Brief Answer:
I suggest you to continue with Rx; response takes time; use gentle cleanser

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have understood it well.

After going through your treatment history I could make out that you have moderately severe to severe grade of inflammatory acne, that usually takes some time to respond to medications.

Treatment for acne is individualized and varies from patient to patient.

It is guided by severity of acne and response to treatment. Treatment may need to be modified depending on the response.

Moreover, treatment may take some time to control inflammatory acne and there may be eruption of new acne lesions while on treatment, specially early on, therefore it is important to stick to treatment and be patient.

Currently you are on an Oral retinoid i.e Isotretinoin, which is one of the best antiacne drug even for the worst of acne.
However, Isotretinoin may cause dryness of skin and lips as a side effect because it inhibits sebaceous gland secretion/ oil production.
A few patients may have a flare up early on in treatment with Isotretinoin, as previously unseen lesions/ deeper lesions may come up to surface but that is temporary and one should stick to treatment.

Your other treatment comprises clindamycin gel, dapsone gel and Tab Azithromycin.
Your doctor must have started azithromycin because of the inflammatory flare. Azithromycin is effective in suppressing the flare and I suggest that you continue with it.
Topical dapsone gel as well as topical clindamycin gel too are both very good for inflammatory acne.

Side effects commonly associated with antiacne medications are dryness, irritation, redness. It is important to use topical medications just a thin film. Using too much would cause more of these side effects.
Soaps / face washes also further exacerbate dryness, irritation due to medications therefore I suggest that you discontinue with it.
I would rather suggest a gentle cleanser e.g cetaphil cleansing lotion, twice daily.
After reviewing your treatment history I could gather that you are on the right treatment and I would suggest that you continue with it, specially the one which I have talked about in this discussion.
I have just suggested you to stop face wash and rather use a gentle cleansing lotion e.g cetaphil cleansing lotion, twice daily.

Regards

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Brief Answer:
You can expect treatment to last for at least 6 months

Detailed Answer:
Hi.

As i mentioned, response to treatment may vary, accordingly to initial severity.
However, 6-8 weeks of Oral Isotretinoin usually produces noticeable/ significant improvement.
Isotretinoin is usually continued for 6-8 months Or more.
Therefore you can expect your treatment to last for at least 6 months for complete cure.
Oral antibiotics and topical antiacne preparations are usually stopped once Isotretinoin take full effect i.e usually 6-8 weeks.
Oral Azithromycin is rarely required after the first 4-6 weeks.

Regards

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