Dr. Kakkar S
Dermatology, HIV/AIDS Specialist, Venereology
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I have gone through your query and I have viewed the image (attachment removed to protect patient identity).
You have inflammatory acne (moderate to severe grade). The flakiness over the oily skin zone is perhaps due to associated seborrheic dermatitis or sebopsoriasis.
You would require oral antibiotics like Doxycycline or Minocycline. In addition, I suggest you try using topical Clindamycin and Benzoyl peroxide gel.
I would also like to rule out a hormonal etiology such as PCOD (polycystic ovarian disease) as the reason for your acne. If found, you may have to be on monthly hormonal pills.
For flakiness over the oily skin zones, you may use cortisone cream twice daily. Consult your specialist doctor, discuss with him or her, and start taking the medicines with their consent.
For more information consult a dermatologist online --> https://icliniq.com./ask-a-doctor-online/dermatologist