Personalized Acne Treatment: Combining Topical Therapy, Spot Treatments, and Injections
At Reena Jogi MD in Katy and Houston, Texas, we understand that acne is not a one-size-fits-all condition. Each patient requires a personalized treatment approach depending on the type and severity of breakouts, prior therapies, and long-term goals.
Case Overview
A 29-year-old female presented as a new patient with moderate acne on the face, primarily affecting the chin. Her acne had been present for four weeks and consisted of:
Pimples (inflammatory papules and pustules)
Comedonal papules (clogged pores and blackheads)
An isolated inflamed cyst on the chin
She had previously tried doxycycline and was using adapalene topical gel to help control her breakouts. While this regimen had helped in the past, her acne had worsened in recent weeks.
Treatment Plan
After discussing multiple treatment options—including oral antibiotics, spironolactone, birth control, and isotretinoin—we created a stepwise treatment regimen tailored to her needs:
Topical Medications
Clindamycin 1% lotion: to be used as a spot treatment.
Winlevi 1% cream (clascoterone): applied each morning to target hormonal activity in the skin.
Adapalene 0.3% gel: continued at bedtime as a retinoid for pore unclogging and skin cell turnover.
If Winlevi is not effective, the plan includes switching to daily clindamycin lotion in the morning and adding Neutrogena Stubborn Acne as a spot treatment.
Intralesional Kenalog (ILK) Injection
For her inflamed cystic lesion on the chin, we performed an ILK injection with 2.5 mg/cc of Kenalog. This helps reduce swelling, pain, and inflammation more quickly than topical therapies alone.Supportive Skin Care
Cleansers: Cetaphil Oil Control, CeraVe Foaming, SkinMedica AHA/BHA Cleanser, or Neutrogena Oil-Free Acne Wash
Moisturizers: CeraVe PM, Cetaphil Oil Control, or EltaMD UV Clear
Sunscreen: Daily use of broad-spectrum SPF 30+
Counseling and Expectations
We emphasized the following:
Acne is a chronic condition that may take 2–3 months to improve by 60–80%.
Non-comedogenic products are essential to avoid worsening breakouts.
Intralesional Kenalog injections are safe and effective for inflamed cysts but may rarely cause localized skin thinning (atrophy).
Contact the office if acne worsens, new scars develop, or allergic reactions occur.
Key Takeaways
This case highlights the value of customized acne care:
Combination therapy with topical retinoids, antibiotics, and androgen blockers
Procedural treatments such as ILK injections for stubborn cysts
Patient education on skincare, expectations, and long-term management
At Reena Jogi MD, we specialize in helping patients across Katy and Houston, Texas, find tailored solutions for acne—whether mild, moderate, or severe.
