Welcome to icliniq.com.
From your description, he is suffering from acne vulgaris. As it is spreading to the upper back, it is problematic.
Here are some tips for facial hygiene which he can follow:
- Use a mild soap and avoid medicated ones.
- While washing the face, the skin of the face should not be rubbed roughly. It should be sponged gently.
- He can wash his face three or four times a day with plain water, but soap is to be used only twice a day.
- Avoid exposure to dust, dirt or oily cosmetics.
- Please avoid fatty diet though it is not scientifically proved.
- Do not squeeze the acne as it may leave a scar permanently.
Regarding treatment, I suggest the following:
- Capsule Doxycycline 100 mg two times a day.
- Tablet Brufen (Ibuprofen) 400 mg two times for five days.
- Tablet Isotretinoin once a day for 15 days.
- Cream Retino-A (Tretinoin) locally at night.
For more information consult a family physician online --> https://icliniq.com./ask-a-doctor-online/family-physician