When I stop applying Deriva, pimples reappear. Please help.

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Deriva cream is a combination of Clindamycin and Adapalene. Please mention whether you have any irritation and burning. Isotretinoin helps to heal active acne lesions. Azithromycin is an antibiotic that kills the bacteria causing acne. Aquasoft is used to avoid dryness caused due to Adapalene in Deriva and it helps in moisturizing the skin. Please mention whether you have acne scars and any present active acne lesions. Please mention whether you have painful nodulocystic lesions and postinflammatory hyperpigmentation marks. Please attach a picture to guide you further. Please mention whether you have an oily skin type.

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You can use Ahaglow face wash twice daily for 20 days. You can stop using Deriva if it causes irritation.

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Punch excision, graft replacement can be done for treating boxcar scars. Rolling acne scars or chemical peeling helps a lot. You can use Retin A 0.025 percent cream at night for 15 days. Apply it for 30 minutes and then wash it off. Take tablet Limcee 500 mg once a day for thirty days. You can use Cetaphil moisturizing lotion twice daily for 20 days. You can use Photostable sunscreen at 9 am in the morning, 12 pm in the afternoon, and 3 pm in the afternoon daily for 20 days. Avoid using harsh soaps and use mild soaps like Cetaphil and Dove. You can use Acnesol gel in the daytime for 15 days on the new pimples. Relax and be stress-free as stress is a big contributing factor. Apply sunscreen as mentioned above. Avoid having direct exposure to the sun. Avoid taking oily food, junk food, dairy products, egg yolk, fatty foods, and a high carbohydrate diet with spicy foods. Eat vitamin A-rich foods like carrots and papaya. Do not prick your acne as it leads to deep and permanent scarring. If you have any burning sensation, you can revert back. You can use Cetaphil cream or lotion in the morning and afternoon. Drink two to three liters of water daily. Avoid having hair oil application. You can use Scalpe or Nizoral shampoo to keep the scalp dandruff free. You can use Ahaglow face wash to wash the face twice a day with plain water. Retin A has a peeling action and if you have any burning sensation or irritation, you can revert back. For mild acne lesions, you can use Tretinoin 0.025 percent gel at the night for ten days. You can use Acnesol gel in the daytime for 15 days. CO2 fractional laser is a cosmetic procedure and it is a good option for scarring. It stimulates fibroblasts, increases collagen production, and improves scars. Chemical peels with Glycolic acid 15 percent and lactic acid peels help to improve texture. Microneedling, derma roller, laser, and peels work better in combination. Dermafiller stimulates collagen formation. For atrophic scarring, laser resurfacing with dermal collagen injection-like fillers works best. You can use Kojic cream at night for 20 days. It should be used on hyperpigmentation patches and it improves skin tone.

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