Brief Answer:
Acne vulgaris : suggestions as below

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for pimples. For a female it is really distressing if there is presence of pimples on face.

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

The hormone testosterone and its bye-products plays the most important role in high oil secretion and increase the size of oil glands especially in males. As the pores or ducts of the glands are blocked so it leads to formation of pimples.

In females there is not a direct presence of testosterone is there but the female hormones turns into the testosterone and other of related chemicals. 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 they 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 31 years also. So probably 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).

Kindly tell me some details regarding yourself

- your marital status and if married then future planning for pregnancy or feeding baby.

- Your job profile.

- History of delayed menses.

- How many pimples you get in a week and are these big ones.

It will be better if you can send a picture of your present status. I request you to kindly upload few good resolution pictures of your face areas so that I can analyze it better. Kindly send good resolution pictures focusing the area of concern which can be seen on higher magnification. 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 from your side.

With regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology

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Brief Answer:
Various anti-acne treatment options can be taken

Detailed Answer:
Hello young lady,

Welcome again to the forum and thanks for your follow up with important details.

In your kind of cases of married females I first start a weekly course of oral Azithromycin 500 mg for 3 times a week can be taken for 2 months.

I also give certain gel formulations to apply. For topical application If I were your treating doctor then would have prescribed you a gel containing Clindamycin with Adapalene in it. This should be applied at night time in thinnest possible amount over pimples only. For initial few days apply for 1 hour and then wash it off.

For married females who do not wish to conceive in near future of atleast 1 year then Isotretinoin for 3-6 months by mouth is the best available treatment for preventing further progression of pimples. If a female wants to conceive in next few months then it should NEVER be started. It is drug of choice which acts on all aspect of pimple formation BUT UNDER STRICT DERMATOLOGICAL SUPERVISION ONLY. Why I have written in capitals letters is because it is double edged sword- if not used under medical advice it can cause serious side effects. We always first go for certain basic investigation of blood before we start this medicine. There is also a norm of continuous supervision with further blood test monthly basis and clinically also where we judge either to reduce or to stop the medication. So this drug is to be started under a dermatologist's guidance only.

The other of the way is to go for hormonal therapy in low dose along with anti-androgen tablets can be taken for 3 months. Again you need to take it under dermatological supervision only.

For any of the above treatment it would be better to consult a proper dermatologist and discuss all sorts of measure which I have suggested to you. Be in good follow up of the treating dermatologist.

Do not at all try self implicated therapies as can harm you rather than helping. Rest of the suggestions are previous. 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:
medicines to be taken under dermatological guidanc

Detailed Answer:
Dear Young lady,

I highly appreciate your trust in me. But our forum is basically meant for guidance so I very humbly request you to take medications under physical guidance of a dermatologist only.

None of the medications should be taken without a dermatological guidance. I suggest you tot discuss the points as I guided you. The medications should be given only after physical assessment of the problem and looking after so many other issues of follow up.

So it is my brotherly suggestion to you to meet a dermatologist and take guidance and discuss all the points guided by me.

My all best wishes for healthy and glowing skin.

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)

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