Brief Answer:
Kindly elaborate and send pictures

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the cystic hormonal acne on jaw line and on face despite taking various treatment in form of gels and oral medications.

In view to help you better I request you to kindly tell me certain important points:

- Since how long you have these cystic acne.

- How often in a week you get these type of eruptions.

- Do you have regular menses or felt any irregularity in menses at any time.

- Your marital status and if married then planning to conceive or if feeding baby.

- Your occupation and daily routine with emphasis on any stress in daily routine.

It would be better if you can send good resolution pictures of face area so that I can analyze it better. For uploading the pictures you have a facility on the right side of the page or can send on:

YYYY@YYYY

with "attention:Dr Sanjay Kumar Kanodia"

Hope to hear soon form your side.

With regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology

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Brief Answer:
Hormonal acne- combination of Diane + Isotretinoin

Detailed Answer:
Hi,

Welcome again and thanks for posting important details along with pictures.

After analyzing the complete problem along with pictures I can make out that you have got cytic or better known as nodular acne and there is definitely an impact of hormones in your case because of presence near lower face.

I can understand that for a female it is really distressing if there is presence of big pimples on face.

Before I proceed to your issue let me explain you elaborately regarding pimples- Acne or pimples generally appears at the age of 13-14 years and then almost vanishes by the age of 25-30 years.

These erupts basically due to hormones (chemicals which are influencing one or other body functions including growth, puberty and development of body in adults) in addition to the influence of certain other factors causing its aggravation.

Basic XXXXXXX the hormone testosterone (androgens) and its bye-products play the most important role in high oil secretion and increase the size of oil glands especially in males. Because of more oil secretion the pores or ducts of the glands are blocked leading to formation of pimples.

In females there is not a direct presence of testosterone but the female hormones turns into the testosterone and other of related chemicals. I can make out that your Androgen hormone is towards higher side and therefore there is irregularity in menses too.

There are certain other factors such as application of oily or creamy products, over exposure to sunlight, heat and humidity or due to pinching, popping and squeezing of the pimples also leads to formation of pimples. Once these are healing these leave the most problematic thing which are either marks or scars.

Therefore any of the above factors along with hormones can cause appearance of pimples at the age of 26 years also. So perhaps you got some idea regarding your acne.

There are certain suggestions which you can follow:

1. Do not pinch, pop or squeeze any area on face.

2. Do not apply any creamy or oily stuff or any other cosmetics over face.

3. Try to avoid any home remedies suggested by your friends or family members or otherwise self implicated therapies also.

4. Try avoiding situations of direct continuous exposure to sunlight or heat and humidity for long hours. Make your room properly ventilated it will improve the status of pimples.

5. Kindly do not use any antibiotic as self medication.

6. Do not apply any hair oil on scalp or apply in very less amount. Wash your scalp daily with some good shampoo and let there be no dandruff in your scalp ( because dandruff itself causes blockage of pores of oil glands and then pimples).

For the part of treatment:

You have been provided with very good medications both for application as well to take orally. As it is just 18 days since you are using the medications so you will not find a visible result at this time. It requires almost minimum of 6-8 weeks to show the results.

Additionally to tell you that in your kind of cases the best medication for the same is isotretinoin- it is drug of choice which acts on all aspect of pimple formation BUT UNDER STRICT DERMATOLOGICAL SUPERVISION ONLY.

As I said previously, Isotretinoin for 3 -6 months by mouth is the best available treatment for preventing further progression of pimples. If a married female who wants to conceive in next few months then it should not be started. But as you are unmarried and if you are not planning to get married in next 6 months then it can be one of the best drugs for your problem of nodular acne.

For the same it would be better to consult your treating dermatologist and discuss addition of Isotretinoin in your treatment. The rest of the treatment is very good and will be very helpful in reducing the aggravation. Be in good follow up of the treating dermatologist. Do not at all try self implicated therapies as can harm you rather than helping.

There is no effect of diet in case of acne and therefore you do not require to either stop or start anything specif for reducing acne. There is myth that you should stop eating spicy and oily food but actually speaking it is scientifically proven that there is no effect of these type of foods. In some cases it has been shown that bit more sugary things such as chocolates and related items can aggravate but personally speaking I have not seen any impact.

So finally speaking in your kind of hormonal acne- combination of Diane + Isotretinoin will be the most effective treatment and can see long lasting results within 2 months.

Reduce your stress level too as high stress leads to hormonal up surge and thereby more eruption of pimples.

I hope that the information will help you. If you have any further query I will be happy to help.

"With healthy skin wishes"

Regards,

Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
combination treatment will take care of acne

Detailed Answer:
Hello young lady,

Welcome again to the forum.

Regarding sudden eruptions and healing- it is quite common due to upsurge an down surge of hormones. In all the persons having bit excess of hormones there is always a tendency to have sudden eruptions.

In my patients with your kind of condition I treat them with combination of hormonal treatment and isotretinoin. Hormonal treatment on one side takes care of normalizing the hormones and isotretinoin on other side takes care of all aspects of treating pimples.

As I said earlier it takes minimum of 6-8 weeks to take the control of acne so in your case also it may take the same time.

You should discuss the use of this combination treatment with your treating dermatologist.

I hope these informations will help you.

I will be glad to answer any further queries.

With regards,

Dr Sanjay

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