From the photos it seems to me your acne breakouts are still quite active, and I will not advise treating your acne scars before addressing your acne breakouts. This is because:
- some of the acne scarring treatments can irritate the skin and even cause breakouts themselves.
- if acne is undertreated, newly formed acne lesions can develop into new acne scars
Isotretinoin is an effective treatment for cystic acne. But for it to work well, it has to be administered at the correct dosage and optimal duration. In my practice, I do regular monitoring of my patients' skin as well as blood profile to ensure the are responding well to treatment, without side effects. Besides Isotretinoin, I usually employ an array of tools to deal with acne vulgaris :
- Oral medications to regulate excessive sebum production (ie isotretinoin)
- Oral antibiotics to reduce the P.acnes bacteria load on the skin
- Effective home-use skincare to keep your pore clean, and reduce hyperkeratinization, the first step in the formation of a blackhead/whitehead
- Medical extractions for stubborn acne lesions for quick relief of pain and cosmetic symptoms
- Laser/light treatment to be added on if there is benefit to the patient
- Modification of lifestyle factors. E.g. some young men tend to take whey protein supplements, which can worsen their existing acne conditions. I will advise them to hold off their protein supplements while on treatments.
It is unlikely that all therapies stated above will be used at the same time. Customization of treatment plan according to patient skin condition and lifestyle will give the best results. After your acne is under control, we can definitely go into a detailed discussion about treatment modalities for acne scarring.
Hope that helps. Get well soon!
Dr Heng Wee Soon