Azelex and other questions

Hi Dr. R,

There are 3 questions woven in - I have numbered them.

1. What do you think of Azelex? I had to go off of the pill (orthotricyclen) and spironolactdone (sp?) recently because I had hip surgery recently. In addition, I want to become pregnant as soon as it is safe post hip surgery - so I probably won't go back on them. So, my derma recommended I try Azelex.

2. Currently, my skin has been just fine (yahoo!) since stopping the meds (stopped ortho 2 months ago, stopped spironolactone 7 weeks ago). Although I have continued with Retin A and metrogel (Rosacea) and benzaclin (benz I use as needed for spot treatment of pimples). Should I start Azelex proactively, or wait for a flare up? Do people often have irritation or flareups up the start with this med?

3. A question about spot treatment. When you sense one of those underground pimples coming (can see a bump coming) what is the best thing to do? (Usually in the divet in my chin). I put benzaclin on it with a coverup that has salicytic acid. I do this a few times a day and it often goes away without coming up. Is that the best approach? Am I dreaming or could that work? Any other ideas? Would a little ice help? I have one of these now - shall I try Azelex on it? Thank you!!!

[Alan Rockoff, MD]

1.  Good idea.  It's safe, helpful, and can be used during pregnancy.
2. Since there is no downside, I'd start it now.  But Retin-A and Metrogel shouldn't be used if pregnancy is possible.
3. Whatever you do, don't squeeze 'em.  Hot compresses may help.  Salicylic acid is not a bad idea, and Azelex would be OK too.

Best.

Dr. Rockoff

[KMD98]

My 6 year old daughter has light brown patches on her upper lip. I took her to the dr today, and she recommended Azelex, which is for acne-related problems. The spots are due to her skin pigmentation which is slightly dark. I am Hispanic. Has anyone experienced this problem? It is not melasma.