Dr. Dhepe Snehal Madhav
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have severe acne on my chin, but the rest of my face and body are clear. These are typically pus-filled whiteheads, papules, and pustules. There are also many red spots and hyperpigmentation. There is a spot that feels like filled with pus or fluid, but nothing comes of it. There are no visible blackheads. My skin seems to alter daily, with new spots appearing. I try not to touch it, yet the patches occasionally burst on their own. It is getting to me. Tablet Yasmin was prescribed to me a year ago, and it cleared my skin up for a few months before it returned and worsened. I have been on tablet Dianette for one and a half months, and my skin is still getting worse. I also have a large boil on my chin that is quite swollen and around 2cm in diameter. It has caused the glands beneath my chin to expand, which is pretty uncomfortable. I have tried Salicylic acid, Azelaic acid, and Acnecide (Benzol Peroxide), but they all irritate and peel my face and do not get rid of the spots. My spots returned after my father was diagnosed with cancer. And I have been wondering whether it is due to that stress. Even though he is doing well with treatment today and I am not stressed, I still get it.
Hello,
Welcome to icliniq.com.
I understand your concern. It looks like hormonal acne with a secondary bacterial infection. Apply an antibacterial cream or gel containing 2 % Nadifloxacin cream or gel twice daily for 20 days. Also, use D Acne soap containing Salicylic acid and Clindamycin for 20 days. For seven days, use Cidofovir gel at night. Take tablet Doxycycline 100 mg once daily for 14 days. Avoid stress and stay relaxed. Also, practice yoga and meditation. Please answer a few questions so I can properly evaluate and assess the issue. Do you have a fever? Do you experience any burning or tingling sensations? Is there a history of herpes or atopy? Is there anything else that might be causing this? Do you have any habits? Are you on any medications?
Patient's Query
Hi doctor,
Thank you for the reply. I am a student, and I do not have any fever. However, I get a tingling and burning sensation when I use Azelaic acid. I have no history of herpes and atopy. I have not discovered anything that makes it worse, except for touching it. I drink occasionally. I am not on any medications. What do you think I should do before using these drugs and creams? Should I only wash and apply sunscreen in the morning and moisturizer in the evening, or should I also use benzoyl peroxide, salicylic acid, and azelaic acid in a rotation?
Hello,
Welcome back to icliniq.com.
I understand your concern. Apply Nadibact (Nadifloxacin) cream (topical anti-bacterial) twice daily for ten days and check whether the condition improves. Let us see how things progress in 10 days. If things worsen, I recommend you get HSV-1 (herpes simplex virus), IgG (Immunoglobulin G), and IgM (Immunoglobulin M) tests and follow up with these reports.
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Venereology
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