### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am latha, 37yr old lady and been suffering acne for the past 15yrs.I dont have pcod nor dandruff . I have taken homeopathy and alopathy medicines for more than 5yrs but condition still persists. Periods are regular. Since 3yrs acne started on my back too. Last year i developed a fibroid and taking medicine for that. My skin becomes very red and acne doesnt stop. I am vegetarian and doesnt take oily foods and dairy products as i read that dairy products enhance estrogen levels which might result in aggravation of acne. I am too tired and feel depressed due to my skin problems. thank you.

### output:

Hi Latham. Thanks for your query. You present with an adult onset acne, which is one of the most challenging types of acne to treat. It is mainly due to hormonal causes and as you have pointed out, PCOD is one of them. In your case I would suggest a complete hormonal investigation to be done. This should include thyroid, estrogen,testosterone, lipid profile as well as estimation of cortisol levels in blood. Only after a complete study can the cause be found. Fibroids may /may not be related. However, although believed, food has failed to provide any consistent relation with the onset and course of acne.Hence, no need to avoid any kind of food unnecessarily. I am not sure if already prescribed, but you should do well with anti an Chat Doctor. . This has to be determined based on the results of the investigations and can only be done by a dermatologist. In RESISTANT CASES, oral retinoids also do well, provided the precautions are adhered to. Hope this helps. Take care.