Patients often don’t want to bring up the discussion of acne during an office visit. If it is bad enough to bother you, it bothers us. So be a squeaky wheel. Here are the questions to ask that will help you make sure you are on the right track to treatment and resolution of your acne.

1. Is my acne hormonal? Your doctor can tell by the look and your story whether it is. If your acne is hormonal good options for treatment exist: oral contraceptives and aldactone (spironolactone) will help.

2. Should I change my diet? Whether or not eliminating dairy helps is controversial. Many studies have shown, however, that eating a diet with a high glycemic index makes acne worse. Examples are potatoes, white bread, watermelon, donuts, and cornflakes. Look at this list of low glycemic index foods to make a change in your diet.

3. Acne meds are so expensive, is there a generic option? Acne medications are a huge money maker for drug companies. Whether is an antibiotic, benzoyl peroxide, retin-A, combinations of all of those…there are generic options that will be cheaper so ask about them

4. The doxycycline you gave me upsets my stomach are there other options? Make sure you are on Doxycycline monohydrate not Doxycycline Hyclate. The first is much better tolerated so see if that helps.

5. Could my acne be something else? Often the cause of acne in adults (aged 20-40) is rosacea which is treated differently. Folliculitis with pityrosporum (a yeast) causes what looks like acne on your chest and upper back. Make sure it’s not something like that as it is treated much differently.

6. Do I have too many male hormones (androgens) causing my acne? If you are a woman with acne who is also overweight with irregular periods you need to be ruled out for Polycystic Ovary Syndrome (PCOS). Your doctor can draw some blood tests to figure this out.

7. I have blackheads, is that treated differently? Yes. If blackheads are your problem bring it up to your doctor for a different treatment.

8. How long do I use this cream/pill before I see results? All acne treatments take weeks to months to see results. Hang in there as you will be using treatment for a long time before you see positive results.

9. When will my acne go away? Acne is the worst during adolescence and will resolve as you head into adulthood. As I mentioned above adult acne can occur between ages 20-40 and is usually rosacea.

10. The biggest mistake. Quitting too early is the biggest mistake my patients make. Whether its retin-A, topical antibiotics + benzoyl peroxide, oral antibiotics or aldactone people quit using them too soon due to frustrations. Great things take time; please give it the time as it will help.

See my previous blog for details about treatment.

- Dr. O