Struggling with Persistent Acne: Seeking Effective Solutions - Dermatology

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Seeking help for acne on the face?


Hello, doctor.
I am currently seeing a dermatologist, but I have not seen any improvement.
I asked the doctor who is treating me why this is happening, and he said my condition is more difficult to manage.
He has been prescribing me different topical and oral medications, and it has been almost four months now.
I still have a lot of acne on my face.
Initially, there was some improvement, but now it seems to have plateaued.
I have been experiencing persistent breakouts of acne and blackheads on my cheeks and neck, and they are larger than usual and sometimes become infected.
People often think I am using drugs because of my appearance.
What should I do? Please give me some advice.
Thank you.

A-Jie, 20~29 year old female. Ask Date: 2005/03/31

Dr. Zheng Lizhen reply Dermatology


Hello, could you please ask your dermatologist to consider applying for oral isotretinoin treatment? Sincerely, Dr.
Cheng Li-Chen, Dermatology.

Reply Date: 2005/03/31

More Info


Dealing with persistent acne can be incredibly frustrating, especially when it seems like nothing is working despite ongoing treatment. It’s important to understand that acne can be a complex condition influenced by various factors, including hormonal changes, genetics, diet, and skin care routines. Here are some insights and suggestions that may help you navigate your situation more effectively.

1. Consultation with a Dermatologist: Since you are already seeing a dermatologist, it is crucial to maintain open communication with them. If your current treatment plan is not yielding results after four months, it may be time to discuss alternative options. Dermatologists can prescribe a range of treatments, including topical retinoids, antibiotics, hormonal therapies, or even isotretinoin for severe cases. If you haven’t already, consider asking about these options or seeking a second opinion from another dermatologist.

2. Understanding Acne Types: Acne can manifest in various forms, including inflammatory acne (like cysts and pustules) and non-inflammatory acne (like blackheads and whiteheads). Understanding the type of acne you have can help tailor your treatment. For example, cystic acne often requires more aggressive treatment than mild acne.

3. Lifestyle and Dietary Considerations: Some studies suggest that diet may play a role in acne severity. High glycemic index foods (like white bread and sugary snacks) and dairy products have been linked to increased acne in some individuals. Keeping a food diary to track your diet and any correlations with your acne flare-ups could be beneficial. Additionally, staying hydrated and maintaining a balanced diet rich in fruits, vegetables, and whole grains can support overall skin health.

4. Skin Care Routine: Evaluate your current skin care routine. Using non-comedogenic products (those that do not clog pores) is essential. Gentle cleansing twice a day, using a mild exfoliant, and applying non-irritating moisturizers can help manage acne. Avoid harsh scrubs or over-cleansing, as these can irritate the skin and exacerbate acne.

5. Hormonal Factors: If you are a woman, hormonal fluctuations related to your menstrual cycle can significantly impact acne. Discussing hormonal treatments, such as birth control pills that regulate hormones, may be an option worth exploring with your dermatologist.

6. Stress Management: Stress can exacerbate acne for some individuals. Incorporating stress-reducing techniques such as mindfulness, yoga, or regular exercise can be beneficial for both your mental health and skin condition.

7. Patience and Persistence: Acne treatments often take time to show significant results. While it can be disheartening, it’s essential to remain patient and consistent with your treatment plan. If you notice any new side effects or worsening of your condition, communicate this with your dermatologist promptly.

8. Consider Professional Treatments: In-office treatments such as chemical peels, laser therapy, or light therapy can provide additional options for managing persistent acne. These treatments can help reduce inflammation and promote healing.

In conclusion, while it can be disheartening to deal with persistent acne, there are multiple avenues to explore. Collaborate closely with your dermatologist, consider lifestyle changes, and be open to trying different treatment modalities. Acne is a common condition, and with the right approach, it can be managed effectively. Remember, you are not alone in this journey, and there are solutions available that can help improve your skin health and overall confidence.

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