Q.How can I get retinols or benzoyl peroxides to get rid of my blackheads?

A.I have a lot of white flaky white heads on my chin and around my nose.  If I scrub hard enough they come off but I'm worried I shouldn't be doing this. I assume they're just white heads but they don't look like they need to be squeezed.  What are they and how should I treat them?



Q.Hello, my situation is very complex. I started to develop mild-moderate acne at the age of 12. From the ages 12-17 I broke out but was able to control my breakouts with oxy and clearasil. In the past year or so, my acne has become out of hand. I get breakouts on my back, chest and neck occasionally, but my face has been really bad. I do get cystic pimples sometimes, but lots of red small ones and puss filled ones pop up nonstop. I tried retin a micro and it did not work. I have been using Proactiv for about 2 months and while it does help my acne somewhat, I wake up one morning with a clear face, but pimples develop by 12-1 o clock in the afternoon out of no where. I just started Ortho Tri Cyclin about a week ago and I'm hoping it helps. Acne runs in my family. My mother is against me using Accutane and I took Minocycline but may have had an allergic reaction to it. Any ideas? And do you know why I wake up with clear skin in the morning and develop like 10 pimples in the middle of the day?

A.White flaking areas on the face are suggestive of seborrhea (dandruff). Seborrhea is not limited to the face.  Involvement on the face around the nose, chin, eyebrows and upper chest is common. Seborrhea is a chronic condition that can be controlled but not cured.  The cause is unknown however some scientists feel it is from an organism in the skin called Pityrosporon ovale.  This organism is very common and is not considered an infection.  Treatment consists of shampoos, topical cortisone creams, tar preparations and anti fungal agents.



Q. I can see no rash, but I have a slight burning sensation around my hairline above my forehead. I had minor surgery three weeks ago to remove a growth on the inside of my nose, a local was used. Any ideas? It takes two months around here to get in to see a good skin doctor.

A.Anytime the body is traumatized or a stressful event has occurred, seborrhea/dandruff will flare. We see this all the time when people are admitted to the hospital. This is easily treated with over-the-counter hydrocortisone creams or antiseborrheic shampoos. Read about dandruff on YourSkinDoctor.com.



Q.I am 17 years old and I have facial skin that is very reddish looking compared to the rest of the skin on my body. It has been this way since I got burned while taking the drug doxycycline for acne. I still have acne, but no products help, they only make my skin worse. The only thing that helps make my skin more "mild" is a cortisone. Could I have sundamaged skin since my skin is very pinkish and older looking?

A.Most sun damage accumulates from adolescence to the early twenties. I have seen skin cancer in teenagers but it is rare . Usually the effects of sun damage will not disappear with cortisone. Seborrhea (dandruff) is very common on the face and responds readily to mild cortisones. Too much cortisone on the face can cause redness and acne. This is one case where it sounds like multiple things are going on. Take a step back and stop everything. Have your dermatologist sort it out!



Q.My skin around my mouth and nose is red & flakey, and stings. I am putting moisturizer on every hour or so. I thought it was windburn from walking the dog, but three days out of the cold & it is worse. Usually my skin is normal in this area, with the T zone kind of oily. I have not changed soaps, detergents, etc. Although I did use Neutrogena acne soap (by mistake) one time about three days before I saw signs of trouble. I am now using regular Neutrogena soap. Help!

A.Red, scaling rashes on the face are suggestive of seborrheic dermatitis (dandruff). This condition is a common problem of unclear origin. There is no rhyme or reason why people get this and it can be controlled but not cured.



Q.I'm a African American female age 27. My skin complexion is brown. The problem is that the area on my face that they call the "T" area is lighter than the rest of my face by one or two shades. I sometimes get dry patches on my face as well. What can you do to help me?

A.Sometimes darker skin can get lighter when there is associated inflammation. Seborrhea (dandruff) is very common in the "T" zone. Anti-seborrheic shampoos and over-the-counter hydrocortisone creams help control this. A sunscreen is also beneficial as the skin around the involved area will darken in sunlight and increase the contrast between the light and dark skin. This takes many weeks to improve. Remember, African-Americans can get suntan and sunburn. (YSD product recommendations - Medicated Moisturizing Shampoo, Soothing Cream with Aloe and Daily Protectant Sunscreen.)