Dear Doctor, I sometimes develop some swellings which look like pimples around the mouth and nose. What could be the problem and how can I deal with it? Alyce Dear Alyce, Pimples and acne are one of the most common inflammatory conditions of the skin. They usually develop due to over production of oil from oil glands. They are said to be due to infection by propriono bacterium. Imbalance in level of hormones, stress are other causes of acne. They are more common during teenage years but can occur at any age. Some women get them around menstruation, while in some it may be persistent. Typical acne consists of blackish or reddish eruptions over the face, neck or upper chest. Acne rosacea is a condition of reddish papules/pustular regions, mostly occurring over face in people aged 30-50 years. Its exact cause is not known. Perioral dermatitis commonly occurs in middle aged women. It consists of dry, reddish, papules or pustules occurring over and around mouth and nose. This can occur due to long term steroid therapy. Gram negative folliculitis causes eruptions to occur around nose and mouth. This can be due to long term antibiotic therapy. Long term steroid therapy can cause eruptions around mouth and nose. At times other skin lesions like those caused due to allergy or viral infections may also resemble acne. Prevention consists of avoiding spicy, oily food, avoiding cosmetics which are greasy or can cause allergy, keeping face clean. Treatment consists of antibiotics, local applications of vitamin A. Estrogen containing birth pills help in clearing of pimples, but considering their side effects, benefits versus risks should be considered. If lesions persist, derm abrasion or electric ablation of the eruptions are interventions which can be considered. But steroids should never be used in any form for treatment of pimples. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
