Case Report: Severe Acne Management in a 36-Year-Old Male Patient

Aug 29

At Village Dermatology in Katy and Houston, Texas, we frequently see patients struggling with acne that has persisted for years despite over-the-counter treatments. Acne can affect not only the face but also the back, chest, and shoulders, often causing both physical discomfort and emotional distress.

Patient Case Overview

A 36-year-old male presented for follow-up management of severe acne involving his back and face. Previously, his treatment regimen included:

Topical regimen: benzoyl peroxide wash, clindamycin lotion, gentle cleansers, and moisturizers with SPF 30+.
Oral antibiotic: doxycycline 100 mg twice daily.

Despite consistent use, his acne remained severe, with inflammatory papules, pustules, and comedonal lesions.

Considering Treatment Options

Given the persistence of his acne, the patient and dermatologist discussed escalation to isotretinoin (Accutane)—a highly effective therapy for severe, scarring acne.

Benefits of Isotretinoin:

Significant long-term clearance of acne.
Reduced risk of permanent scarring.
Addresses the root causes of acne: oil production, clogged pores, bacteria, and inflammation.

Risks and Counseling Provided:

The patient was counseled in detail about possible side effects, including dryness, joint aches, mood changes, and photosensitivity. Rare side effects such as abnormal cholesterol and liver function were also reviewed. Because isotretinoin is a high-risk medication, monthly follow-up visits and blood tests are required to monitor safety.

The patient initially agreed to proceed with isotretinoin, but later reconsidered. Alternative options such as acitretin, intralesional Kenalog (ILK) injections, or surgical excision of affected areas (with surgical clearance) were discussed.

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Why Acne Requires Expert Dermatology Care

Acne is often dismissed as a cosmetic nuisance, but in reality, severe acne can:

Cause permanent scarring.
Impact self-esteem and mental health.
Require advanced medical therapy when standard treatments fail.

At Village Dermatology, our board-certified dermatologists specialize in tailoring treatment plans to each patient’s needs, whether that involves topical therapies, oral medications, or advanced options like isotretinoin and intralesional injections.

Takeaway

This case highlights the importance of specialist care for severe acne. For patients in Katy and Houston, Texas, Village Dermatology offers comprehensive evaluation and treatment to achieve long-lasting results and minimize the risk of scarring.

If you or a loved one is struggling with persistent acne, schedule a consultation today at Village Dermatology to explore your options.

Honey Cisneros