My 15-year-old son has been suffering from acne for three years. Since last year he has started getting large cystic lesions on his face, shoulder and upper back, which are leaving scars after healing. Oral antibiotics and creams are failing to improve his skin condition. Please advise.

Your son is most likely suffering from nodulocystic acne, which in its more severe form is also known as acne conglobata. This form has quite different presentation and behaviour in terms of its skin lesions as well as its response to various acne treatments.

On acne severity scale, it is considered to be most severe type while comparing with common forms of mild to moderately active acne, where the sufferers usually get papulopustular lesions (small to medium-sized pimples). About 10 per cent of total acne sufferers can develop severe nodulocystic lesions, as it is in the case with your son.

The treatment of nodulocystic acne requires more specialised therapeutic approach, as majority of the sufferers fail to respond to common/routine acne treatments, including oral antibiotics and various topical preparations, which has been true in the case of your son as well. Oral medication with a certain drug is one treatment option.

Also read: Proper skincare for every age

But the patient needs to be closely monitored for any potential adverse effects. The monitoring protocol requires to do periodic blood works in addition to monthly clinical consultations and observations. Once the active acne gets successfully treated, then we can address your son’s second issue of post-acne scarring.

Dr Ikramullah Al Nasir is a Dubai-based dermatologist. got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to