DEAR DR. DONOHUE: I am 17 years old. I have pimples all over my face. The only thing that helped was an antibiotic, but it made me sensitive to sunlight. My parents don’t want me to continue to use an antibiotic. Can you help? — G.G.

ANSWER: Let’s start with a couple of mistakes made by most people with acne. Don’t scrub your face or any place where acne has broken out. Scrubbing causes irritation and worsens acne. Use a mild soap like Dove when washing. Don’t squeeze pimples, whiteheads or blackheads. You force bacteria into adjacent skin.

Acne develops because of clogged pores through which hairs grow and through which sebaceous (oil) glands empty their oil onto the skin. The first signs of trouble are whiteheads or blackheads. They indicate that the pore is plugged. Deep in the pore, down from the blockage, the oil glands continue to secrete oil and greatly distend the pore, which can rupture. Bacteria thrive on the oil. At this point, a pimple is born. Acne control involves unplugging the pore, eliminating the bacteria and putting the brakes on oil production. The oil production is in high gear because of the increase of male hormones at this time in life.

Benzoyl peroxide unplugs pores. Brand names include Clearasil and AcneClear, both available without prescription, as are many other brands.

From this point on, effective medicines require a prescription. The first choice is retinoids — Renova cream and Retin-A. They’re often used on alternating days with benzoyl peroxide. The next step up is antibiotics. In creams and lotions, they aren’t absorbed very much. Clindamycin and erythromycin are two such products. If no progress comes from skin-applied antibiotics, then oral antibiotics are the next step. Tetracycline, doxycycline and minocycline are examples. Your parents should reconsider their ban on their use. Even if they sensitize you to sunlight, simply stay out of sunlight when using them. They worked for you.

I haven’t listed all acne medicines. Bad acne, like yours, calls for treatment by the family doctor or a dermatologist.

DEAR DR. DONOHUE: My husband chews tobacco and has used it sporadically for 18 years. He uses five tins a week. I am worried about this. His gums look horrible and have white patches. His dentist reminds him of the consequences. His answer is, “But I like it.” Please provide your input. — J.B.

ANSWER: Your husband runs a great risk of cancer of the mouth, tongue, gums and inner cheeks. Those white patches on his gum most likely are signs of precancer. He doesn’t want oral cancer. It’s a very formidable cancer that requires formidable treatment. Futhermore, his oral tissues are absorbing nicotine, which can be hard on his heart. Your husband would be wise to stop immediately. Five tins a week isn’t sporadic.

DEAR DR. DONOHUE: My concern is “tan without the sun” lotions. The “bronzers” work over a period of hours. If they were simple dyes, the color change would be immediate. It isn’t. It takes hours before an effect is noticeable.

Do they bring a natural skin pigment to the surface, and do they protect from the sun? — A.R.

ANSWER: Most of these products contain dihydroacetone, which reacts with cells in the topmost layer of skin and imparts the tan hue to it. It fades as these cells are shed. The color change does not protect against sunlight.

These bronzers are not skin dyes.

TO WOMEN READERS: The booklet on fibroids describes these common uterine growths and how they’re treated. Women can obtain a copy by writing: Dr. Donohue — No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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. Readers may also order health newsletters from www.rbmamall.com.

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