- Wash face with mild soap or salicylic acid cleanser OTC morning and night with their hands.
- Use a towel separate from the one used on the rest of the body for patting the face dry.
- Clindamycin topical lotion, solution or gel twice daily after washing morning and night.
- 5% hydrocortisone lotion after clindamycin in the morning and
- Tretinoin cream 0.05% after clindamycin at night.
- Doxycycline 100 mg daily if there are no contradictions.
Patient should apply all products to the whole face not just breakouts except for the nasolabial fold angels of the mouth and upper eyelids. The skin will worsen before it gets better so they should dedicate at least 6 to 8 weeks to see results.
They should not apply any other products to their face. Females may wear make-up as long as it is oil free and after they are clear. Sunblock for everyone as long as oil free.
Females will worsen with menses, stress, oily products or dried perspirations on face, unclean and oily hair or hair products friction or rubbing of the face with the hands or headgear and noncompliance.
Males are prone to have more severe acne and more areas involved such as chest and back. Once controlled they are easier to keep controlled because they do not have the hormone cycling. Chest and back may be treated with the same therapeutic regimen. Males worsen with stress, dries perspiration, friction from hands or headgear, oily hair or hair products and non-compliance.
Patients who perspire a lot or after their work out may use fragrance free baby wipes to remove perspiration before it dries.
Acne is controlled, it is not cured. Patients must understand that. From a holistic standpoint, they should understand that eating well, sleeping well exercising and managing stress is essential to clear skin.
They should never under any circumstances pick, rub, or manipulate active lesions as this may lead to permanent scarring of the skin. Darker skin types will get post inflammatory hyperpigmentation. This is not scarring and will fade once acne is controlled. Patients with nodulocystic, scarring acne should be referred in for assessment and possible management with Accutane.