Dear Doctor,

I always develop pimples whenever I eat fries (chips) or any oily foods yet my friends with whom I eat never experience any skin reactions. What causes this and how can I overcome this skin reaction?

Jeanette

Dear Jeannete,

Pimples/acne are reddish or blackish eruptions occurring mostly on face, neck and upper trunk. As such it is a problem commonly occurring in teen years, but can occur at any age. It does not pose any serious health hazard. But they look bad and reduce self-esteem of affected person. Removing the pimple mechanically or scratching carries risk of permanent scarring.

Pimples occur when pores of skin are blocked by a greasy substance called sebum. Why pimples occur in one individual and not in another is not known precisely. There are several hypothesis as to why pimples occur. They are said to occur due to hormonal influence. One may develop pimples due to excess level of testosterones or body being more sensitive to existing levels of testosterone. Stress is also implicated in causing pimples, possibly by increasing testosterone levels. Increased levels of insulin like growth factor, a hormone are also said to result in forming pimples. Pimples also occur due to oily cosmetic products, medicines like steroids, some anti-depressants. Oily food has long been said to be responsible for pimples, but still conclusive data are lacking. Milk and milk products have also been implicated. Recent studies have suggested pimples to occur due to infection by proprinibacterium acne, a bacterial infection. These microbes are normally present over skin. But when sebum blocks skin pores, these bacteria accumulate there. This induces local inflammation causing the eruption and redness.

Genetic factors also play an important role in causing pimples.

Prevention lies in keeping face clean and dry, avoiding oily skin care cosmetics. Taking a healthy, diet with lots of fresh vegetables, fruits, avoiding stress, minimizes risk of pimples or at least keep them minimal. Avoid over scrubbing the face and avoid oily cosmetics. Antibiotics like doxycycline, erythromycin are useful in testing pimples. Local applications of antibiotic and or tretinoin containing ointments also help. One has to be patient because after initiating treatment, results come after 4 to 8 weeks. If problem is severe or persistent, interventions like electric ablation or derm abrasion can help. It is important to remember that pimples can relapse after treatment. One should never squeeze or pop them, otherwise permanent scars can form.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital