Brief Answer:
Need some details

Detailed Answer:
Hello. Thank you for writing to us.

I have taken note of your query and i have also reviewed the image.

You have 2 concerns: acne and melasma.

R-cin is rifampicin.
It is not a treatment either for acne or for melasma.
Therefore you must stop it.

I would like to know more from you so that i am able to guide you better.

-Do you have any history of hormonal imbalance like menstural irregularity? Coarse facial hair?
- What all alopathic medications have you used already? Kindly list those.
- What is your face care routine. I mean what all products do you use on face? Moisturizers? Sunscreen? Face wash Or soap?

Kindly provide me with these details.

Regards

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Brief Answer:
Advice regarding acne and pigmentation

Detailed Answer:
Hello shobhna

Thank you for the details. No surgery is required. Allopathic treatment would be better.

Continue with the sunscreen that you are using. Use it throughout the day. Reapply every 2-3 hours, specially if outdoors.

Also continue with the gentle cleansing lotion i.e Episoft cleansing lotion, twice daily.

You may use an azaleic acid 20% gel. Azaleic acid would work well for both acne as well as pigmentation. Initially use it just once daily at night. Thereafter, if there is no irritation/ redness, you may use it twice daily.

Alternatively you may use Hydroquinone 5% lotion once daily at night for pigmentation. Hydroquinone inhibits melanin synthesis and therefore helps lighten pigmentation.

Along with medical treatment you may also take a few sessions of chemical peeling from a dermatologist.
Salicylic acid peel is particularly suitable for acne. Salicylic peel also helps dry excessive oil and is suitable for oily skin.
Glycolic acid chemical peeling is particularly useful for pigmentation.

A series of peeling sessions would be required. Each session at 2 weeks interval.

For acne I would suggest an Oral antibiotic e.g either doxycycline Or azithromycin for a few weeks.

The topical antiacne gel that you have been using i.e peroduo gel contains benzoyl peroxide and along with adapalene.
It is irritating and therefore may cause more irritation in addition to other topical medications that you would be using for pigmentation.
Therefore I suggest you to discontinue it. Instead you may use topically clindamycin 1% lotion for acne affected area.
Clindamycin 1% lotion is suitable for oily skin and dries immediately on application and would not be irritating unlike peroduo gel.
You may use it twice daily over the acne affected area.

These are all prescription medications. Therefore I suggest that you take these only under the supervision of a dermatologist.

Regards

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