Age 20, closed comedones that never go away - what else can I do? (Photos)

Question

Hello, I am 20 years old. I have had these bumps and red papules on my skin for 7 years. Nothing has helped me get rid of them. I am so frustrated and I don’t know what to do. I have used 0.1% Tretinoin , clindamycin 1%, Azelaic acid, BHA 2%, benzoyl peroxide, no silicones, Nizoral/ketoconazole, no moisturizers, lots of moisturizers, AHA 10%… i don’t know what else to do. this might be tmi but when I pick them white sebum comes out very easily. Thank you!

Nelson Lee Novick, MD · Answer

The kind of acne you appear to have is not uncommon and is known milial acne, In my experience, and apparently yours, as well, topical medications are often not particularly effective for treating the bumps that have already appeared; they work better, after several months of use, to prevent or diminish the formation of new milial acne lesions. I have been successfully been treating this form of acne for decades via the use of an in-office professionally performed cleaning, i.e. acne surgery). In one treatment session, literalliy a couple of hundred of these nuisances can be removed in one treatment session. Make sure to consult with a board certified dermatologist who doesn't rely on "bells and whistles" lasers or other expensive gizmos, but actually manually performs the necessary acne cleaning him/herself. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

​Acne requires a combination approach to get long-term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling with PRP, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with an expert. Best, Dr. Emer​

Timothy Osborn, MD · Answer

I would recommend looking into chemical peels (medical grade). A series of those should help reduce the bumps and pigmentations. You may also try looking into microneedling. Both of these treatments resurface the skin, and help to promote collagen production. You also have some laser options as well. They have specific acne treatments for some lasers. I would suggest finding a plastic surgery or dermatology office because they will have best products and trained staff to get you the best results possible.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

Get on a strict regime of Hydrafacial and Vi Peels.  Consistency is key.  You may also want to do a series of Laser Genesis.

Best of luck!

Age 20, closed comedones that never go away - what else can I do? (Photos)

Answers (5)

Answer: Chemical peels

Answer: Chemical peels

Answer: Hydrafacial/ Chem Peels

Answer: Hydrafacial/ Chem Peels

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Everything you need to know about Chemical Peel

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Age 20, closed comedones that never go away - what else can I do? (Photos)

Answers (5)

Answer: Chemical peels

Answer: Chemical peels

Answer: Hydrafacial/ Chem Peels

Answer: Hydrafacial/ Chem Peels

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Recommended reading

Everything you need to know about Chemical Peel

Our mission is to create a world where every investment in modern beauty is Worth It.