I am a 21-years-old female, and I have acne mostly on my cheeks. This problem started when I was 18 years old. I consulted a dermatologist for the first time, and she prescribed me the tablet Roaccutane. I am a bit skeptical about taking the tablet Roaccutane as the first step in clearing acne because I am aware of the side effects that Roaccutane can have on my body. Kindly suggest.
I have gone through the history provided by you. Acne vulgaris grade 4 is severe acne and requires the tablet Roaccutane (Isotretinoin). However, since it is the first step to treating acne, I suggest you take antibiotics, oral medications, topical creams, face wash, and lifestyle modifications. Acne is caused due to multiple factors that include genetic susceptibility (a transmission from parents genetically), due to hormonal fluctuations, especially androgen, or hormonal imbalances due to an underlying gynecological condition like PCOS (polycystic ovarian syndrome), associated with menstrual irregularities, hair fall, and unwanted facial hair growth. I would suggest you consult a gynecologist in person to rule out PCOS. Other conditions that can cause acne vulgaris include climate changes, sweating, stress, and dietary factors such as oily and fried food, sweets, red meat, milk, and dairy products, and intake of medicines for any underlying medical conditions.
I would suggest -
1. Cera Ve SA facial cleanser (Cocamidopropyl hydroxysultaine, Glycerin, Sodium lauroyl sarcosinate, Niacinamide, Gluconolactone, and Sodium methylcocoyl taurate) use it twice daily. Apply a sufficient quantity, massage for one minute in gentle circular motions, and wash off.
2. Duac gel 2.5 % (Clindamycin and Benzoyl peroxide) to be used once in the morning after using the cleanser. Use it on the acne lesions only in a thin layer.
3. Skinoren 20 % cream (Azelaic acid 20 %) is to be applied in a very small quantity on the affected acne spots only in a very thin layer as the medication is strong and should be used with caution. First-time users may experience irritation, redness, burning sensation, and itching therefore, use the smallest quantity possible. Start by using it on alternate nights and then after six weeks you can use it every night.
4. Tablet of Ascorbic acid 500 mg to be taken orally once daily at night for two months. This helps in the fast healing of acne. Kindly provide an image of the affected area for severity assessment, grading of acne, and prescription of oral antibiotics if needed.
5. Avoid oily and fried food, sweets, red meat, milk, and dairy products, and consume more fruits, vegetables, fruits, and at least 10 glasses of water a day in a 250 ml glass size on a daily basis.
6. Procedures alone with medications show the best result. Glycolic acid chemical peels may be done once every two weeks for at least six sessions. They help with mild peeling and helping with regularization of sebum production. I would suggest you consult a dermatologist in person for undergoing the procedure.
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