How can clogged pores be treated?

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I have gone through the history and the image provided (attachment removed to protect the patient's identity) from your end, and it appears to be acne vulgaris grade one. Acne is caused due to multiple factors, including genetic susceptibility due to transmission from parents or ancestors. These hormonal fluctuations change the androgen levels within the body, altering sebum production and forming acne due to triggering the normal commensal bacteria present within one's skin. The other causes of acne include climate changes, excess sweating, stress, and using skin care products with strong and unusual ingredients to alteration in the keratin layer of the skin. One of the most common causes of hormone fluctuations leading to acne among women is PCOS or polycystic ovarian syndrome, requiring one to consult a gynecologist to rule it out. The other symptoms which can be seen along with PCOS include menstrual irregularities, hair loss, and unwanted excess hair growth in other parts of the body. However, the symptoms can be present to be diagnosed with PCOS. Therefore, I request you consult a gynecologist to rule out its presence. The other conditions causing acne include diet and excessive consumption of oily and fried food, sweets, red meat, milk, and dairy products.

The management of acne is time-consuming and requires using medications consistently over months to obtain better results.

My advice:

1. Salicylic acid facial cleanser may be used for external application. Massage in circular motions all over the face for one minute and wash off. They need to be continuously used for months for better results.

2. Apply Clindamycin and Nicotinamide gel on the acne spots and the clogged areas alone following the usage of the cleanser. The gel must be used in the morning daily and on alternate nights alone on the affected area.

3. Skinoren 20 % cream (Azelaic acid 20 percent). This cream can be applied on alternate nights in the affected areas only. This cream is very strong due, so it is always advisable to use the smallest quantity possible in a very thin layer on the affected area. Initially, it should be started on alternate days, and then later, once the skin gets accustomed to the cream, it can be used daily at night alone. Due to the formulation being strong, in case of sensitive skin, the cream can be avoided for first-time users as it can lead to the formation of redness, burning sensation, irritation, itching sensation, and pain. In case of sensitive skin and adverse effects, as mentioned above from the cream, Clindamycin and Nicotinamide gel can be used daily in the morning and at night. This medication, however, is beneficial in reducing the formation of clogged pores, large pores, acne, and pigmentation following acne.

4. Kindly avoid using any other skin care products. Once the acne has subsided, you may use them. However, the current skincare products used at home are very strong and may cause skin peeling, burning sensation, irritation, and damage. Therefore their use needs to be restricted, and medical treatments in the form of creams and face washes need to be started for the time being.

5. Procedures done on the face would have a better effect when coupled with medications. Therefore, glycolic acid chemical peels, which are done every two weeks for a session of at least six, would be beneficial in reducing the presence of acne and clogged pores and help rejuvenate the skin in general.

6. Laser techniques that help reduce the inflammation present due to acne by having antibacterial properties and mild peeling functions in the form of carbon lasers, Q switch lasers may be helpful and are usually done every three weeks for at least four to five sessions. This treatment may be relatively expensive. Both the above treatments require one to consult a dermatologist in person; therefore, I request you to consult a dermatologist directly to undergo the procedure.

7. Apart from the above, avoid oily and fried food, sweets, red meat, milk, and dairy products. Consume more fruits, vegetables, and fiber and consume at least 12 glasses of water daily in a 250 ml glass size.

8. Direct consultation with a gynecologist would help rule out the presence of PCOS.

9. Tablet Ascorbic acid 500 mg can be consumed once daily at night after food for one month.

Consult your specialist doctor, talk to them, and take medications with their consent.

Medications, when coupled with procedures, have a better effect, and therefore I advise you to undergo procedures along with taking medications as prescribed above. Acne may be on and off and managed in case of external factors. However, acne, due to internal factors, can be challenging to control. Therefore consistency with the medications is always advised.

Hope the details provided above were helpful and provided clarity.

Thank you.