How to manage pimples and dark spots on the face?

Hello,

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I understand your concern and will surely help you out.

I have reviewed your pictures (attachment removed to protect the patient's identity). As per the history and image provided, it is acne vulgaris and post-acne hyperpigmentation or PIH. Acne appears most often due to hormonal fluctuations, imbalances, genetic reasons, climate changes, food habits, consumption of oily, fried, and sweet foods, or as a reaction to new products being used on the face. Acne may occur on and off, and it can be managed each time the acne triggers or appears. Dark spots and pores accompany acne, which develop following Inflammation of acne and due to excess oil secretion from the skin respectively. There are medications and procedures available for managing the same.

I suggest the below treatment plan:

• AHA glow S foaming face wash (Salicylic Acid 2 % Glycolic Acid face wash) to be applied, massaged gently in circular motions, and washed off within one minute, and used twice daily.
• Clinmiskin gel ( Clindamycin Niacinamide) to be applied on the pimples once daily in the morning.
• Aziderm 10 % (Azelaic Acid) cream to be applied in a very thin layer on the affected area on alternate days only at night. Make sure your face is cleansed and dried well. Your hands and face should be absolutely dry without any moisture. Apply the cream in a pea-sized quantity on the affected areas in a very thin layer. Please do not use it all over the face; do not use it in large quantities since the medication is strong and may cause irritation. This cream may be applied to pimples, dark spots, and spot treatment.
• Tablet Ascorbic acid 500 mg (Vitamin C) chewable tablet once daily after dinner.
• Capsule Evion 400 mg (vitamin E) 400 mg once daily at night after food to be taken with water.

Consult a specialist doctor, talk to him or her, and start the medicines with their consent. The above medications are for active acne and the management of new acne; they seldom help with the complete fading of dark spots. For the treatment of PIH or dark spots, there are procedures to reduce them. In severe cases, antibiotics may also be needed. Refrain from using skin care products as they may cause reactions depending on the contents of the product and may lead to breakouts. PIH may be managed only by undergoing procedures as medications have limitations, whereas procedures have the capacity to penetrate through the skin to help with internal problems and correct them. Most scarring is caused to inflammatory reactions and due to habitual picking of acne; therefore, they lead to the formation of depressed scars, which require intervention through procedures.

Below are the procedures:

• • Laser therapy procedures may be done once a month to help reduce current acne, fading of hyperpigmented spots, and scarring. Q switch and Erbium lasers, when combined, can be very beneficial and do wonders for the treatment of acne and post-acne scarring and dark spots. They are done in monthly sessions and may require direct consultation with a dermatologist to undergo the procedure.
  • Superficial procedures like chemical peels in which glycolic acid peels once in two weeks to one month help manage the existing acne, scarring, and dark spots. They cause mild peeling of the affected area and are done in sessions, rejuvenating the skin and reducing its appearance. You may need to consult a dermatologist in person for the procedure details and in order to undergo the procedure. Medications can also be prescribed along with the procedure.

I suggest you avoid oily and fried foods, milk and dairy products, sweets, and chocolates as they trigger acne. Instead, consume more fruits, vegetables, and fiber-rich foods, and ensure adequate hydration by drinking at least ten glasses of water a day. Vitamin C creams and face washes may also be helpful. However, the above medication may be more beneficial coupled with procedures for better results. Having said that, I would like to mention that acne may occur on and off depending on the above factors. However, they may be managed with medications and procedures and by protecting yourself from external triggers. On the other hand, internal triggers depend on hormonal fluctuations, which cannot be controlled but may be managed with the help of a gynecologist. For most individuals, acne fades as they grow older with regularisation of hormonal levels. Refrain from picking of acne as it may lead to hyperpigmentation.

I hope the details were informative.

Stay happy, healthy, and safe.

Thank you.