Dousing occasional flare-ups

When she was in eighth grade, Margot’s parents had taken her to see a dermatologist
who prescribed a cream and a gel. This approach worked very well for several years
and kept her acne under good control. However, during midterms in her sophomore
year of college, she began getting red bumps all over her face. She started to wear a
coverup makeup, which she hated to use. “It looked so artificial,” she said. “I stopped
going out on dates; I was so embarrassed about the way I looked.” Moreover, her pim-
ples would flare up “like clockwork” right before her periods.
When I first saw her in my office, I recommended that oral antibiotics (acne med-
cations that are taken by mouth) might help to clear up her skin. She said that she
was somewhat reluctant to start taking them because she was concerned about
he possible dangers, but nonetheless agreed to start taking them.
On a subsequent appointment, she was very pleased with how much progress she’d
made. Her face was looking better and her red pimples were now flat, so she could
more easily cover them with makeup. I then suggested that she gradually taper off
he oral antibiotic by lowering her dosage and suggested that hopefully she could
“wean” herself off of the oral therapy and see if the cream and gel alone would do
he job. If not, I told her that we could try the oral method again, if necessary.
The system worked very well. Except for breakouts before her period, Margot’s acne
was not much of a problem. On several occasions during her junior and senior years,
she required the oral antibiotics and they continued to have success in quelling her
bad flare-ups.