Acne Treatments Questions and Answers

Question:

I have a severe problem of dry lips. The skin on both the upper and lower lips dries up and comes of from the same place over and over again(localised to lips only).I have had this problem for a very long time ..so its not due to the weather.I have tried all kinds of things.It is very very severe drying. What can you advice?

Answer:

Hi...not being a Doc, I can't diagnose your problem but...I looked through many websites and found this one that may help... "FAMILY MEDICINE® COLUMN By John C. Wolf, D.O. Associate Professor of Family Medicine® Ohio University College of Osteopathic Medicine "MOUTH BREATHING" CAN LEAD TO NIGHTTIME DRY LIPS AND DRY NOSE Question: Every night my lips get very dry, and so does my nose. I put Vicks on my lips, but it doesn't seem to do any good. I use saline nose drops that help for a few hours. If I awaken in the night I usually need to use both medicines again. What can I do for my dry sore lips and nose? Answer: As I'm sure you know, the skin of the lips is usually smooth and dry while the tissue inside the nose is usually moist. Neither area should be uncomfortable. I don't have enough information to know which one of the several conditions that can cause your symptoms you actually have, so I'll go over the most common maladies in hope that you can identify your problem. A deficiency of some of the B vitamins, particularly riboflavin (B2) and pyridoxine (B6), can cause the symptoms you describe, particularly the dry lips. In fact, the painful lips may be among the first signs of this problem. Fortunately, pyridoxine deficiency is quite rare, and the diagnosis is even rarer since there is no easy test to measure the level of it in the body. Riboflavin deficiency is more common, but it still is infrequent. A blood test is available to measure it. Vitamin supplements taken by mouth are all that is necessary to correct either problem, but be aware that taking too much B6 (over 600 mg per day) can cause serious health problems. Taking large amounts of vitamin A can cause sore lips. This "overdose" can occur from frequently eating liver or from taking large amounts of vitamin supplements in tablet form. If you are doing either of these, you should stop immediately and seek the advice of your physician. There are several drugs that can cause drying of the lips and nose. Antihistamines, antidepressants, cancer drugs, some acne drugs, and some stomach remedies are among the most commonly used ones. You should talk to your doctor or pharmacist if you are using a non-prescription or a prescription product in any of these categories. Often an alternative is available that causes less drying. An emotional habit of constantly wetting the lips, either by licking them or by frequently sipping a beverage, can cause dry lips. This paradoxical response occurs just as dry hands result from frequent hand washing. The liquid washes away some of the protective oils of the lips so that they dry out easily. Usually a protective film over the lips such as Chapstick or lipstick is quite helpful. The most likely cause for your nighttime dry lips and dry nose is mouth breathing. The mucosal lining of the nose is usually moist. This is helpful in moisturizing the air that is inhaled. In the winter the inside air is usually quite dry. This "desert dry" air can dry the nasal tissues excessively, thereby causing discomfort. Mouth breathing often occurs as a response to this drying in the nose and ultimately results in a similar drying of the lips and throat. By the time you awaken, you have developed a dry sore nose, throat and lips. The best solution for excessively dry air is the addition of moisture. Using a vaporizer or humidifier in the bedroom is the easiest solution. It is a simple and inexpensive treatment. Other conditions that cause swelling of the nasal tissues, such as the common conditions allergic rhinitis and vasomotor rhinitis, can also produce the same uncomfortable dry nose and lips. Try a vaporizer in your bedroom for a few days. If your symptoms persist, go to your family doctor. He or she can help you find a solution for these problems." Hope this helps you... Julie Adinolfe RN Askanurse

Question:

Hi! I just got ortho tri-cyclen for my acne, but I was told by my gyno to take the first white pill the first sunday after my period begins, why do I have to do it that way? Will it make any difference is I start taking it say.. tomorrow? Please help me 'cause I really don't understand why! Also, There are white, blue & green pills in the package, what's the difference and what are each of them for? Thank you a ton!! =)

Answer:

Hi...I don't know why he said to start it on the first Sunday...maybe because it's easy to remember every month. This is what medline says about the different colors... "It is very important that you keep the tablets in their original container and take the tablets in the same order that they appear in the container. The containers help you keep track of which tablets to take next. Different colored tablets in the same package contain different amounts of hormones or are placebos (tablets that do not contain hormones). The effectiveness of the medicine is reduced if the tablets are taken out of order ." Here's the website for Ortho tricyclen for you to read...http://www.nlm.nih.gov/medlineplus/druginfo/estrogensandprogestinsoralcont202228.html Hope this helps.. Julie Adinolfe RN

Question:

I've been taking Accutane for acne 20 mg (.5mg/kg) once a day for 5 weeks . I have since developed an infection around a wisdom tooth, and it looks like it needs to be removed. Should I stop the Accutane, and, if so, how long should I wait before oral surgery?

Answer 1:

Good question. Accutane must be stopped several months prior to cosmetic laser surgery due to its affects on sebaceous gland function and skin keratinization. It is also well known to affect many other areas of your body, including inhibiting contraceptive drugs. Oral skin has both areas of keratinization and without and there are no sebaceous glands in the oral cavity so the chance of problems are most likely small but may slow the healing of the gum tissue. I would suggest you also contact the prescribing doctor.

Answer 2:

It should not prohibit you from have the tooth removed.

Question:

I have Hidradentis Suppurativa. I also have Diabetes. My family doctor is recommending surgery. I'm having a hard time finding out any information about Hidradentis. Could you please give me some information about this condition and the pro and con of surgery. THe surgery would be the nodes in my groins. Thank you for any help you can give me.

Answer:

Here is an archived Q&A that should give you some good info from Dr. Taub. Question: Oct 08, 2001 My father in law has been diagnosed with hidradenitis suppurativa and has had 20 surgeries to help out with his pain. It has reached a point where the pain has become unbearable for him. He has lost a lot of weight and the condition is spreading. Do you have a name of a doctor who can help him? Is there anything that we can do to get him to feel a liitle better? We are desperate... Answer: I am so sorry to hear that your father-in-law is in such terrible discomfort. I did a literature search and found that there are really two main treatments for hidradenitis. One you might consider is oral isotretinoin, brand name Accutane, which is usually used for severe acne but has been shown to be successful in suppressing (not curing) the symptoms of some cases of hidradenitis. The most widely accepted treatment, however, appears to be radical surgery, that is wide excision of the entire skin surface in the affected area. With 20 surgeries behind him, it doesn't sound like this option is going to be one that gives him much hope. The authors that were associated with these papers about surgical procedures included Drs. Ratz and Finley at the Department of Dermatology at the Ochsner Clinic and Alton Ochsner Medical Foundation in New Orleans, LA and Drs. Brown, Rosen and Orengo, from the departments of dermatology at Baylor College of Medicine and Veterans Administration Medical Center in Houston Texas. Perhaps contacting one of these doctors for consultation on your father-in-law's case would prove fruitful. In addition, please have him checked carefully as squamous cell carcinoma, a type of skin cancer, can develop in long-standing open wounds. If he has hidradentis in the groin, he also may need to be evaluated by a gastroenterologist as this has been associated with rectal cancer. Good luck! Amy Taub M.D. Hope this helps you. Good Luck. Julie Adinolfe RN

Question:

A couple of months ago I had a real bad reaction to some makeup. I broke out with really bad acne. The acne has cleared, but some scars were left. What would you recommend to have these scars removed?

Answer 1:

Dear Marie, I wish it was easy to remove scars. It depends upon their character and depth. If they are very deep, they may need to be surgically removed. If more superficial, a type of deep resurfacing will improve them markedly and, if very superficial, a light treatment such as microdermabrasion performed a few times will make them much better. I would suggest that you visit with a dermatologist or plastic surgeon who offers all of the options in order to determine what is best for you.

Answer 2:

I would wait at least 6 months before I would attempt any surgical endeavor. It is difficult to evaluate over the internet. A trip to a plastic surgeon/dermatologist is in order.

Question:

what kind of medication can i use for breakouts on my face if i am pregnant?

Answer:

Over the counter acne preps as well as other similar medications that contain antibiotics that are available from your dermatologist. Avoid tetracycline, Acutane, Retin-A, retinoic acid, reinoids or other vitamin A derrivatives. Consult your MD beofre starting any medications.

Question:

I AM AFRICAN AMERICAN. HOW DO I GET RID OF DARK SCARRING FROM ACNE AND ECZEMA BREAKOUTS?

Answer:

Dear Visa, This is a difficult problem since African Americans do not want to remove all of the pigment but merely reduce the amount of color in darker areas so as to match the lighter brown of the rest of the skin. A white area actually looks worse in this patient population. My suggestion to you is to seek out someone experienced with treatment of darker skin with lasers. This is the only controlled way of reducing but not eliminating the excess pigment. I would suggest either a Q-switched KYP or Q-switched ruby laser for this process. Make certain that test spots are performed first and that at least 3 months is left before an actual treatment (it can take a while for the pigment to reduce).

Question:

I'm 29 years old and have had menstrual irregularities since I was 17 years old. I've seen 4 MD's, 1 ENDO (not reproductive endo.) and 1 GYN in the last 12 years. I've gone as long as 2 years without menstrating. It's now been 6 months since my last period. I've been married for 11 years and of course do not have children. I definitely feel the clock ticking now and would like to become pregnant. Every doctor I've seen has told me it's related to my weight and if I lost weight I would menstrate (except for the endo. he didn't state this). My lowest weight was 160 when I started skipping periods at the age of 17. Now you can add another 120 pounds to that 160 weight. I had 6 periods last year and we tried to conceive after each one of them with no success. Realize 6 periods in one year at 280 lbs was the same at 160 lbs. Some other problems I'm having is unwanted facial hair (which I've mentioned to all my doctors). Newest symptoms are: pains and pressure almost similar to cramping without actualy bleeding, and occasional acne breakouts. Help!

Answer 1:

Hi, You desperately need to see a reproductive endocrinologist!!! It is highly abnormal and unhealthy for you to go so long without periods, as this can increase your odds of health problems and even cancer. Didn't anyone give you a diagnosis? Do you have polycystic ovarian syndrome (PCOS)? You MUST be tested and treated appropriately, and if no one has told you not to go more than a few months without a period then you've been poorly cared for! If you need a referral to an RE in CA, please let me know if you're closer to L.A., San Diego, San Francsisco, or other large cities. Dr. Roseff, Director WECARE Visit us at www.reproendo.com

Answer 2:

Dear Lisa It is time to see a Reproductive Endocrinologist (RE), and not a regular endocrinologist. You may require some medications (including one called Metformin), but you need an appropriate doctor. FInd out which city is close by that has some REs. Good luck Fady Sharara, M.D

Question:

I have deep acne scarring on my face. I had laser surgery 3 years ago, and it didn't improve. What could I do to help my face become smoother?

Answer:

Dear Kristina, I am surprised that you got no improvement, however, that procedure, like all others is very operator dependent. You may require pre-excision of deep pits followed by another resurfacing procedure. Make certain that you visit with someone who is either board-certified in laser surgery or who has great experience and does many similar cases to yours. Ask to speak with past patients to make certain that the results are as described to you. I would also suggest that you plan on taking 3 weeks off from whatever you do since a deep resurfacing will take about that long to heal and still be red for another several weeks thereafter.

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