DEAR DR. DONOHUE: I am having a hard time getting a straight answer on the safety of taking minocycline for adult acne, which I have had for a long time. I have taken the medicine for at least four years. It seems to be the only thing that keeps my acne controlled. I have had no side effects, but I still worry. I’m open to any other suggestions. I am 54. – L.C.

ANSWER: Acne usually is associated with adolescence, but some people have to deal with it into adult years, and even into late adult years.

Acne is an inflammation of a hair follicle and the oil gland associated with the follicle. The oil gland, under stimulation from male hormones (women make them as well as men), pours oil into the hair follicle, and the oils clogs the skin pore. A common skin bacterium, Propionibacterium acnes, feasts on the oil, multiplies in the pore and leads to irritation and inflammation. The result is an acne pimple.

Minocycline is a relative of the antibiotic tetracycline. It works well for some people’s acne. Most often, six months is about the length of time it is used. It can make a person dizzy and it can promote diarrhea. It has done neither to you. It’s an exception to the rule that long-term use of antibiotics creates a supergerm. Minocycline use doesn’t do that. So long as a doctor is overseeing your treatment, you can continue using it.

Have you tried topical antibiotic creams, gels and lotions? “Topical” means “applied directly to the skin.” They rarely have side effects. Aczone gel – not an antibiotic – is a newer topical drug for acne. You might not have tried it. How about the well-known other acne topicals: Retin-A, Differin and Tazorac? Spironolactone is a mild diuretic that blunts the effect of male hormones on oil glands. Many older women who suffer from acne have found it quite useful.

DEAR DR. DONOHUE: Several months ago my wife was having frequent cramps in her legs at night. A close friend advised her to place a bar of soap in bed. My wife did put a bar of soap in our bed, and she no longer has leg cramps. We discovered that my brother and his wife have a bar of soap in their bed for the same purpose, and it works for them. Are they all wrong? I don’t see how this works. – J.G.

ANSWER: I don’t see how it works either. “Skeptic” is too weak of a word when it comes to me and soap in the bed for nighttime leg cramps.

On the other hand, I get many letters telling me that it put an end to nights made miserable by painful leg cramps. It doesn’t matter if the soap is covered or uncovered. The brand doesn’t make a difference. Most place it between the sheets.

Maybe it’s a psychological thing that somehow affects the body. I don’t know.

The booklet on restless leg syndrome and nighttime leg cramps discusses these conditions with a bit more scientific approach. Readers can obtain a copy by writing: Dr. Donohue, No. 306, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.