DEAR DR. DONOHUE: I am a 26-year-old woman with a teenager’s problem – acne. I had it slightly when I was in my teens, and I have it now, when it is more noticeable. I scrub my face three times a day, I don’t eat fatty or fried foods, and I never touch chocolate. What more can I do? – K.R.

Acne is not confined to adolescence. About one in 10 women older than 25 must contend with it, and some battle acne for most of their lives.

Acne is the end product of an overproduction of skin oil, an obstructed oil-gland duct and the proliferation of bacteria within the blocked gland. In adolescence the imbalance of male to female hormones causes oil glands to enlarge, producing too much oil and, eventually, a clogged oil-gland duct. In some women, the imbalance persists into adult life, and for some of them, the only consequence is acne.

The treatment of acne centers on restoring normal hormone balance, opening the oil duct and attacking the bacteria within the gland.

Stop scrubbing your face three times a day. You are irritating your skin, and you are aggravating matters. Wash your face gently twice a day with a mild soap, such as Dove. You cannot scrub pimples off your face.

You can find acne medicines on the shelves of any drugstore. Begin with a lotion, cream or gel containing benzoyl peroxide or salicylic acid, both of which open oil ducts. Don’t use any oil-containing moisturizers or cosmetics on your face. Give this treatment plan six weeks. The acne you treat is not the acne currently on the face but the acne that is destined to pop up in six weeks. If there is not an improvement by then, raise a white flag of surrender and see a doctor. Prescription meds are called for then. Interestingly, birth control pills correct the hormone imbalance and are a legitimate treatment for acne.

You don’t have to watch your diet. No food has been consistently shown to promote acne.

DEAR DR. DONOHUE: Lately I have noticed that my bowel movements have a good deal of mucus. I have no pain, and I am never constipated. What is the significance of this? – R.K.

The intestine secretes mucus to facilitate the passage of undigested food through it. One of the most common digestive tract problems that features mucus as a prominent sign is irritable bowel syndrome. Along with an increased mucus production, abdominal pain, bloating and constipation alternating with diarrhea are indications of irritable bowel syndrome. If you have these other symptoms, then irritable bowel syndrome is a likely diagnosis.

Eating too much fatty food and fried food can also induce increased mucus production.

Some important illnesses have an oversupply of mucus as a sign. Ulcerative colitis, diverticulitis and cancer are three such ills. To play it safe, see your doctor. The chances of your having a serious problem are slim.

If your doctor discovers no trouble and if the mucus bothers you, a high-fiber diet decreases its production. Fiber keeps stool soft by holding onto water.

The intestine senses that and cuts down its manufacturing of mucus. Mucus or not, upping dietary fiber to a daily range of 25 to 35 grams keeps the intestine healthy. For one, it lowers the risk of forming diverticula – bulges of the colon wall that can become inflamed.

DEAR DR. DONOHUE: Every summer the skin beneath my breasts becomes raw and painful. How can I prevent this? I am a large-breasted woman. – D.D.

My sight-unseen diagnosis is intertrigo. Warmth and moisture promote it. It is raw, red skin that appears in skin folds, like the area beneath the breasts. One skin surface rubbing against another is its third ingredient, after warmth and moisture.

With a mild soap gently wash the skin beneath the breasts two or three times a day. Then apply a drying powder such as Zeasorb.

If the skin doesn’t respond, you could have a superimposed fungal infection, and that, of course, requires antifungal medicines as part of the treatment.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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