Skinrepublic

Dear Dr. Jen,

I break out on my face once in a while.  But this time, on the right side of my forehead, my pimples are accompanied by some pain and numbness.  The past few days, I get a headache where the pimples are.  What kind of acne gives this kind of symptoms?  Is there a deeper infection I should be worried about?

Lory

Dear Lory,

Pimple-like lesions that appear on one side of the forehead, accompanied by some pain, numbness, tingling sensation, or heat, may not be acne but a viral infection.  Shingles or zoster can present with fluid-filled vesicles, and some look like pimples.  They never cross the midline and only remain on one side of the face.

If the forehead area is affected, check if the tip of the nose also has any similar spots.  Is your vision bothered?  Sometimes, zoster on this part of the face can also affect the nerves of the eyes.

 The best treatment for shingles is anti-viral meds, acyclovir or valacyclovir.  But if 3 to 4 days have passed or the lesions are no longer new, then anti-viral meds will not be effective anymore.  Supportive treatment with a good pain-reliever, anti-histamines, warm saline compress, and antibiotic ointment are most helpful.  Don't pick on the scabs or the vesicles because it may cause scarring. Taking supplements for the nerves (like vitamin B complex) is recommended.

Dear Dr.  Jen,

Is there something that can be done for old surgical scars?  I have scars from a cyst that was removed from my thigh.  It looks rough and unevenly toned.

Ella

Dear Ella,

What kind of scars do you have?  Hypertrophic or keloid scars are elevated and bumpy.  It can be painful at times.  Best treatment is with injectable steroids.  Dark scars can be whitened with the usual round of bleaching agents (arbutin, vitamin C, tretinoin, kojic, etc).  Dark scars may take time to get back to their original skin color. The last type of scar is the uneven or atrophic scars.  These can be rough or may have an indentation in the middle.  Fractional laser can do wonders for the uneven scars.  It will help remodel collagen and make the skin more even after a few sessions.

If you are feeling more adventurous, some reconstructive surgeons also perform scar revision.  Whatever kind of scar you have, make sure you are having the procedures performed by a PDS dermatologist.  Older scars technically take a longer time to treat.  Have patience and be diligent with the treatment regimen advised. 

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan. (FREEMAN)