Suggest Treatment For Severe Acne And Oily Skin

Posted on Thu, 17 Aug 2017

Question: I have a moderately severe acne and skin condition that is chronic and I have been struggling with it for 10 years or more now.

In the beginning, I used to have lot of pustular acne in and around the chin area primarily, accompanied by some acne in the back and chest. Later on the condition on the chest aggravated and I had cystic acne there that would bleed and release pus. I then took treatment from a local derma and he prescribed me Isotretion. I took it for about an year. My skin was a lot better during the course of the treatment. After I stopped taking it, the problem returned slowly and gradually. This was about 8 years ago.

Right now, I have acne all over my body. Acne on scalp, back, shoulders, everywhere. And the condition seems to be getting worse every year.

My skin is very oily, and most of the acne I get is pustular in nature, red indurated base and yellow head at the top. Lot of people have oily skin, but they don't have the same condition. So I am really frustrated now.

Age 31
Male
Oily Skin
Acne pustular in nature, leave spots
Mostly on back, chest, shoulders, scalp

I need detailed advise, prescription, etc. from an experienced doctor.

Thanks in advance.

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Isotretinoin can be restarted

Detailed Answer:
Hello. Thank you for writing to us

I am Dr..Kakkar (dermatologist). I have gone through your query and I have noted your concern. I have viewed the image.
Many patients with severe acne may relapse and require repeated courses of isotretinoin. Isotretinoin is US FDA approved treatment for severe acne i.e pustular, nodular and cystic acne that is usually resistant to traditional antiacne treatment. I suggest you to consider restarting isotretinoin. In addition you may use clindoxyl gel (clindamycin 1% and benzoyl peroxide 5% gel) over active acne. I also suggest you to take an oral antibiotic e.g Tab. Trimethoprim 800mg + Sulphamethoxazole 160mg (Septran DS tablet), twice daily for a week.
These are all prescription medications and I suggest that you take them under supervision of your dermatologist.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Kakkar (3 hours later)

Thanks for your response. I do not want to visit a dermatologist that is why I put my question here. Can I not take your prescribed medicines without consulting a doctor in person?

Some questions for you:

Is Isotretinoin not an antibiotic? If not, what is it?
You said I can restart it, but did not specify the dose and frequency. Please recommend that as well. I am 31, Male, 92-95kg weight.
What are those antibiotics for? Is it necessary to take them?

Looking forward.

Answered by Dr. Dr. Kakkar (16 hours later)

Brief Answer:
Regarding isotretinoin

Detailed Answer:
Hi.

Isotretinoin is an oral retinoid. It is not an antibiotic. It acts by reducing the activity of sebaceous glands and by normalizing keratinization of hair follicles. Isotretinoin is a prescription drug and requires monitoring for liver function tests and serum lipid profile. So it is advisable to take it under supervision of a dermatologist. It can be started in a dose of 0.3- 0.5mg/kg/day i.e around 40mg per day and later may even be increases to 60mg per day.
The oral antibiotic i.e Septran DS is for initial few days to reduce pus and inflammation till isotretinoin takes over.

Regards

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. Remy Koshy