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Suggest Treatment For Acne On Skin Despite Using Clobeta-GM
Question: Hi Doctor,
My Sister is having lot of pimples/acne on her face.
Some relative in our hometown suggested to use "Clobeta GM" cream for that. She used it for almost 6 months. Initially that gave good result. But after that there is not much result. So she stopped using it. Then pimples becoming big and also number of pimples got increased after stopping that cream.
Then we consulted a Dermatologist in XXXXXXX 4 months back. That Doctor asked us to do some blood tests and the reports are fine.
Now Doctor asked us to go through Acne Control Peel sessions and Skin brightning sessions. And now my sister is using "SOTRET" tablet and also going through those sessions. And also using "Keracnyl" cream and moisturizers.
Please let us know whether these tablets, creams and sessions are fine? OR do you suggest to use some other process?
And also let us know the best Dermatologist in XXXXXXX who can solve this issue.
Thx
My Sister is having lot of pimples/acne on her face.
Some relative in our hometown suggested to use "Clobeta GM" cream for that. She used it for almost 6 months. Initially that gave good result. But after that there is not much result. So she stopped using it. Then pimples becoming big and also number of pimples got increased after stopping that cream.
Then we consulted a Dermatologist in XXXXXXX 4 months back. That Doctor asked us to do some blood tests and the reports are fine.
Now Doctor asked us to go through Acne Control Peel sessions and Skin brightning sessions. And now my sister is using "SOTRET" tablet and also going through those sessions. And also using "Keracnyl" cream and moisturizers.
Please let us know whether these tablets, creams and sessions are fine? OR do you suggest to use some other process?
And also let us know the best Dermatologist in XXXXXXX who can solve this issue.
Thx
Brief Answer:
"Steroid Abuse" or "Steroid dependence":kindly upload few pcitures of face.
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for pimples on the face of your sister.
After reading your query I can make out that you have applied Clobeta GM cream for long time. The findings which I can get from your query makes the diagnosis of "Steroid Abuse" or "Steroid dependence".
"Steroid Abuse" or "Steroid dependence" is quite common phenomenon where after long term, injudicious and unregistered use of steroid creams without medical advice lead to the multiple side effects.
Topical steroid creams are potentially known to cause side effects on long term or injudicious use in form of thinning of skin, hair growth on affected area and prominence of vessels with rashes.
In your sister's case she have applied Clobeta GM which contains Clobetasol in it. This is a strong potency steroid and is never to be used on face. If at all is used on other parts too then also not beyond 15 days. I very often see person of your sister's age using this cream and damaging the skin.
Once it is started on face it initially gives fair complexion. This is because of mild stoppage of the activity of color producing cells. SO it gives initial fair complexion. But on regular usage it produces skin atrophy and then dependence on it. It is a must to stop the cream at the earliest.
In view to help you best I humbly request you to kindly upload few good resolution pictures of the affected area of face. For that you have a feature on the right side of the page. For that you have a feature on the right side of the page or else you can send your pictures at:
YYYY@YYYY
With attention " Dr Sanjay Kanodia "
Hope to hear soon from your side.
With regards,
Dr Sanjay Kanodia
MD-DERMATOLOGY
"Steroid Abuse" or "Steroid dependence":kindly upload few pcitures of face.
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for pimples on the face of your sister.
After reading your query I can make out that you have applied Clobeta GM cream for long time. The findings which I can get from your query makes the diagnosis of "Steroid Abuse" or "Steroid dependence".
"Steroid Abuse" or "Steroid dependence" is quite common phenomenon where after long term, injudicious and unregistered use of steroid creams without medical advice lead to the multiple side effects.
Topical steroid creams are potentially known to cause side effects on long term or injudicious use in form of thinning of skin, hair growth on affected area and prominence of vessels with rashes.
In your sister's case she have applied Clobeta GM which contains Clobetasol in it. This is a strong potency steroid and is never to be used on face. If at all is used on other parts too then also not beyond 15 days. I very often see person of your sister's age using this cream and damaging the skin.
Once it is started on face it initially gives fair complexion. This is because of mild stoppage of the activity of color producing cells. SO it gives initial fair complexion. But on regular usage it produces skin atrophy and then dependence on it. It is a must to stop the cream at the earliest.
In view to help you best I humbly request you to kindly upload few good resolution pictures of the affected area of face. For that you have a feature on the right side of the page. For that you have a feature on the right side of the page or else you can send your pictures at:
YYYY@YYYY
With attention " Dr Sanjay Kanodia "
Hope to hear soon from your side.
With regards,
Dr Sanjay Kanodia
MD-DERMATOLOGY
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Thanks for the quick reply and detailed explanation. I am going to upload pics to night.
How can we recover from this and Will this be recoverable completely?
Let me know if you are based out of XXXXXXX ? Otherwise please suggest good doctors from XXXXXXX
Thanks.
Thanks for the quick reply and detailed explanation. I am going to upload pics to night.
How can we recover from this and Will this be recoverable completely?
Let me know if you are based out of XXXXXXX ? Otherwise please suggest good doctors from XXXXXXX
Thanks.
Brief Answer:
This is completely recoverable condition but requires great patience.
Detailed Answer:
Dear young fellow,
Welcome back and thanks a lot for your quick revert. I am basically based at XXXXXXX but will guide you for good dermatologist at XXXXXXX
This is completely recoverable condition but requires great patience from doctor as well as patient.
I will wait for the pictures to get uploaded and then guide you accordingly. Do inform me as you upload the pictures.
With regards,
Dr Sanjay Kanodia
MD-DERMATOLOGY
This is completely recoverable condition but requires great patience.
Detailed Answer:
Dear young fellow,
Welcome back and thanks a lot for your quick revert. I am basically based at XXXXXXX but will guide you for good dermatologist at XXXXXXX
This is completely recoverable condition but requires great patience from doctor as well as patient.
I will wait for the pictures to get uploaded and then guide you accordingly. Do inform me as you upload the pictures.
With regards,
Dr Sanjay Kanodia
MD-DERMATOLOGY
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Thanks for the information.
I have uploaded latest two photos (Latest1.jpg and Latest2.jpg) and also one photo (oneyearback.jpg) which is one year back, to know the difference.
And also I have uploaded the Test Reports (TestReports-2.pdf and report-5.pdf).
Please go through the photos and reports, and let me know how to proceed further for the treatment.
And also let us know good Dermatologist in XXXXXXX
Thanks.
Thanks for the information.
I have uploaded latest two photos (Latest1.jpg and Latest2.jpg) and also one photo (oneyearback.jpg) which is one year back, to know the difference.
And also I have uploaded the Test Reports (TestReports-2.pdf and report-5.pdf).
Please go through the photos and reports, and let me know how to proceed further for the treatment.
And also let us know good Dermatologist in XXXXXXX
Thanks.
Brief Answer:
Steroid abuse and dependence: various suggestions.
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks for your follow up with pictures and details.
I am really empathetic to see the side effect of steroid in the pictures. The steroid based cream has really worsened the face.
The reports are quite fine and there is no issues for the same except for slightly raised TSH which actually have no direct implication on your condition.
Steroid abuse and dependence is quite notorious condition and we have to try different regimens as per close physical examination in regular follow up.
In my patients I use steroid sparing agents such as tacrolimus to take off the steroid side effects. Sotret is a very good medication but in case if she is married and going to conceive in near future if feeding then should not be taken.
Peels are quite alright but requires a long time to give results. Basically it requires multiple modes of therapy with extraction of comedones, oral therapy and steroid sparing application to get the best results.
In XXXXXXX you can meet Dr XXXXXXX Kumar. You can take his contact details by the customer care number of the forum. Do let me know if you find any problem or want any further guidance.
I hope this information will help you. If you have any further query I will be happy to help.
I wish best and early resolution of the problem.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Steroid abuse and dependence: various suggestions.
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks for your follow up with pictures and details.
I am really empathetic to see the side effect of steroid in the pictures. The steroid based cream has really worsened the face.
The reports are quite fine and there is no issues for the same except for slightly raised TSH which actually have no direct implication on your condition.
Steroid abuse and dependence is quite notorious condition and we have to try different regimens as per close physical examination in regular follow up.
In my patients I use steroid sparing agents such as tacrolimus to take off the steroid side effects. Sotret is a very good medication but in case if she is married and going to conceive in near future if feeding then should not be taken.
Peels are quite alright but requires a long time to give results. Basically it requires multiple modes of therapy with extraction of comedones, oral therapy and steroid sparing application to get the best results.
In XXXXXXX you can meet Dr XXXXXXX Kumar. You can take his contact details by the customer care number of the forum. Do let me know if you find any problem or want any further guidance.
I hope this information will help you. If you have any further query I will be happy to help.
I wish best and early resolution of the problem.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Thank you so much for explaining all the details.
I have few questions:
1) After stopping that "Clobeta GM" cream, she is getting more new pimples and that too bigger in size. Earlier (before using that cream), she used to get very rarely. And her face color also changed to dark complexion. This is also due to the side effect of that cream?
2) She is going for the Peeling sessions and using Keracnyl and DerivaCMS creams from last 3 months. And using SOTRET from last 15 days. Still she is getting new pimples. What could be the reason for new pimples?
3) So we have multiple issues to solve here. One is controlling new pimples to come up and other one is reducing the existing acne and getting rid of scars.
Please let us know your inputs.
Thanks.
Thank you so much for explaining all the details.
I have few questions:
1) After stopping that "Clobeta GM" cream, she is getting more new pimples and that too bigger in size. Earlier (before using that cream), she used to get very rarely. And her face color also changed to dark complexion. This is also due to the side effect of that cream?
2) She is going for the Peeling sessions and using Keracnyl and DerivaCMS creams from last 3 months. And using SOTRET from last 15 days. Still she is getting new pimples. What could be the reason for new pimples?
3) So we have multiple issues to solve here. One is controlling new pimples to come up and other one is reducing the existing acne and getting rid of scars.
Please let us know your inputs.
Thanks.
Brief Answer:
Steroid abuse and dependence on face: various suggestions and guidance.
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks for your further follow up.
You are right in your perception that it is because of the cream that she is getting bigger and more pimples as a side effect of the clobetasol. This cream is either not used on face or if used then never for more than few days. In case if it is used even for more than few weeks then also we find such kind of side effects. It even can cause thinning of skin with hair growth on face too. In your sister's case it had been used for more than 6 months which is quite a long time to cause the major side effects.
But as I guided you in my previous mail that it can be fully recoverable. So do not worry for the same and reassure your sister too.
Sotret is one of a very good treatment option but in case if she is going to conceive in next few months or if feeding then should never be given. Do let me know her marital status and if married then number of kids or if feeding baby.
It takes minimum of 8 weeks of period to take up the effect of Sotret. 2 Weeks is quite a short period of time to show the effect of sotret. It basically works by reducing the oil secretion and thereby reducing blockage of pores of the same.
Deriva CMS is a good gel and reduces the existing pimples but causes lot of dryness. So it should be applied in a very thin layer. I guide my patients to take a pea size amount and then apply it with a ear bud in such a manner that it should not be visible to the naked eye. I also suggest to keep it only for 1 hour in initial few days to week period to avoid the contact irritation.
I again reassure you that she will be alright but should have patience for the same.
I hope this information will help you. If you have any further query I will be happy to help.
I wish best and early resolution of the problem.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Steroid abuse and dependence on face: various suggestions and guidance.
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks for your further follow up.
You are right in your perception that it is because of the cream that she is getting bigger and more pimples as a side effect of the clobetasol. This cream is either not used on face or if used then never for more than few days. In case if it is used even for more than few weeks then also we find such kind of side effects. It even can cause thinning of skin with hair growth on face too. In your sister's case it had been used for more than 6 months which is quite a long time to cause the major side effects.
But as I guided you in my previous mail that it can be fully recoverable. So do not worry for the same and reassure your sister too.
Sotret is one of a very good treatment option but in case if she is going to conceive in next few months or if feeding then should never be given. Do let me know her marital status and if married then number of kids or if feeding baby.
It takes minimum of 8 weeks of period to take up the effect of Sotret. 2 Weeks is quite a short period of time to show the effect of sotret. It basically works by reducing the oil secretion and thereby reducing blockage of pores of the same.
Deriva CMS is a good gel and reduces the existing pimples but causes lot of dryness. So it should be applied in a very thin layer. I guide my patients to take a pea size amount and then apply it with a ear bud in such a manner that it should not be visible to the naked eye. I also suggest to keep it only for 1 hour in initial few days to week period to avoid the contact irritation.
I again reassure you that she will be alright but should have patience for the same.
I hope this information will help you. If you have any further query I will be happy to help.
I wish best and early resolution of the problem.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Thank you so much for the assurance and detailed explanation.
She is married and has a 3 year old son and not feeding. And no plans to conceive in near future.
As suggested by our Dermatologist, we had taken test of Vitamin-B12. I have uploaded the test report for that (vitaminB12test.jpg). As the value is less than required range, Doctor suggested us to take Vitamin B12 injection (ME-12 injection) once in every week for 4 weeks. So she started taking that injection as well. Please let us know is it fine or not.
And also do you suggest us to take any tests other than the existing ones?
And does she need to follow any food restrictions?
Hopefully all these treatments should work for her and should have a complete and permanent recovery. And hope she won't get them again in future after she recovers.
Sorry for troubling you with so many questions.
Thank you so much once again.
Thanks.
Thank you so much for the assurance and detailed explanation.
She is married and has a 3 year old son and not feeding. And no plans to conceive in near future.
As suggested by our Dermatologist, we had taken test of Vitamin-B12. I have uploaded the test report for that (vitaminB12test.jpg). As the value is less than required range, Doctor suggested us to take Vitamin B12 injection (ME-12 injection) once in every week for 4 weeks. So she started taking that injection as well. Please let us know is it fine or not.
And also do you suggest us to take any tests other than the existing ones?
And does she need to follow any food restrictions?
Hopefully all these treatments should work for her and should have a complete and permanent recovery. And hope she won't get them again in future after she recovers.
Sorry for troubling you with so many questions.
Thank you so much once again.
Thanks.
Brief Answer:
"My best wishes for her glowing skin"
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks a lot for your swift follow with further queries. You are most welcome to take as much as guidance you can as it will help you in dealing the condition better.
Regarding vitamin B12 issues: It is good to treat the low level of Vitamin B12. Though it is not related to the present issue of steroid abuse but it is always good to treat any deficiency state. In one or the other way this will help her in day to day life. So you can go for the same as suggested by the treating doctor.
Sotret is not given in ladies who want to conceive in near future. SO if she is not conceiving in near future then there is no issues for the same. But do take full guidance from the treating doctor.
There is no any need of additional testing. Steroid abuse is a simple condition not related to any abnormality of the tests.
There si no need for any food restriction. Though it is a age old myth that spicy or fried or oily food induces more of pimples but it is been proved by medical science that there is no such implication of food in any of these issues. Rather I say that she should have best of her food to replenish her vitamin and mineral reserves.
I reassure you fully that she will be alright with proper best treatment. Ask her to have patience and should not repeat such kind of thing again.
"My best wishes for her glowing skin"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
"My best wishes for her glowing skin"
Detailed Answer:
Dear XXXXXXX
Welcome back and thanks a lot for your swift follow with further queries. You are most welcome to take as much as guidance you can as it will help you in dealing the condition better.
Regarding vitamin B12 issues: It is good to treat the low level of Vitamin B12. Though it is not related to the present issue of steroid abuse but it is always good to treat any deficiency state. In one or the other way this will help her in day to day life. So you can go for the same as suggested by the treating doctor.
Sotret is not given in ladies who want to conceive in near future. SO if she is not conceiving in near future then there is no issues for the same. But do take full guidance from the treating doctor.
There is no any need of additional testing. Steroid abuse is a simple condition not related to any abnormality of the tests.
There si no need for any food restriction. Though it is a age old myth that spicy or fried or oily food induces more of pimples but it is been proved by medical science that there is no such implication of food in any of these issues. Rather I say that she should have best of her food to replenish her vitamin and mineral reserves.
I reassure you fully that she will be alright with proper best treatment. Ask her to have patience and should not repeat such kind of thing again.
"My best wishes for her glowing skin"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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