Skinrepublic

Dear Dr. Jen,

I am getting very bad acne on my back! My problem is I am getting married in December and would like to wear a gown that is revealing in the back. Is there still hope for my skin to recover in time for the big day? 

Bridezilla

Dear Bridezilla,

Congratulations on your engagement! I am glad that you are finding solutions to your "bacne" this early. It is very suspense-filled and sometimes futile when patients come to me 2 weeks before their wedding expecting me to work miracles! Four months is perfect to give us enough time to control the acne and deal with the acne scars in time for your wedding.

The back acne is not just your regular pimples. Most of the time it comes with a condition called pityrosporum folliculitis. Pityrosporumfollicultitis includes some fungal component within the "pimple" which grows directly on the hair follicle. There is some itching and may even contain pus.

The fungus resides on everyone's skin but when the environment becomes too hot and the area is often sweaty and occluded, there is uncontrolled growth of the yeast. Aside from the usual anti-acne regimens, you will likely need anti-fungal treatment too. Depending on the distribution and extent of involvement, your PDS dermatologist can prescribe you with anti-fungal in either shampoo, lotion or oral forms. 

It is better to show your skin to your PDS dermatologist to identify if some pityrosporum infection is actually present in your "bacne". Your derma will probably use a Wood's lamp, get some smears or even just look at the typical presentation of the lesion and the proper diagnosis will be easily given. 

After the "bacne" problem is adequately controlled (taking about 1-2 months depending on your response), next on your list will be to treat the dark acne spots. Lightening the area with laser, repeated chemical peels or take home bleaching creams will be your options. If you start treatment now, your back will be ready in December for that gorgeous backless dress that you have in mind. 

Dear Dr. Jen,

I am ashamed to say that I have very smelly feet. Sometimes I've noticed that there are scaly spots in between my toes too. I have tried deodorizing foot powders but they have not helped. What can I do to permanently get rid of this problem?

Julio

Dear Julio,

Our feet naturally sweat. When sweaty feet are encased in closed footwear for long periods of time, it sometimes gives off an unpleasant odor. Furthermore, it promotes the proliferation of fungus. The area between the toes are especially susceptible because of the difficulty of the area to be dried and aired out.

Athlete's foot or tineapedis gives off a typical funky odor. This is one of the tell-tale signs that fungus is indeed present.This can be easily treated with anti-fungal creams such as terbinafine, ketoconazole, clotrimazole and the likes. Your PDS dermatologist will have to take a look at it first to ensure that no concomitant bacterial infection is present. Also, it is important to disinfect your footwear so you don't get a repeat of the tineapedis again.

It takes 2-4 weeks of committed application of the anti-fungal cream for the problem to completely disappear. Good luck and hope this finds you with better smelling feet soon!