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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Dermatology
Satisfied Customers: 19328
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Having acne on my scalp from the last 3 years. Had so Many

Customer Question

Having acne on my scalp from the last 3 years. Had so
Many medicines nothing works! Acne comes back after I stop using medicines. Have done courses for as long as 6 months. It's like there are cysts inside my head! Please help.
Submitted: 3 years ago.
Category: Dermatology
Expert:  Dr. D. Love replied 3 years ago.
Have you seen a Dermatologist for this?
Or have these medicines been prescribed by your primary care physician?

Customer: replied 3 years ago.
Yes, I've been prescribed these medicines by the dermatologists themselves.
Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

I ask about whether you had seen a Dermatologist to be assured of the diagnosis. The majority of people that appear to have common acne (also called acne vulgaris) truly do have acne vulgaris. However, there are some other conditions that can appear similar to acne vulgaris (called acneiform eruptions), and we usually are more suspicious about the possibility of one of these conditions if the person has an atypical presentation or it is resistant to common medicines used for acne vulgaris. A Dermatologist would have more experience in recognizing these acneiform eruptions, which is why I asked whether you had seen a Dermatologist.

As for stubborn acne vulgaris, you have already been tried on the usual chronic medicines that are used for acne vulgaris. There are a couple of other options at this point. It may help to use different combinations of the same medicines. If the primary manifestation are cysts in the skin, it may help to use injections of steroids into the cysts, called intralesional steroids. There have been some studies at using forms of light therapy, although these may be harder to apply to the scalp.

Otherwise, the usual approach is to continue whichever treatment is most effective for the individual. The acne will typically improve spontaneously over time. These medicines are better at controlling the disease than curing the disease, so treatment may need to be continued as long as the acne is causing significant symptoms.

If you need any clarification, please let me know.