I have acne despite medication. Are chemical peels safe?

Question

Hello doctor,

I am 29 and struggling with persistent acne and dark marks on my face. My dermatologist prescribed Tretinoin cream and Doxycycline, but after six weeks, I still see new pimples and irritation.

My recent hormone test showed slightly raised androgens, with free testosterone at 5.9 pg/mL. My concerns are:

Could this be related to PCOS, even though my cycles are regular?
Also, are chemical peels or laser treatments safer options for scars, or should I wait until active acne is controlled?
Lastly, can dietary changes like avoiding dairy and sugar really make a difference in skin breakouts long term?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

This appears to be hormonal acne (acne vulgaris), which is very common in people with oily skin.

The site of acne can sometimes point to contributing factors, for example, forehead acne may be linked to scalp dandruff or buildup, while cheek acne can occur from using an unclean phone or face cloth.

Since you have been prescribed Tretinoin and oral Doxycycline, this suggests stage four nodulocystic acne. Such acne can recur, so it is important to follow a consistent skincare routine over time to control new breakouts.

Diet also plays an important role; avoid excess sugar and dairy products, maintain regular exercise, follow a proper sleep schedule, and drink plenty of fluids.

If you are comfortable, kindly share pictures of the acne so I can recommend a suitable cleanser. Acne marks can also be treated effectively with procedures such as chemical peels, which are safe if performed by a trained professional.

It would also be useful to get the following tests done:

Random blood sugar.
Serum insulin.
Thyroid function tests.

Please follow up with these reports and photographs for better assessment and guidance.

I hope this helps.

Thank you.