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Question
Posted by: Tasha | 2012/10/09

Acne scars post-Roaccutane - what can I do?

HI Expert. Roaccutane, taken for the 7th time at a horrendously high dosage (almost 2mg/kg) has finally worked. But post-Roaccutane I still have ice pick scars and quite heavy pigmentation - after 28 years of acne there was no way my skin was not going to look this haggard. Ten months after I stopped I still have some pimples here and there but otherwise the improvement is very noticeable. I guess I was just someone who needed a very very high dosage because it never worked all the times before. However as I said the surface is very uneven due to ice pick scarring and I have lots of dark brown spots where the pimples were, the distribution is very much like freckles except on my black skin. Nothing is fading them and nothing is giving my skin an even surface. What are your recommendations, especially for black skin?

Creams per se are not working, I imagine laser resurfacing or some sort of peel is what I need? Can you suggest any treatment for a skin which has been through hell –  28 years of harsh benzoyl peroxide, salicylic acid, retinoic acid, isotretinoin, etc. At any given point whatever was on my face had acne-fighting properties –  I have never been able to use normal skin products. So in that sense my skin, although it is finally sort of clear, is very aged and ragged form the continued harshness of acne lotions and potions. The skin is aged and worn in much the same way a face becomes aged and worn with constant sun exposure. Mine is due to constant exposure to acne-fighting lotions for close to three decades. The question is what can I now do to be kind to my skin yet work on these scars and the pitting?

The second thing i wanted to ask is whether, in your opinion, threading might help with acne. Reason being I understand breakouts to occur when oil gets trapped in the glands of the hair follicle. I am so hairy thus it is easy for this process to take place. I have always been a very hairy woman and since puberty have had a lot of ''peach fuzz'' on my face. Were I to remove this hair via threading, might I lessen the chance of new acne eruptions? I am totally dreading the possible return of my acne. Ten months down the line I wldnt say it is back but I have a fresh rash of sorts on the forehead, which is exactly how my acne began at age 11 - and I am 39 now. I am loathe to take Roaccutane again as it in fact damaged my joints (but for me was still worth it). If I keep my face free of hair, might I avert a breakout?

Thanks sorry the post is long

Tasha

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Our expert says:
Expert ImageAnti-ageing expert

Hi Tasha, thank you for the question.

The concern with threading would be that it may cause an acne like eruption following the inflammatory process and the renewed hair growth; typically acne is caused by overproduction of the sebum found in skin pores and hair follicles rather than just the hair follicles. So your better approach would be to consider laser hair removal and some form of maintenance program to reduce the production of the sebum and bacteria production – such as glycolic acid peels and topical products containing no oil but with added alphahydroxy and polyhydroxy acids.
The scars may be difficult to treat and the best approach would be to consult a cosmetic dermatologist who can examine the scars and decide on the best treatment for you. Please submit a new question and let me know in which city you live in so I can refer you to the appropriate dermatologist.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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Our users say:
Posted by: BUSISIWE | 2012/11/09

HELP I TRYED ALL CREAMS BUT THEY ARE NOT WORKING

Reply to BUSISIWE
Posted by: Madhu | 2012/10/24

sometimes what i do is squeeze half a lemon and mix it with 2 teonaopss of honey until its just a golden liquid'' then using my fingers i spread that all around my face after washing it then let it sit for 10-15 minutes while just laying down as not to move your face a lot then wash it off and pat dry obviously with a towel and it sort of gives you a natural glow and also makes your skin really soft

Reply to Madhu
Posted by: anti-ageing expert | 2012/10/16

Hi Tasha, thank you for the question.

The concern with threading would be that it may cause an acne like eruption following the inflammatory process and the renewed hair growth; typically acne is caused by overproduction of the sebum found in skin pores and hair follicles rather than just the hair follicles. So your better approach would be to consider laser hair removal and some form of maintenance program to reduce the production of the sebum and bacteria production – such as glycolic acid peels and topical products containing no oil but with added alphahydroxy and polyhydroxy acids.
The scars may be difficult to treat and the best approach would be to consult a cosmetic dermatologist who can examine the scars and decide on the best treatment for you. Please submit a new question and let me know in which city you live in so I can refer you to the appropriate dermatologist.

Reply to anti-ageing expert

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