• I'm 18 years old, and I have a lot of acne and pigment problems on my upper back. I've tried everything from gels and creams, to oral medications and benzoyl peroxide washes. Nothing seems to work. I've heard of acid peels, are they something that could help me?

    Acne is from skin irritation, blocked pores, bacteria and oil secretion in the skin. If your outbreak is sudden, go back and look at any predisposing factors such as oil containing skin products, a new exercise regimen with excessive sweating, or even a new hair style with hair rubbing on your skin. The answer may be simple elimination of an irritation.

    Sometimes acne will present with no apparent reason. The treatment is then daily maintenance. Face washing 2-3 times a day is a must. Use of over-the-counter topical acid products and benzoyl peroxides are very helpful. It takes six weeks for acne treatments to start working. As acne is improving, it will leave a temporary "dark area" in the skin. This "dark area" is not scar and will disappear with time - usually many months. If you continue to get new acne despite daily maintenance, you should consult your dermatologist.

  • I have very large clogged pores on my nose and cheeks. I believe this may be hereditary as I remember my Mom having the same problem. I cleanse twice daily and have tried several different products but nothing seems to help. Do you have any suggestions?

    "Clogged pores" are called comedones. This is a type of acne that can be controlled with daily maintenance. Hydroxy acids and retinols are a good place to start. Many people benefit from facials. The cosmetologist will extract all the debris. Have the cosmetologist teach you how to clean the pores at home.
  • My face is broken out, dry, and oily at the same time. I never know how to fit in putting on lotion and putting on my acne medication (Retin-A tretinoin 0.05%) and when to put on which in my daily basis. My skin gets very shiny and gets in the way when I'm trying to go out and feel confident. The lotions I've used (Keri, Eucerin, Aveeno) cause my skin to get even more shiny or more broken out or they just don't moisturize my skin very well. Am I using the wrong lotions or cream and how and when should I put each on? I'm also using an oil-free cream cleanser with 2% salicylic acid by Neutrogena which seems to dry out my skin further, but my dermatologist recommended it. Is this not good and can I just switch to something else despite my dermatologist's advice?

    Your problem is very common and not really complicated. Combination skin is always a challenge. It is important that the basics are covered as far as washing and make-up. If the wash is drying you out, then it's time to switch. Gentle cleansing or glycerin bars are always a nice start. Use your hands and no wash rag or buff puff. Make sure that all your make-up is oil free. It cannot say water based. Also, do your hair styling first before you wash your face. This is so the hair care products do not get on your face. The term non-comedogenic is also acceptable. Retinols (Retin - A) is excellent for acne. Sometimes people will breakout before they get better and I encourage them to stick with it (good or bad) for six weeks. That is the time required to see if the acne is going to clear. In the oily areas we encourage the retinol to be applied a little more liberal. Conversely, in the dry areas, the retinol is applied sparingly. A moisturizer can also be applied to the dry areas as long as it is oil free. Moisturizers are most effective when used twice a day. Before you start adding new products, see how you do with what you have.
  • I started taking the medication erythromycin for my acne about a week ago and it seems to be getting worse. How long does it take for the medication to kick in and is it suppose to get worst before it gets better?

    In some people, acne will get worse before it gets better. As a rule of thumb, it takes six to eight weeks before significant improvement is seen. If after two months, the acne is as bad or worse, then it is time to switch treatment programs. Remember, most acne treatment is designed to suppress acne and not cure it. You must continue with your medications until your physician prescribes otherwise.

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