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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29269
Experience:  MD
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I am a 39 years old and have had acne since I was about 12

Customer Question

I am a 39 years old and have had acne since I was about 12 years old, I have seen many dermatologists and tried all treatments several times over the years. I have pigmentation on my face and legs which could be a combination of Sun and certain antibiotics and dianette contrceptive pill (which did not help my acne). for the last 10 months I have been trying Erythromycin for one month and then alternating it with Trimethoprim the next month ( it only works for one month at time), and has been successful at keeping majority of my spots away, but the last couple of months have not been working. Do you have any suggestions as these two are known not to increase my pigmentation. thank you Louise
Submitted: 4 years ago.
Category: Medical
Expert:  Dr Basu replied 4 years ago.

Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hello,

Mysticdoc :

Thanks for your question.

Mysticdoc :

To remove the spots, You can try Tretinoin cream 0.05% daily.

Mysticdoc :

THis is a vitamin A derivative helps to grow new skin and remove the blemishes.

Mysticdoc :

Have you tried tretinoin before?

JACUSTOMER-qksbbskm- :

I have tried both, the cream was not very successful, I have been on Tretinoin 3 times twice with short sharp big doses

JACUSTOMER-qksbbskm- :

and once small dose over a long time. It worked whilst taking, but acne returned after I had finished.

JACUSTOMER-qksbbskm- :

Are you still there

Mysticdoc :

yes

Mysticdoc :

ok

Mysticdoc :

hold on be patient --

JACUSTOMER-qksbbskm- :

sorry

Mysticdoc :

have you tried any other ointment like adapalene?

Mysticdoc :

Another good option will be Dapsone 5% topical cream.

Mysticdoc :

THis is newer acne reatment proven to be effective in your type of resistant cases.

JACUSTOMER-qksbbskm- :

Yes it worked on some of the smaller pimples, but the big sist type spots it did not work on.

Mysticdoc :

Ok so you will need a combination regimen.

Mysticdoc :

It is better to combine erythromycin and tretinoin together

JACUSTOMER-qksbbskm- :

I have found antibiotics gret

Mysticdoc :

yes that is why combination of antibiotic and tretinoin will work good.

Mysticdoc :

Dapsone is also an antibiotic.

Mysticdoc :

This is combined with benzoyl peroxide or tretinoin

JACUSTOMER-qksbbskm- :

I have found antibiotics great when they work, is there a way of using them so that I can kick

JACUSTOMER-qksbbskm- :

start them to work effectively

JACUSTOMER-qksbbskm- :

I find that they stop working after a month and alternate, but could the antibiotic still now loose

Mysticdoc :

antibiotic ointment can be alternated.

Mysticdoc :

another option oral antibiotic like doxycycline or minocycline

JACUSTOMER-qksbbskm- :

its effectiveness. I am sorry I forgot to mention that I am using retin A to minimise my

Mysticdoc :

ok

Mysticdoc :

combining with retin A will increase the effectiveness.

Mysticdoc :

you can start with oral doxycycline

Mysticdoc :

then switch to topical antibiotic ointment after 4 weeks.

JACUSTOMER-qksbbskm- :

pores and keep my face clearer, I also use hydroquinine in the summer for pigmentation

Mysticdoc :

ok that is also good to remove scars.

Mysticdoc :

So consider the above suggestion.

JACUSTOMER-qksbbskm- :

Will oral doxycycline bring my pigmenation out

Mysticdoc :

yes

Mysticdoc :

it will be more effective

JACUSTOMER-qksbbskm- :

Thank you, could I just ask one last question, will I be able to alternate antibiotics again or

JACUSTOMER-qksbbskm- :

because I have used them alot in the past they will not work for me anymore.

Mysticdoc :

Yes you can alternate antibiotics and that is common practice.

Mysticdoc :

Best wishes,

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