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Shahid Karim
Shahid Karim, Doctor
Category: Dermatology
Satisfied Customers: 397
Experience:  Medical Specialist
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For the last 12 months on and off I have had several unusual

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For the last 12 months on and off I have had several unusual skin complaints.
Starting with very inflamed sore cheeks last year. To a crusty, red and painful nose. To now some mild what I believe is acne on one cheek with a couple of deep nodules and smaller white heads.
I’ve always had very good skin and this has been very uncomfortable and painful at times as well as upsetting.
The skin is now becoming very sensitive, with scaring and big pores.
I have spoken to my GP at several different
Occasions and they have given a couple of steroid and antibiotic creams as well as oral antibiotics but as soon as something works and the skin clears up then something else appears.
I guess I’m looking for some advice, a diagnosis and possibly some treatment.Thanks for your time.
Kind regards
Siân Gordon
JA: How long have you had the symptoms? What seems to make the symptoms worse or better?
Customer: Tea tree helps for a while and then stops helping. I’ve had these spots on my cheek for a month now
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: no
Customer: replied 12 days ago.
File attached (355P45Q)
Customer: replied 12 days ago.
This is my skin now
Customer: replied 12 days ago.
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Customer: replied 12 days ago.
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Customer: replied 12 days ago.
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Customer: replied 12 days ago.
The last three photos are it over the last 12 months at different stages
Customer: replied 12 days ago.
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Customer: replied 12 days ago.
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Hi, thanks for getting in touch. It looks to me like you have cystic acne which can be really troublesome to treat and leads to recurrent blocked pores which can turn into rather large cysts which often are quite deep too. I'd advise:

-Start by asking your GP for a prescription of benzyl peroxide gel 5%, this is good at reducing oil production and blocking of pores

-Wash your face and pat dry a few times a day

-Avoid pore-clogging makeup or creams

-Stay well hydrated

-If you get red, inflamed spots, you can ask your GP for an antibiotic cream

-You can also ask for tretinoin cream from your GP to keep things at bay

That's the mainstay first line of treatment. If this wasn't enough you're really left with two options:

1. a regular antibiotic taken every day to keep it at bay


2. Consideration of starting isotretinoin (accutane) which is a very powerful anti-acne drug and would need to be started by a dermatologist but has a fairly lengthy list of possible side effects and you mustn't get pregnant on it.

Customer: replied 12 days ago.
Ok thank you. Is it common to just have it in one area like this. I always thought acne would be all over the face. What causes it? I’ve never had it before and I’m 34.
Customer: replied 12 days ago.
Thanks for your help.
Customer: replied 12 days ago.
Also my skin is quite dehydrated rather than oily.

There are a variety of reasons it could be in one area such as the pores there being more dysfunctional than the other side. The other possibility is that it's actually the same couple of cysts which are re-filling each time. The treatments above should help in any case. If it literally is the same cysts that keep coming back in that one area, sometimes there's an arguement to have them surgically removed but of course this has the possibility of scarring so I prefer the methods above. You're so welcome, I'm glad I could help. If you'd consider leaving a positive review I'd be grateful. Wishing you the very best moving forwards :)

Customer: replied 11 days ago.
Thanks again I will leave a positive review and get on to my GP this morning. Do you think the redness around my nose is related? The previous Dr thought it was rosacea on my cheeks and nose so I have been using a cream for that but I felt it made it worse so stopped.
Customer: replied 11 days ago.
Also had this cream
Customer: replied 11 days ago.
this one for Roseaca

No I don't think it's rosacea and the daktakort is for fungal infections which it definitely isn't. I hope that helps. A positive review would be gratefully received. All the best again :)

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