Exterminating Those Zits From Hell

It is plausible that hormones given to cows could somehow be related to the development of acne -- but it is unlikely that this is the only cause, she says, adding that it is not "unreasonable to ask a patient to refrain from consuming partially skimmed milk products if they report that such food affects the severity of their acne."

Adds Weinberg: "This is controversial, but at this point, it is at least worth asking patients with acne if they have high dairy consumption, and thinking about lowering it, especially in resistant cases."

Q: Nothing works on my cysts. What should I do?

A: Go to a dermatologist; most insurance plans will pay for office visits. Retin-A is but one of several useful topical medications. Antibiotics may also be prescribed. A drug called Accutane belongs to the strongest class of drugs and is prescribed for relatively short-term use.

Q: I don't like the idea of being on antibiotics indefinitely, and I heard that Accutane can cause severe depression.

A: If you have any sort of psychological disorder (or plan on getting pregnant) no responsible doctor would prescribe Accutane for you. That said, Weinberg emphasizes that Accutane is "safe and effective, despite the bad press," but adds that "We need new subantimicrobial antibiotics with high potency."

Says Pacheco: "It's regulated through a government-mandated drug safety program and can be used safely when monitored appropriately. I have not had a complications to date."

Of course, you can also get a quick fix by having your most painful zits lanced and injected with a steroid.

Q: Can't I just lance them myself?

A: You'll risk scarring. If you do nothing to a cystic zit, there's a good chance it will leave a scar. If you try and pop it yourself, you're nearly guaranteed. According to Reed, only a dermatologist knows what individual zits will benefit from the needle and which will just get more infected. Moreover, it takes skill to do it correctly.

Says Granstein: "Lancing may not always be the best thing to do for acute lesions. Injection of a small amount of a corticosteroid (usually triamcinolone) leads to rapid and effective improvement. Patients should never open them at home due to the risk of scarring and infection."

Q: What else is there?

A: Thermage, a relatively new procedure developed to tighten the skin with heat with a radio frequency device has shown promise, says Lee.

Laser technology -- not just for zapping scars, but for penetrating individual zits and killing the bacteria with light -- is the most exciting development to date.

Yet Pacheco predicts that laser and light device will have only an adjunctive role in treatment.

Besides, she says, at this time insurance won't cover it.

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