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Dr. Bob
Dr. Bob, Medical Doctor
Category: Dermatology
Satisfied Customers: 5056
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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Im trying to understand my skin issue, I have had mild

Customer Question

Hi. Im trying to understand my skin issue, I have had mild closed comedones for about 7 months now, none of them have changed in size and they've just stayed there, but im getting spontaneous scarring all over my face even in spots there is no closed comedomes, seems the scarring in happening inbetween them. I had a scar that appeared on my cheek that looked like a small dry patch but was not dry at all, and over the next few days you can tell the scar is indented. I also have a rolling scar on my cheek that looks like a lightening bolt shape that seems to be getting wider and spreading, yet there is no acne. Scars are forming and sometimes VERY tiny white bumps will appear on top of it. Im desprite for answers, i used to never have skin problems and it seems every week i have some new type of rolling scar and not sure how to stop them as I dont really know the cause. i can send some pictures, my camera is not all that great, but my face is literally 95% scarred and I dont know what to do about this.
Submitted: 1 month ago.
Category: Dermatology
Expert:  Dr. Bob replied 1 month ago.

It sounds like you may have nodulocystic acne or acne conglobata. These can cause inflammation and scarring even when the comodome burden is not that great. This degree of acne is typically not responsive to the usual conventional treatments such as antibiotics and topical agents, though these are usually tried first. I would suggest you see a dermatologist who prescribes Accutane and ask if you are a candidate for this medication. It is very effective for most acne, even recalcitrant cases.

Customer: replied 1 month ago.
I've heard lots that accutane can cause more scars, is it normal for this acne your taking about to have spontaneous scars where there is definitely so sign of any type of acne at all? Because I've had few large scars appear where there is co closed comedones are anything and overtime it becomes more visible. My camera is not all that great and pica don't even show half of the scarring but I will send them anyway
Expert:  Dr. Bob replied 1 month ago.

You appear to have a mixed type of acne with some papules, developing pustules, cysts and nodules. I would recommend a prolonged course of antibiotics (e.g. minocycline or septra for several months) and a topical tretinoin cream. If you have tried this already, find a doctor that prescribes accutane, as it is the only medication I know that is almost universally effective when taken in the right way.

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