For persistent acne, your doctor may transition you from oral azithromycin to topical retinoids like adapalene or a combination of benzoyl peroxide and clindamycin gel, paired with a gentle, non-comedogenic cleanser. Regarding being underweight, there is no standard 'pill' for weight gain; the primary approach involves a structured, high-calorie, nutrient-dense diet. However, if an underlying medical issue is ruled out, a physician might occasionally prescribe appetite stimulants like cyproheptadine. Please consult a doctor to safely tailor these treatments to your specific health profile.

Acne and black spots on the face are very common and usually happen due to excess oil production, clogged pores, hormonal changes, stress, poor sleep, or improper skincare habits. The black spots often develop after pimples heal and are known as post-acne marks. To control acne, wash your face gently twice daily with a mild face wash made for oily or acne-prone skin. Avoid scrubbing the skin harshly, as this can increase irritation and make marks darker. Do not squeeze or pick pimples, because this increases the risk of scarring and pigmentation. Using non-greasy moisturisers and sunscreen regularly is important, as sunlight can worsen dark spots. Over-the-counter products containing ingredients such as salicylic acid, benzoyl peroxide, niacinamide, or adapalene may help reduce pimples, but they should be used carefully to avoid dryness or irritation. Eating a balanced diet, drinking enough water, reducing junk food intake, managing stress, and getting proper sleep can also support healthier skin. Acne marks usually fade slowly over time, but if the pimples are severe, painful, leave scars, or do not improve after a few weeks, it is best to consult a dermatologist. A skin specialist may prescribe creams, medicines, chemical peels, or other treatments depending on your skin type and the severity of acne. With regular skincare and patience, most people see gradual improvement in both pimples and dark spots.

For mild acne, start with over-the-counter topical creams containing Benzoyl Peroxide (to kill bacteria) or Salicylic Acid (to unclog pores). If your acne is moderate to severe, prescription-strength options like topical retinoids (e.g., Tretinoin), oral antibiotics, or hormonal treatments may be necessary. Always wash your face twice daily with a gentle, fragrance-free cleanser, use oil-free (non-comedogenic) moisturizers, and avoid squeezing pimples to prevent scarring. Because everyone's skin is unique, I highly recommend consulting a dermatologist for a personalized evaluation and targeted treatment plan.