QUESTION: I am a female, 30, with very oily pores and blackheads and whiteheads. I have the habit of squeezing them to keep them under control. What about Accutane? Could you please comment on this drug, how it works, dosage, etc.? - S.N.
ANSWER: Accutane is for stubborn and severe acne, the cystic kind. Its main action is deactivation of the skin's oil glands, the scene of cystic acne formation. Just how it does this is not clear.Blackheads and whiteheads are only degrees of the oil-gland problem. A whitehead is a follicle whose pore opening is still closed. When it opens, reaction to air turns the sebum (oil) black. This is the only difference between whiteheads and blackheads.
Most people can subdue their acne by preventing oil accumulation with non-prescription lotions and creams, those with benzoyl peroxide being favored. Sensible skin hygiene is important. Avoid cosmetics that promote oily skin and keep skin clean without scrubbing. And please, stop squeezing. That forces follicle oil into neighboring cells to form a pocket for a potential cyst.
If things don't improve, your doctor may decide you need a prescription medicine. As to Accutane, the usual therapy is daily use for a few months. Often, a single course works, and if it doesn't, the doctor may decide on a second one. The important warning about Accutane has to do with pregnancy. You must have ample proof that you are not now pregnant or likely to become so during or immediately after treatment. From your description, I doubt that your acne is of the severity where Accutane is required.
Acne occurring at such a relatively late age raises the specter of hormone imbalance. Male hormones promote inordinate oil-gland activity, and elevated male hormone levels can reflect waning production of female hormones. This idea should be investigated. I am sending on the acne report. Other readers may order by writing: Dr. Donohue/No.39, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, stamped (52 cents), self-addressed envelope and $2.
QUESTION: My wife sleepwalks on a fairly regular basis. She gets up in the middle of the night and does and says some pretty unusual things, including turning on lights, talking to people and searching for things. Also, I've noticed that her son by a previous marriage does the same thing sometimes. Is it inherited? Is this a problem we should be concerned about? - D.V.
ANSWER: Surveys tell us that up to 6 percent of people sleepwalk, at least at sometime in their lives. In the usual sleepwalking episode, the person is up for about 10 minutes and cannot remember a thing about it the next morning.
There are familial ties, with about 80 percent of sleepwalkers having relatives with the same problem. Children usually outgrow it. Adults in whom it persists should be examined, for often there are psychological, even physical problems in the background. Meanwhile, you have to provide for the obvious safety precautions.
QUESTION: I suffer occasional bouts of neuritis. I understand that alcohol is involved. But I don't drink. Years ago a doctor told me that my system manufactured alcohol. Please explain - M.M.
ANSWER: It's true that alcohol ingestion can cause neuritis. Maybe that doctor was referring to diabetic neuropathy. With that kind, a body-made alcohol, sorbitol, can lead to nerve swelling and pain. You don't mention diabetes as part of your problem. Has that been checked out recently?