How can I manage comedonal acne and get clear skin?

Hello,

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Thank you for sharing your concern. Understandably, dealing with stubborn acne can be frustrating. Comedonal acne (whiteheads and blackheads) can be persistent and often improves more slowly than inflammatory acne. Avoiding sugar and dairy products is reasonable; however, diet alone rarely clears purely comedonal acne unless there is a strong individual trigger.

Since Tretinoin is already being used, the most important factors are duration and consistency of use. Tretinoin usually takes eight to 12 weeks to show visible improvement. During the first four to six weeks, acne may appear worse due to a process known as purging, where clogged pores come to the surface.

If there is still no improvement, the following adjustments may help:

• Use only a pea-sized amount for the entire face at night.

• Apply it to completely dry skin.

• Follow with a gentle, non-comedogenic moisturizer.

• Avoid overuse, as excessive application can irritate without improving results.

• If irritation occurs, apply it on alternate nights and gradually increase frequency.

• Use a mild cleanser and avoid harsh scrubs, heavy creams, oils, or occlusive makeup that may worsen comedones.

If whiteheads are resistant to treatment, manual extraction performed by a qualified dermatologist may be required. This procedure may involve sterile comedone extraction or electrocautery (a procedure that uses heat generated by electric current).

Attempting to squeeze or open lesions at home should be avoided, as it can lead to infection, spreading of acne, scarring, or post-inflammatory hyperpigmentation.

Another option in selected cases is oral Isotretinoin. It reduces sebum production and increases skin cell turnover. It is generally reserved for moderate to severe acne or treatment-resistant cases. Before starting Isotretinoin, proper screening for contraindications and baseline investigations are required under medical supervision.

Instead of plain Tretinoin, a combination gel containing Adapalene and Benzoyl peroxide may also be considered. This combination can be effective for comedonal acne and mild inflammatory acne. A consultation with a dermatologist is recommended to assess the severity of acne and select the most appropriate treatment plan.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.