I have acne, acne scars and enlarged pores. I tried alternative medicine treatments but have not found results. I’ve cut down drastically on oily and sugary foods and have included a lot of veggies in my diet. Yet there has not been much change. A doctor suggested that I undergo laser treatment. What is your opinion?

Acne in general can be treated with various treatment options, ranging from topical creams, gels, lotions, solutions and cleansing masks as a first-line treatment. As a second-line of acne treatment, oral antibiotics can be prescribed before moving on to other therapies depending on the severity of the condition. Acne in general is diagnosed only on clinical examination. Common treatment options include various acid peels as well as use of lasers. However, if the laser treatment is not done by a well qualified dermatologist, side effects could be severe. The problem of your large pores is a sister issue related to your acne, and indicates the presence of hyperactive oil (sebaceous) glands in dermal layer of your skin. With improvement of acne, particularly through the oil controlling treatments, these large pores also get simultaneously improved to a greater extent. In few cases of incomplete success, topical gentle facial peels or few microdermabrasion treatment sessions can help.

As a kid I had a skin allergy with my skin becoming dry and constantly itchy. Although I don’t have the condition now, I find that parts of my face have dark patches.

Repeated episodes of vigorous scratching of inflamed areas of skin, over long periods of time, can create skin thickening on affected areas. This thickened skin surface looks darkish in colour and makes the skin look darker. The treatment of your skin complaints will be tricky. This will be due to the reason that most of the skin lightening treatments usually consist of skin exfoliating agents like retinoic acid in combination with skin bleaching agents like hydroquinone or azelaic acid. The potential risk of this combination therapy could be a treatment-induced irritant inflammatory reaction seen on the treated areas. However, addition of one per cent hydrocortisone can significantly minimise such a risk. Similarly, frequent application of suitably selected “water in oil” thick emollients will also play a positive role during and even after the successful completion of your treatment. Finally, avoid excessive sun exposure.