is 64 inches. I am experiencing hyperpigmentation and acne on my face. Acne is usually found on the face and can be painful.

I was initially prescribed Amclavin for the acne, which cured it, but then I experienced another one. I use a ceramide cleanser, licorice toner from Acwell, and a moisturizer from Uncover.

I also use Skin Aqua sunscreen when I step out, but it never seems to help. I also have a Glycolic cleanser that has salicylic acid that I use mostly at night.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

There are several possible reasons for acne breakouts. I would like to know if you also experience any menstrual irregularities, as polycystic ovarian syndrome (PCOS) is quite common these days.

So, PCOS is a hormonal condition (spectrum disorder) that can cause:

Irregular menstrual cycles.
Hirsutism (thick, coarse hair on the face or body).
Insulin resistance is often associated with acne breakouts.

It is usually diagnosed based on symptoms and an ultrasound of the pelvis, along with hormone level tests if required.

Regarding your skincare routine, I reviewed the products you are using, and kindly follow the instructions mentioned below:

Salicylic acid (one to two percent) can help reduce acne but may irritate sensitive skin. Avoid it for now, as it requires regular sunscreen use to prevent burning or pigmentation.
Since your skin type is oily, avoid thick creams. Use light, gel-based formulations instead.
Choose an SPF (sun protection factor) 50 sunscreen in gel form and reapply every three hours using the two-finger rule for proper coverage.
You may continue with a cleanser for oily, sensitive skin once or twice daily.
Toners and heavy moisturizers are not necessary. Use a lightweight moisturizer only in winter if needed.
For now, I am prescribing an antibiotic ointment for your acne. Clindamycin one percent gel. Apply locally on acne-affected areas twice daily for 15 days.
Avoid dairy and processed foods.
Exercise regularly to improve hormone balance.

Please get the following test done:

Serum Insulin levels.
HbA1c (glycated hemoglobin).

Kindly follow up with a clear image of your face for further evaluation.

I hope this helps you.

Thank you.