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Joshua from Singapore asked a question

What is the best treatment method for acne if I have sensitive and oily skin? (photo)

Hi Doctors! I’m a 21 yo male, and I’ve had mild acne ever since I was 14. I have sensitive and oily skin. It has been affecting my confidence as my acne is unsightly. I normally use salicylic acid cleansers. On top of that, I’ve used Oxy 5 and clindamycin gel prescribed by my doctor to try to clear up my acne, but it has not been very effective. I was wondering what is the best method to resolve acne for my skin type, and what the approximate costs in Singapore would be? Thanks in advance!

DOCTOR’S ANSWER (3)
Dr Jiwei Wu
Aesthetic
Singapore
(3 Ratings)
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Dr Jiwei Wu
Aesthetic
Singapore
(3 Ratings)
Answered on Tue May 15 2018 12:27:34 GMT+0000 (UTC)

Hello Joshua

Thank you for your question. There are many options available to treat oily and acne prone skin 

  • Topical retinoid (Retin A/ Differin) 
  • Chemical peel (Salicylic acid) 
  • Oral isotretinoin/ antibiotic 
  • Carbon laser peel 

I will recommend starting with a topical retinoid for 1 to 2 months first. You can then add chemical peel or carbon laser peel or both for better results. Low dose oral isotretinoin can be included as well for stubborn cases.

Chemical peel and carbon laser peel can cost anywhere between $120 - $300 per session. Hope this helps. 

Regards, 

Dr Jiwei Wu 

0 258 views 0 Doctors agree Tue May 15 2018 12:27:34 GMT+0000 (UTC)
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Dr David Deng
Aesthetic
Singapore
(7 Ratings)
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Dr David Deng
Aesthetic
Singapore
(7 Ratings)
Answered on Wed May 16 2018 04:06:04 GMT+0000 (UTC)

Dear Joshua,

You seem to have oily, acne-prone and sensitive skin from the snapshot. I agree with Dr Jiwei's excellent recommendations.

I would suggest trying out topical retinoid- specifically tretinoin gel at a concentration of 0.025% first, to be applied as a thin layer, entire face, every other night. If there is no major skin peeling/ redness, you can step up the application to every night.

Higher concentrations/ newer generations of retinoid such as differin can be considered if your acne control is refractory. As all retinoids require a doctor's prescription, it will be most appropriate to seek consultation with a doctor first for appropriate assessment and recommendation. 

I would advise to stop Oxy 5 (Benzyl Peroxide) to be used together with retinoid as studies have shown reduction in effectiveness of retinoid, when used in combination. You should continue using topical antibiotics such as clindamycin gel twice a day on acne spots when using topical tretinoin at night.

Chemical peels and carbon lasers are good adjuncts that can help to speed up reduction of blemishes, active acne and prevention of acne via oil-control.

If the above fail, oral antibiotics, isotretinoin and spironolactone can be started.

Hope this helps!

Cheers,

Dr David Deng

0 242 views 0 Doctors agree Wed May 16 2018 04:06:04 GMT+0000 (UTC)
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Dr Shane Abucewicz Tan
Aesthetic
Singapore
(13 Ratings)
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Dr Shane Abucewicz Tan
Aesthetic
Singapore
(13 Ratings)
Answered on Mon May 21 2018 10:59:19 GMT+0000 (UTC)

Hi Joshua,

Glad to hear you are looking to control that acne early; uncontrolled acne typically leaves scars and the management of acne scars is a bit more complicated, so early prevention is key.

Your skin is very much alive, so daily maintenance topical therapy will be necessary.

To increase exfoliation, prevent sebum build up and hence prevent acne, options include
1. Retin/Differin gels: I personally prefer differin due to their better tolerability by the skin. It is also more resilient to benzyl peroxide (oxy 5 that you are using) Starting it once a day to the whole face and then building it up to twice a day over 4-6 weeks is advisable. Sets you back approximately 30-50 SGD a tube.

2. Acidic toners: AHAs and BHAs can help with the excessive sebum production and comedone buildup. Go slow though, using it once every two days and bulding it to once to twice a day; using it too often can cause burn-like injuries to the face and aggravate your skin. Depending on the brand, a bottle can set you back 70 - hundreds of dollars.

You can continue to use your oxy 5 for spot treatment up to twice a day. Do note, however, that using a combination of the products mentioned can and will make you skin more sensitive during the initial 2-4 weeks, so adopt a patient approach and build up the dose over time.

The above, again, is for maintenance - keep at it for best results.

Should that be too slow for you, aesthetic procedures involving stronger chemical peels, lasers, or even oral therapy such as antibiotics or oral isotretinoin are all options to give that additional boost. All these, however, come with a certain risk and you would be best off getting a thorough consult on them before attempting them.

Cheers,

Dr Shane Tan

0 163 views 0 Doctors agree Mon May 21 2018 10:59:19 GMT+0000 (UTC)
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