Brief Answer:
Acne and hair fall treatment

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I am Dr. Kakkar. I have gone through your query.

You have mentioned 2 concerns in your query:

-Acne
-Hair fall

Your first concern is acne. Topical treatment of acne mainly revolves around Topical antibacterials, like Nadifloxacin, Clindamycin; Topical benzoyl peroxide and Topical retinoids.

The cream you have been using contains Nadifloxacin, which is a topical antibacterial.

Topical antibacterials are mainly given for inflammatory acne (red lesions, papules, nodules etc). They are antibacterial, anti-inflammatory.
Topical benzoyl peroxide is also antibacterial, antiinflammatory as well as keratolytic in its action. Its main use is also for inflammatory acne.
Topical retinoids are first line treatment in all grades of acne (whether inflammatory or non-inflammatory). They are comedolytic, anti-inflammatory and therefore prevent formation of new acne lesions as well.

However, topical treatment alone is sometimes not effective on its own to take complete control of acne activity.
Oral antibiotics are usually also combined with topical anti-acne treatment. Commonly prescribed oral antibiotics in acne are either Doxycycline, Azithromycin , Or Minocycline.

Finally, I would like to mention about Oral retinoids (Isotretinoin). Oral retinoids are the most effective anti-acne medication. They are first line treatment for severe grade acne as well as acne which is not responding as expected to traditional anti-acne medications.

I would suggest that you seek another appointment with your dermatologist. Your dermatologist would definitely contemplate starting you on oral treatment along with topical nadifloxacin and might add another topical (e.g topical retinoid).

Regarding your hair fall, which is your second concern, I would like to gather more information from you in order to be able to guide you better,

-The duration of your hair fall? How many hair strands do you lose per day, the approximate number (whether < 50, 50-100 Or >100)?
Do you have dandruff?
-Any history of Thyroid (Hypothyroid or Hyperthyroid)? Have you ever been investigated for this?
-Any history of Sudden/Significant weight loss preceding hair loss?
-Any history of major stressful event preceding hair loss (preceding 3-6 months) e.g history of medical illness (e.g jaundice, malaria, typhoid, dengue etc) Or preceding surgery Or any other major psychological/mental stress?
-Is the hair fall related to recent delivery/post pregnancy telogen effluvium?

Kindly get back to me with the details.

Regards

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Brief Answer:
Oral antibiotics for acne;Test thyroid, S.ferritin

Detailed Answer:
Hi.

I have gone through the photographs and I have also seen the prescription.

You seem to have moderate inflammatory acne. Acne can last for years or even decades. I am of the view that you need to be started on oral antibiotics as well. You are even a candidate for Oral retinoids since your acne has lasted for more than 2 decades.
You may continue with nadifloxacin during day time. At night benzoyl peroxide may be added.
These are prescription drugs. I would suggest that you seek another appointment with a dermatologist for the needful.
You can also opt for a few sessions of chemical peeling from a dermatologist. Salicylic acid peel is good for acne

Regarding hair fall, I will keep a possibility of either Telogen Effluvium Or Female pattern Androgenetic Alopecia.
I can see that it is a recent prescription (20/9/14). Hair fall takes some time to respond (may be 3-4 months), therefore you need to be patient and continue with the prescription. Topical Minoxidil and Biotin supplement capsules can be continued as before.
Get you thyroid status known and also test for serum ferritin levels and Vitamin D levels.

Regards

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