Ifechi had been using three different over-the-counter creams simultaneously for three years with minimal improvement. At Mascot Healthcare, a structured treatment plan with prescription-grade topicals cleared her skin in 12 weeks.
University student, Akoka. 3-year history of moderate facial acne.
Acne VulgarisBy the time Ifechi was 21, her bathroom shelf held a tube of salicylic acid face wash, a benzoyl peroxide spot cream, and a brightening cream she had been told would reduce the dark marks. She used all three, sometimes simultaneously, and her skin was persistently irritated, dry, and broken out.
She had visited a pharmacist twice who advised her to 'give the creams more time.' She had watched countless skincare videos. She had cut out chocolate, dairy, and fried food in turn — none of which made a measurable difference to her skin.
She attended Mascot Healthcare after a friend's acne cleared following treatment there. 'I just want to know what's actually wrong with my skin,' she said at the consultation.
Ifechi's acne had been present since age 18 — consistently moderate, predominantly on the cheeks, chin, and forehead.
Blackheads on the nose and forehead; whiteheads on the chin — the baseline lesions.
Red, tender raised spots — predominantly cheeks and chin, consistent with hormonal pattern.
Every healed spot left a dark mark that lasted months — PIH common in darker skin.
Pus-filled lesions that Ifechi would frequently pick — worsening scarring risk.
Avoided going out without foundation; declined video calls without makeup.
The combination of salicylic acid, benzoyl peroxide, and a brightening cream — all applied to already-inflamed skin — was causing more irritation than it was treating. Mixing multiple active ingredients without a structured plan frequently impairs the skin barrier, making acne worse.
Ifechi had also tried a steroid cream (betamethasone) that a neighbour had recommended. Topical steroids on acne suppress superficial inflammation temporarily but cause rebound flares and, with prolonged use, steroid-induced acne — a distinct and harder-to-treat condition.
the doctor assessed lesion type and distribution. The pattern — comedones plus inflammatory papules predominantly on the cheeks and chin — was consistent with moderate acne with a hormonal component. The post-inflammatory hyperpigmentation (dark marks) was extensive and required specific management.
A simple hormonal screen was offered — testosterone and DHEA-S — to assess for a hyperandrogen-driven component, relevant given the jawline/chin distribution. Results were within normal range. The acne was intrinsic follicular inflammation, not driven by a PCOS-type hormonal excess.
Clinical assessment: moderate acne vulgaris, mixed comedonal and inflammatory, with significant post-inflammatory hyperpigmentation. Hormonal screen normal. No PCOS features.
A prescription topical regimen (applied morning and night, gradually introduced) to treat the acne and the dark marks. Gentle non-comedogenic moisturiser to support skin barrier. Sunscreen SPF 30+ daily — critical during treatment. A course of oral medication for the inflammatory component.
Review at 8 weeks to assess response. Topical treatment strength increased if tolerating well. Oral medication discontinued at 8 weeks. Maintenance topical regimen continued.
Significant improvement by week 8. Active lesions >80% reduced. Post-inflammatory marks lightening noticeably by week 12. Ifechi described the change as 'finally feeling like I have control over my skin.' She continues maintenance topical treatment.
Moderate acne vulgaris is almost always treatable with the appropriate topical regimen. The gap in Nigeria is prescription-grade access — the topical treatments that actually work for moderate disease are not available over the counter.
Post-inflammatory hyperpigmentation — the dark marks left by every healed spot — is the feature that causes most distress in patients with darker skin. It requires its own targeted treatment (a dedicated topical regimen, alongside vitamin C and sun protection) on top of the acne treatment itself.
If over-the-counter acne products have not produced clear improvement within 8–12 weeks, a clinical assessment and prescription-grade treatment plan will almost certainly be more effective. Treating acne early also prevents the scarring and PIH that are harder to reverse.
Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.