Pimple

Dear Dr. Jen,

I have a pimple that never seems to go away.  I’ve had it for several months. It grows into a red bump on my nose then subsides into a brown flat spot. After a few months, I get a pimple on the exact same spot again.  So it grows red then flattens after a few days.  What is going on?  I have tried the usual acne medications on it and nothing seems to work.

Jason

Dear Jason,

Recurrent pimples on the exact same spot are not that rare.  There are a couple of explanations why this could be going on.  The more common explanation is that the nose is an oily area.  Pimples are fond of growing there.

But it could also mean that there might still be some pus and bacteria left underneath the skin. This would usually require treatment with an antibiotic for a few days.  Evacuation or drainage of any remaining pus would also be recommended if any is visible.

Lastly, you can also try having the pimple injected with a mild corticosteroid.  This will bring down any inflammation and also lessen the formation of dark or elevated scars. Please do not attempt to prick or push or manipulate the pimple on this part of the face.  The nose area can connect to blood vessels in the brain and can bring about deeper infections if not controlled properly.

* * *

Dear Dr Jen,

I am in my 20s and have been getting hives on and off. I am not eating anything new and have not used any new products on my skin.  I take antihistamine and it seems to work well.  However, I do not want to take it forever.  What can cause hives?

Debbie

Dear Debbie,

Hives, wheals or urticaria can be caused by a number of things. The most usual temporary cause would be an infection in the body. This would include cough, colds, ear infection, urinary tract infection, and the likes.

Your PDS dermatologist would probably get some lab works done to point out any infection if ever it is present. If the laboratory exams turn out negative then the next step is to run tests that may point to other allergens.

There are multiple tests that may need to get done.  Food allergens, respiratory triggers (pollen, dust, etc.) and skin contactants (paraben, fragrance, etc.) are all possible culprits.  This can be identified through objective tests.

What shouldn’t be done is to keep on guessing what the cause is. With urticaria, as with all allergies, once the trigger is identified, treatment is so easy.  Avoiding the known cause and taking antihistamine as needed when exposed to it can be done.