Question: I have suddenly developed pimples at 22 years of age, having not had them for seven years when I was a schoolgirl. My lifestyle has not changed. My doctor recommends antibiotics, but I am reluctant to take these. I am taking zinc tablets from the chemist, but they don’t seem to be helping.
Pimples may develop at any age, but they are far more common in teenage years when hormone levels are increasing.
Any change to your hormone levels may trigger an attack of acne. Pregnancy is one obvious cause of hormone change, and the oral contraceptive pill may also be a cause in some women, while in others the pill may improve acne.
Treatment involves using the various pimple creams available from chemists, and taking zinc supplements, which benefit some people. If these are ineffective, then it is wise to consult a doctor who can prescribe more potent lotions and creams, along with antibiotics.
Antibiotics especially designed to combat acne are very effective, as they prevent the blocked oil ducts that cause acne from becoming infected. They are designed for long term use, and have no side effects in the majority of patients.

Question: For how long can my son take pills for acne? He has been on Vibra-Tabs for some time now, and they control the severe pimples on his face and back. Can these pills cause any damage?
Vibra-Tabs are specifically designed to prevent and treat acne in teenagers. They contain a low dose of an antibiotic that is in the tetracycline class to destroy the bacteria that are responsible for this distressing problem.
If given to young children, these tablets may cause teeth discolouration and bone deformities. High doses may cause nausea and diarrhoea, and some individuals may be sensitive to the medication. These complications are uncommon, and generally in teenagers and adults they are a very safe and effective treatment for pimples.
There is no reason why your son should not take the tablets for several years if necessary. Thousands of other teenagers have done so without ill effect.

Question: Could you please give me information on the drug prescribed by specialists for the treatment of severe cases of acne. What are the side effects and long term effects?
The drug you are referring to is Roaccutane (isotretinoin), which is a tablet that can radically improve severe acne.
This drug is very effective, but may have serious side effects, and its prescription is limited to dermatologists only.
The most serious complication of its use occurs if it is taken by a pregnant woman. If this does happen, the baby will almost certainly be significantly deformed. For this reason, dermatologists are very careful, when prescribing it for women, that they are well established on an effective form of contraception such as the oral contraceptive pill.
Common non-serious side effects include a dry mouth, nose, eyes and skin; pealing of skin from palms and soles; headaches; vomiting; depression and diarrhoea. Another possible serious, but rare side effect is the development of scars in the eye.
Roaccutane is not a drug to be used lightly, and every other form of acne treatment should be used before it is considered, but some teenagers have severe acne that could cause permanent scarring and lifelong disfigurement. Roaccutane can clear their skin and prevent this scarring, and if used under the close supervision of a dermatologist, may dramatically improve the quality of life and attitudes of an affected teenager.

Question: I had a bad case of acne on my chin. I have been given Clindamycin cream to heal it. Can you tell me what this does to the pimple? Will my acne scars be permanent?
Pimples are infected oil glands in the skin. Clindamycin is an antibiotic that is designed to kill the bacteria that infect the pimples, and thereby cure them. If you are finding it successful, then continue the treatment. If your pimples are still bad, you should see your doctor about using other preparations on the skin, and antibiotics or anti-acne drugs by mouth to keep the condition under control.
Acne scars are often a deep red colour when the pimple initially subsides, but after a period of months or years, they gradually fade to a pale pink or dead white colour. These scars are unfortunately permanent, as are scars on any other part of the body. Once you have grown out of your acne, and no further skin infections are occurring, you can see a dermatologist or plastic surgeon to have one of a number of procedures performed to make the scars less obvious. Dermabrasion, in which the lumps and bumps on your face are reduced, is quite successful if the scarring is widespread.

Question: I have been taking antibiotics, including Vibra-Tabs, Minomycin and Mysteclin, for acne for many years. These keep the acne under some control, but it never completely clears up. If I stop them, the acne flares up terribly. I am worried that the antibiotics may cause my bouts of depression, and can they cause a low sperm count?
Acne can be controlled by antibiotics and other medications, but it cannot be cured. You are not going to have a ‘peaches and cream’ complexion, but there should only be a few pimples present that are not easily noticed by other people.
If your acne is controlled by antibiotics such as those you mention, be grateful, because some victims have to use far more potent medications. The antibiotics may be combined with skin preparations if necessary. I am not aware of these drugs causing depression or a low sperm count, and you should be reassured on these points.
If you are having problems with periods of depression, whether associated with your acne, other problems, or no specific problem, I urge you to discuss it further with your general practitioner, as the depression may also need to be treated to make you a far happier and more confident person.