Clinical Cases

Acne in a Woman of 27

Student homeopath Abeer Iqbal Ahmed shares a case of acne in a woman of 27. Aggravation in cold weather, eruptions with heat and sensation of needles in skin were among the symptoms leading to the simillimum. (CCHM Student Presentation)

This was a 27 year old female who had a long history of severe acne.  After immigrating to Canada in 2015 she developed small blemishes which later progressed to discharging eruptions. To control the eruptions, she was under antibiotic therapy. She had been prescribed tetracycline 250 mg to be taken daily in addition to the daily use of Tactupump lotion. She was left with side effects such as sensitivity to the sun which altered her daily life activities.

This was one of my first few cases as a student.

Case taking November 12 2019

27 y/o patient with acne vulgaris.

There is pain before the pimple develops. Once the pimple develops, there is a yellow discharge. The pain is reduced once the discharge is cleared and she described the pain as sharp like a needle. She described the feeling of heat being omitted from the acne.

The state of her skin is naturally oily on her nose, chin and overall T-zone area. The location of the acne is mainly focused on both cheeks with some eruptions on the forehead and chin. In terms of intensity, the acne is worse on the right side.

She stated the acne would not erupt on its own, but the acne was very sensitive and would discharge with the slightest touch. Her acne would leave craters and scars after an eruption discharged.

She continued to explain that her acne was not that bad when she came to Canada. It only became worse after giving birth. Interestingly, her acne would clear up when she visited Pakistan; her homeland, but it would return when she returned to Canada.

At this point I inquired about her reason for immigration, emotional stressors, diet changes, sensitivity to weather and weather change. Her mental state was normal and there were no emotional symptoms or stressors. She did not notice any modalities in this case either. In the past, she had altered her diet, increased her water intake, and used different face washes and treatments with little to no results.

There had to be more to this case. I learned that her placenta had moved. The baby was not getting enough food and for this reason the baby was not growing at the appropriate speed. She was injected with steroids to help with the baby’s lung development. Further along the pregnancy, she had a preeclampsia toward the third trimester leading to an emergency C-section at 7 months.

She could not recall the name of the steroid used. After doing some research, I learned a general side effect of steroid use can be acne which should clear when the steroid is discontinued. If the acne does not cease, the next course of therapy includes oral antibiotics, topical antibiotics and retinoid creams. Such was the case for this patient.

Her other symptoms included:
Mental emotional: Hard worker, can’t sit still, takes responsibilities on herself, caring, outgoing, laughs and jokes a lot, talkative.
Head: Pain (top of the head) better with pressure or massage
Diet: Consciously eats healthy food. No particular craving, but an aversion to chocolate
Thirst: Can get thirsty, but needs to force herself to drink 2L per day
Back: Pain from getting an epidural. Worse from the cold
Digestions: Always constipated from teenage years. Stool can be hard without any pains or sensations


Rhus-Tox 30C; 2 pellets once daily. With the addition of silica tissue salt 6x; 2 pellets twice daily.

Patient’s symptoms covered by the remedy:

  • Busy/Lively
  • Agg cold weather
  • Back pain worse by cold weather
  • Vesicular eruptions on face
  • Acne; chin/forehead/cheeks
  • Eruptions with heat
  • Sensation of needles in skin
  • Head ache after cold dry weather
  • Yellow discharge
  • Greasy skin
  • Complaints worse on right side
  • Scars
  • Touch agg

Differential rationale:

  • Rhus-tox and Silica were very close. The deciding factor was the totality of symptoms including the mental emotional characteristics
  • In addition to the needle like pain, Rhus tox also has heat emitting from eruptions. Compared to phosphorus which has burning pains Rhus tox is more accurate.
  • This remedy contains granular eruptions which is a way to describe acne vulgaris.
  • The modalities of cold dry weather, location and affinity for the right side are all included in this remedy.
  • The reason for using Silica as a tissue salt is because it will cleanse the non-functional organic matter from the body and initiate the healing process. (from a lecture on tissue salts)

Follow up 1: January 16 2020

  • All symptoms are showing signs of improvement
  • Stitching pain in acne is gone
  • Heat emitted from eruptions is gone
  • Crater type scars have reduced significantly
  • Skin is smoother now
  • Fewer new eruptions
  • All that remains are a few red spots

The patient initially approached me with complaints of cystic type acne. The eruptions were painful and left crater type scars. From the eruptions there was heat and discharge from slight touch. If one eruption subsided, a few more would develop; larger and more painful than the one before. After taking the complete case, Rhus tox 30C and Silica as a tissue salt was prescribed. It is evident that there was a significant improvement in the patient’s condition. Her acne and pain reduced tremendously. The remaining symptoms include redness of skin and small painless eruptions.

It was great to hear that her symptoms were improving, but I was unsure of what was helping her since she was prescribed other medications. I decided to investigate her compliance with the alternate treatments and figure out when the improvement began.

To my surprise, the patient decided to stop using her other medications when she started homeopathy. This made it very clear that homeopathy was treating her!

Plan & Why:

Continue Rhus-tox with Silica tissue salt

  • Rhus-tox has resonated with the patient and made an impact on her skin condition
  • Rhus tox has cleared the heat, needles like pain, scarring
  • This remedy contains granular eruptions which is the same trait as the remaining smaller blemishes
  • The reason for continuing silica as a tissue salt is because it has been effective in purifying the blood
  • This dosing regime has shown to be responsive
  • Daily dosing will continue to give her system the push she needs until we can clear the skin condition completely
  • There rate of improvement shows that there is no need to increase the potency, frequency or number of pellets

The etiology is still not clear. It is difficult to pin point what may have caused this condition. Since the patient is caring for her diet and water intake, there does not seem to be a noticeable obstacle to cure. Additionally, she has discontinued her medications; now there is no chance of the cream suppressing her skin condition.

Conversation with patient a couple months later:  The Patient’s skin was clear and smooth. The red spots reduced and the remaining redness was continuing to improve.

She explained that she found out she was pregnant again and she had discontinued all her medication. At this point, she was improving without continuing the use of homeopathy.

About the author

Abeer Iqbal Ahmed

Abeer Iqbal Ahmed (RPhT, DCHM) - I have always been interested in the interworking of the human body and how it heals. A few years ago I was introduced to homeopathy and saw remarkable results. I was surprised by the effectiveness of this healing method and wondered, “What is Homeopathy?” To answer this question, I joined the Canadian College of Homeopathic Medicine. Joining the College allowed me to work with a team of homeopaths with decades of experience. It was with their guidance and expertise that I was able to change the way I approach a case and strategize a healing plan. After 3 years of training, I am now on my journey to becoming a licensed homeopath!

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