Brief Answer: Gentle cleansing+Anti-acne medications Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX Acne is a very common problem in young. Acne commonly involves face, trunk, chest and shoulders (all these areas are rich in sebaceous glands). Treatment of acne required diligence and patience both on the part of the patient and the doctor. Acnil soap that you are presently using for acne contains a sulphonated surfactant blend, which is not by itself sufficient to improve acne. Moreover it might be causing excessive drynes after washing thus leading to rebound oiliness after sometime. I advice the following general measures regarding cleansing to my acne patients: --Use a mild cleanser like cetaphil twice daily. Harsh cleansing causes the skin to become excessively dry which in turn causes rebound oilyness. --Avoid all the regular use creams, moisturizers, sunscreens that you may be using for the time being till you are on anti-acne treatment. --Avoid taking facials. --Avoid picking your acne. Since Acne and seborrheic dermatitis/dandruff are usually associated it is advisable to use an Anti-dandruff shampoo since acne is worsened by dandruff. Specific treatment for acne: --Oral Antibiotics: For inflammatory acne(papules and pustules) I usually advice my patients to start with one of the oral antibiotics like Azithromycin/ Doxycycline/ Minocycline. --Oral Retinoids: For severe acne OR for acne unresponsive to traditional anti-acne medications, Isotretinoin can be started. It the only drug which offers any chance of long term cure and after a full course of isotretinoin significant number of people never have a recurrence of there acne. It should be taken under the supervision of a dermatologist because of certain lab tests which are to be done before and during treatment with isotretinoin. --Topical treatment: Is a valuable adjunct to any form of acne treatment. Mainly two classes of drugs are used topically 1)Topical Antibacterials: Dermatologists around the world prescribe topical gels/creams containing topical antibiotics like either clindamycin 1%/ benzoyl peroxide 2.5% OR Nadifloxacin during the day time. 2)Topical Retinoids: Either Adapalene 0.1%/ Tretinoin 0.025% OR Azaleic acid (10%/20%) at bed time. I would advice that you consult a dermatologist and have a face to face discussion keeping all these points in mind. I am here to help you out with any further clarifications Hope this information helps you take care regards

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Brief Answer: Oral retinoids+oral antibiotics+topicals Detailed Answer: Hi. You have severe grade acne. In such a case i usually ask my patients to take Oral Azithromycin 500mg three consequtive days/week for 4-12 weeks depending on the response. If i was your treating dermatologist i would have definitely started you on oral Retinoids (Isotretinoin). Topical clindamycin gel(clindac A) can be used day time and Benzoyl peroxide2.5% gel (Benzac -AC gel) for night time aplication. The cream you have been using specially betnovate-N,-S,-C might be the reason for worsening of your acne. They contain a potent steroid, which because of its antiinflammatory action improves acne initially OR in other words settles down acne giving the patient a false belief that it can cure acne but if continued it causes new acne eruptions to develop. So topical steroids (betnovate) should be avoided. Benzoyl peroxide can cause redness because it is an irritant but actually it is a very effective anti-acne drug. To avoid excessive irritation you can use it alternate days initially for a few days till your skin gets used to it. I would advice that you see a dermatologist and get a prescription for these medicines. You can discuss with your dermatologist about oral retinoids(Isotretinoin). Hope this helps you regards

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