Pimples are infected oil glands in the skin. Clindamycin is an antibiotic that is designed to kill the bacteria that infect the pimples, and therby 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.

        Acne in adults is unfortunately, far harder to treat than in teenagers. It is due to the same causes though. In simple terms, a change in the hormone levels causes the oil in the glands just under the skin to become thicker, and this blocks up the ducts leading from the oil glands to the surface of the skin. The gland then becomes infected and a pimple develops. Because women have more hormonal problems than men, it is far more common for women to develop adult acne. Changing the hormone levels by using a contraceptive pill (or a different strength of one) often helps the problem. The antibiotics and skin lotions used by teenagers are also helpful.

Treatment :
Although a cure for acne is not normally possible, medical science can usually control the condition adequately. The steps to follow are :- Gently wash the face with a cloth and non-perfumed non-medicated soap twice a day. Use over the counter chemist preparations that work by drying out the oil in the skin, removing any excess skin flakes, and reducing inflammation. A variety of different prescription creams, lotions and pastes that prevent infection, dry up excess oil and reduce inflammation. Antibiotics (see Medication Table) prescribed by a general practitioner, either short or long term, are successful in controlling more severe acne. Some types of oral contraceptive pill (see Medication Table) and other hormones are very useful in controlling the condition, but only in women. In rare cases, the very potent Roaccutane tablets (see Medication Table) may be prescribed.

Diet :
There is no evidence that diet, vitamins or other herbs have any effect on pimples. A small number of sufferers may find that one particular food causes a fresh crop of spots, but these people usually quickly realise this and avoid the offending substance. There is no truth in the old wives tale that acne is worsened by chocolate.

Complications :
Picking acne spots can cause serious secondary infections. Occasionally secondary infections can develop in acne to cause deeper skin infections that require immediate medical attention with antibiotics.

Outcome :
Usually settles with age and medication, but may cause both skin and psychological scarring.

Medical curiosity :
A century ago, doctors believed that constipation was a cause of acne.

Other names:
Pimples, zits.

Introduction :
A skin disease causing disfiguring pimples, which usually occurs in teenagers.

Types :
Varies from the very occasional spot, to a severely disfiguring form known as acne vulgaris.

Cause :
Pimples are due to a blockage in the outflow of oil (known as sebum) from the thousands of tiny oil (sebaceous) glands in the skin. This blockage can in turn be caused by dirt (uncommon in our super-clean society), dead skin left behind during the normal regular regeneration of the skin surface, or a thickening and excess production of the oil itself. Once the opening of the oil duct becomes blocked, the gland becomes dilated with the thick oil, then inflamed, and eventually infected. The result is a white head, with the surrounding red area of infection. Eventually this bursts, sometimes leaving a scar. The hormonal changes associated with the transition from childhood to adult life is the major aggravating factor in acne. Hormonal variations later in life can also cause changes to the thickness of oil in the skin, and may worsen or improve acne. Pregnancy, menopause and the oral contraceptive pill may all influence pimples in this way. Stress in the patient, either psychological or disease, may cause pimples to worsen. A simple cold, or the onset of exams may see the number of spots increase dramatically. Pressure from spectacles on the bridge of the nose or tight collars, increases in skin humidity from a fringe of hair or nylon clothing, and excessive use of cosmetics that further block the oil duct openings, can all cause deterioration in a person’s acne. If your father or mother had acne, you have a greater risk of developing them. Acne is not infectious.

Incidence :
Usually starts in early teenage years. Acne is generally more severe in teenage males, but starts earlier in females. It may strike later in life too, particularly in women. It affects Caucasians (whites) more than Negroes or Chinese races.

Course :

The removal of tattoos requires multiple treatments, although some may disappear more rapidly than others. Most amateur tattoos require fewer treatments than the professional tattoos, which may require as many as 10-15 re-treatments.

Naturally these would be fully explained by the treating doctor prior to treatment.

• Small bruises at the injection sites, which disappear within 10 days.
• Muscle cramps during treatment, lasting only a few minutes.
• In rare instances, ulceration, which may heal with a small white scar.
• ‘Matting’ or tiny red capillaries which occur near the injection site. This occurs in a small percentage of patients and tends to fade after 6-9 months. Otherwise these vessels can be treated with further injections or laser treatment.
• Blood trapping. Some slightly larger vessels may appear dark and nobbly under the skin after 3-4 weeks. This is due to old blood trapped in the treated veins and will resolve over the next few weeks.

Is there an alternative to sclerotherapy?
Until recently, alternatives to sclerotherapy (such as laser treatment) had been fairly unreliable. We have, however, acquired the new AURA laser, which is showing great promise in the treatment of those who have shown limited response to injection treatment.

No Medicare rebate is available for most of these treatments, though some pigmented birthmarks will attract a Medicare rebate.

Note: In over 25 years of use of different lasers in medicine, no long term undesirable or unusual side effects have so far been reported.