This 24-year-old college student with acne had developed dark marks (hyper pigmentation) on the skin due to pimples.

24-year-old college student, Miss Reena consulted Dr. Randeep Singh Shah for treatment of her acne. She was suffering from acne since about 15 months. Her complaints started with pus-filled, hard and painful eruptions on the cheeks and forehead. She had a very oily skin and her past eruptions had left behind dark marks (hyper pigmentation) on the face.

She goes to one of the renowned skin care centre and undergone laser treatment and glycolic peeling for the same. However, she takes relief only when she takes medicines condition goes worse when stop medicines and her eruptions became more painful. Her complaints would worsen every month before her menses and the acne would last about two weeks. Thereafter, it would leave behind dark marks. Her mother had history of acne problem during her own teenage years and the patient’s maternal uncle also had acne.

The patient has normal appetite and thirst. She likes spicy and hot food. There were no problems of stools or urination were reported. Perspiration was scanty and odorless with no staining. She would sleep on her abdomen and dream of trying to complete her portion during examinations. She would be comfortable with warmth in general but was intolerant of heat. Exposure to the sun would give her sun-burn. Her menses were regular and she would experience anger and irritability before her menses.