Cystic acne

Dear Dr. Jen,

I am nearing my 40s and still getting some cystic acne. What do I do?  I have been to several clinics and keep getting treatments for it like cleaning and injections.  I have also tried creams and antibiotics.  Is there any hope for my skin?

Rhea

Dear Rhea,

Persistent skin breakouts throughout adulthood can be a bother, more so with the cystic kind. Cystic acne is pustular and often leaves craters in its wake. It can also be painful and uncomfortable. Taking antibiotics will bring relief for sure, but for how long it will stay “controlled” is hard to say.

Adult acne can sometimes be caused by hormonal changes or be brought about by genetic predisposition to pimples. Other factors to be investigated are lifestyle, sleep deprivation, and stress. Sometimes a religious topical regimen of tretinoin, clindamycin or erythromycin and some additional alpha hydroxyl acids can do the trick.  If trying these medications fails to prevent breakouts, the last resort is to do oral isotretinoin.  You can inquire with your nearest PDS dermatologist regarding this treatment.

Dear Dr. Jen,

I have always had bad skin on my arms and legs.  I break out into rashes especially during the hot summer.  I get itchy a lot. I was diagnosed to have very sensitive skin and told to apply lotion regularly.  It helps a lot but now I am left with dark scars on my arms and legs.  I am scared to use any bleaching soap because I might get rashes again.  What would you recommend to lighten the scars?

Marianne

Dear Marianne,

It sounds like you have eczema or atopic dermatitis. Skin gets easily inflamed or irritated in response to extreme temperatures, dryness or strong skin products. The rashes are often itchy and due to the scratching, skin becomes rough and thickened.

You are right to avoid bleaching soap like papaya-containing ones. Bleaching soaps tend to contain exfoliating agents which will definitely cause flare-ups in your eczema.

While the marks will go away eventually after several long months, there are some things that can be done to speed up the process. Avoid use of scrubs or abrasive exfoliants. Using a vitamin C-based bleaching agent is your best bet to lighten skin without irritating it. Applying emollients liberally all the time will definitely hasten the healing. 

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with the Perpetual Succour Hospital (PSH). Information on PDS is at www.pds.org.ph. Questions or concerns regarding the skin may be sent by text to 0932 857 7070 or emailed to [email protected]; or coursed thru The Freeman – (032) 2531276, or thru PSH – (032) 2338620 and 2325929. Inquiries will be forwarded to Dr. Tan.