Acne therapy with hyperkeratosis and inflammatory lesions in a 23-year-old woman

Indications

Acne with hyperkeratosis, open and closed comedones, papules and pustules, post-inflammatory spots, and initial signs of dehydration. The patient had previously used mainly Korean brand skincare and had not been managed by a specialist. The anamnesis revealed hormonal test deviations, including elevated LH, testosterone, and 17-OHP, as well as lowered DHEA-S. The patient did not decide to undergo the proposed hormonal therapy with an endocrinologist-gynecologist, so the cosmetological plan was carried out with consideration for a possible hormonal background and the risk of relapse.

Case description

The aim of the therapy was to reduce the number of inflammatory lesions, regulate keratinization, cleanse the skin of blackheads, soothe post-inflammatory spots, and improve hydration levels. Due to the untreated hormonal background, the plan was based on regular, staged in-clinic work and consistent home care.

Treatment protocol

1. Comodex with manual cleansing — 4 treatments once a month.
2. Bio Phyto with manual cleansing — 3 treatments once a month.
3. Comodex and Bio Phyto treatments were performed alternately.
4. During therapy, skin reaction, level of dryness, severity of inflammatory lesions, and tolerance to active products were monitored.

Home care

• Bio Phyto Mild Facial Cleanser — morning.
• Comodex Clean & Clear Cleanser — evening.
• Bio Phyto Refreshing Toner — twice a day.
• Comodex Mattify & Protect Cream SPF 15 — morning.
• Comodex Renew & Repair Night Treatment — evening.
• Rose de Mer Peeling Soap — once a week.
• Comodex Soothe & Regulate Mask — once a week.
• Line Repair Fix Complete Renewal — twice a week.
• Zinc supplementation: 2 months, break, another 2 months.
• Diet discussion: limitation of fats, spicy foods, sweets, dairy, and white bread.

Effect

After 3 months from the completion of the course, a significantly smaller number of papules and pustules, a considerable reduction in congested spots, a more even skin tone, and improved skin hydration were observed. The skin looked calmer and more uniform. Work is ongoing, as the reported hormonal disturbances have not been addressed with causal treatment, which may affect the stability of the results.