Index Home About Blog
From: ((Steven B. Harris))
Subject: Re: Help with acne problem
Date: 15 Apr 1995

I wonder if I might drop in here on the argument with some anectodal
observations.  Ordinarily I hate this kind of thing, but I suppose it's
okay if clearly labeled.  Besides, I want to get comments from others

I've had perhaps five patients who've noted a serious increase in acne
after going on fishoil capsules (EPA), and this also proved to be a
problem for them on linseed oil and (to a lesser extent) borage oil.  I
infer that omega-3 fats may be involved.  I've also see (I think)
patients who were sensitive to B5 and biotin, and broke out when taking
megadoses of these.  This is interesting particularly in that both are
involved in fatty acid metabolism.  Most of these people were taking
vitamin E, so their antioxident defenses were not being particularly

Anyway, the observation was so interesting that I thought I'd throw it
out here.  You won't read about it in any text-- indeed you will read
that acne is not caused by chocolate (no doubt true), and is not diet
related (of this I'm not so sure-- perhaps people didn't notice the fish
and certain plant oils).

Of course, this is not to say that I discount all the other well-known
contributors to acne: genetics, skin bacteria, pore cleansing, hormones,
etc, etc, etc.    Just that I think I've noticed one more factor.

                                       Steve Harris, M.D.

From: ((Steven B. Harris))
Subject: Re: Other antibiotics used for acne?
Date: 26 May 1995

In <> (Heather
Freeman) writes:

>Is anyone familar with any other antibiotics taken orally
>in the treatment of acne besides tetracycline? Also, is
>it true that other antiobiotics will probably cause the
>same side effects (I'm speaking specifically of yeast
>infections here!) as tetracycline? Does decreasing the dose
>seem to help prevent the onset of these infections? Thank

Practially all common oral antibiotics employed for skin infections help
acne, and all these increase yeast problems.  But you don't want to
switch off from one oral antibiotic to another, or you'll breed multiply
resistant bugs in your gut.  People switch off topical antibiotics on
the face more commonly, but I'm not even sure that is very safe.  It is
true there are fewer bacteria there, so your chances of growing the
really nasty one are lessened.  But you're still playing with fire.
Better to think about Accutane, or stick with one facial antibiotic,
plus Retin A and/or hydroxyacids.

                                                 Steve Harris, M.D.

From: B. Harris)
Subject: Re: Is Hepatitits C contagious?
Date: 13 Apr 1997

In <5iob69$> (Chase Emma Lee
A) writes:

>I've heard conflicting reports as to whether it is sexually transmitted or
>not. My ex-husband contracted it from packed cells, and i still test
>negative after 6 years of sexual activity. We were pregnant twice too.

   It can be transmitted sexually, but it's difficult to do it.  As
you've discovered <g>.

>Is there vertical transmission?


>Also, while I've gotcha on here, do you know anything about DHEA-S and
>adult female acne. I've tried everything except Accutane. Right now i use
>Minocin, the Pill, and Retin-A, and still can't get my skin cleared up.
>It is moderate (although i am getting scarred after 12 years of acne),
>yet not severe enough to get me accutane. Any ideas??? It's making me
>depressed and i have missed out on employment, i believe, b/c of it's
>nasty appearance.

   DHEA is a mild androgen for women, so my guess is that it would make
acne worse.  However, I don't know of any actual reports.  Women with
polycystic ovarian syndrome, who make too much DHEA, have acne
problems, however.

   Do watch the combination of minocin and female hormones, as both are
risk factors for pseudotumor cerebri, a temporary nasty increase in CSF
pressure which causes splitting headaches in what are usually females
being treated for acne.  It's medication and hormone caused, and mimics
a brain tumor.  It won't get you operated on, but it can run up a lot
of money in lab bills, no to mention a lot of pain (it goes away slowly
with discontinuing treatment).  Acutane and vitamin A (but not Retin A,
which isn't that well absorbed) are also risk factors.  So watch that
your vitamins have their vitamin A in the form of beta carotene only
(not retinyl palmitate).

   As for your skin, my best advice is to bite the bullet and get
started on Acutane.  People who do are almost universally sorry they
didn't sooner.  But stop the minocin a few weeks before.  If you must,
use another non-tetracycline antibiotic (NOT doxycycline/Vibramycin).
At least three of these are also available topically.  Metrogel
(metronidazole) works well for many people.

                                            Steve Harris, M.D.

From: B. Harris)
Subject: Re: Blackheads:Problem with skin (Not Acne)
Date: 21 Jul 1997

In <> writes:

>On Sun, 20 Jul 1997 03:21:16 -0700, Uri Margalit <>
>>Hi there.
>>I am not sure if these are the groups to post a question like this, but
>>i am going to try. I have been suffering from a terrible condition (well
>>to me its terrible), since i was 13 (i am 27 now). I have very oily
>>skin, and it is not really drying up as i age. My mother is 51 and she
>>still gets pimples. My problem though is not pimples , i dont mind them
>>at all. Its my damm Blackheads. I get them only on my nose. They cause
>>my nose to swell up and nothing i do will get rid of them. All my pores
>>on my nose are clogged. I have used skin washes (all of the ones on the
>>market). Tried washing lots, little, harshly, gently (so as not to strip
>>natural oils). I have used masks and scrubs. Deep cleansers and
>>overnight declogers ( i think most have salacylic acid). I have even
>>tried leaving my nose alone for months. Nothing works. It virtually
>>stays the same. The only thing that offers tempory relief is squeezing
>>the blackheads out. Then for a week or so my nose looks great and
>>shrinks. But they come back and the cycle starts again. People have told
>>me to not sqeeze as it damages the pores etc . I tried this too, no joy,
>>my pores stay clogged. It has really damaged my social life and i am not
>>sure at all what to now. I am at my wits end and ask if anybody knows a
>>soloution to please tell me! I will be grateful forever.
>>Thank You.
>It sounds as though your best bet is to try something called Retin-A,
>which is available by prescription, and is applied to the affected
>area.  It normalises the abnormal keratinisation process occurring to
>give you these blackheads.  Give it some weeks to work though, it is a
>very well used all-round acne therapy as well.  Alternatively, you
>could try using benzoyl peroxide which works extremely well for most,
>and is applied directly to the affected area.  This is available over
>the counter in a number of forms, ranging in its percentage as 2.5%,
>5% and 10%.  Here in England the best product available to my
>knowledge over the counter is called 'Oxy 10', ask your pharmacist for
>what is available to you and what he/she recommends.  Failing these
>you could try benzamycin, another acne therapy applied to the skin
>directly, which contains both benzoyl peroxide and erythromycin (an
>antibiotic), this is only available by prescription.  You would be
>very ill-advised to squeeze the blackheads as this will only result in
>long-term worsening and possibly scarring.
>Best of luck.

   Comment: this is good advice, except that I think that the last
piece of it (which is standard medical advice) is conditional.
Squeezing a blackhead, or for that matter a pustule, is much like
draining an abscess or a boil, but on a smaller scale.  If you can do
the deed without rupturing the thing under the skin, you do solve the
problem until the gland plugs up again.  If you have a professional
"facial" you'll find that squeezing blackheads is exactly what they do,
but before they start, they use hotpacks and gentle abrasion to make
sure that the things come out easily.

                                         Steve Harris, M.D.

Index Home About Blog