Brief Answer:
Pictures requested

Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your concern regarding the skin lesions.
Acne, as you must be aware is pretty common condition caused chiefly due to hormonal influence and clogging of pores and followed by infection and inflammation. It has tendency for recurrence and complications like pigmentation and scarring, thus mandates proper treatment at the earliest. There is no specific time that they occur, it is just that they are more noticeable at the night.
Treatment usually depends on severity of of acne and pigmentation but its difficult to grade severity in absence of clinical examination.
Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way. You can post pictures directly here or you can mail pictures to YYYY@YYYY
with subject titled ' ATTN Dr Hardik Pitroda'.

Thanks
Dr Hardik Pitroda

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Brief Answer:
Oral and topical retinoids

Detailed Answer:
Hello,
I have reviewed your picture. There is acne as well as pigmentation.
First of all avoid pricking or picking of acne, as it can lead to dark marks and scars.
Proper management of acne requires proper course of oral retinoids like isotretinoin which works right at the root cause of acne. In addition I would suggest oral antibiotic like azithromycin for few months.
Apply a mixture of clindamycin, kojic acid and azelaic acid twice a day over full face.
At night apply a cream containing tretinoin and hydroquinone.
Use a gentle cleanser like Cetaphil cleansing lotion twice a day.
Use a water-based sunscreen everytime before going out in sun.
In addition, you can get series of chemical peels for better results.
Drink plently of water amd have lots of fresh fruits and vegetables.
Avoid oil-based cosmetics.
Hope the information was useful.
Thanks
Dr Hardik Pitroda

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