recurring "pimples"

[Ron526]

For the last few months, I've had recurring small "pimples" that never seem to really "come to a head" like a pimple. I went to a Dermatologist and he did nothing but give me topical antibiotic cream to put on it. I've taken Augmentin 875mg for 10 days, which may have decreased their frequency, but within a couple weeks they were back. I only seem to get a few (2-4) at a time and usually when I'm tired or my immune system is a little run down. I'll go a couple weeks with none of them and think they're gone, but then I'll get a couple. I get them most frequently on my torso (belly and chest). When I went to a sun-tanning bed before a vacation, it seemed to "dry them up". I also took a Z-pak with little results. I was on a Caribbean island and in a hot tub there early this year and thought maybe I had some type of folliculitis...but it doesn't seem to be around any hair follicles or on my head. When I squeeze them, they get red and irritated and give off a kind of translucent bloody liquid. After a couple squeezes, the fluid is totally clear. I've tried everything to get rid of these things. I've put Permethrin cream on them, which seems to reduce the redness and kind of dry them up.
I thought maybe there was some Staph or Strep skin infection chronically in my skin from the hot tub. They don't seem contagious. because if I "pop" one of them and the fluid gets on surrounding skin, another one never pops up. Maybe it's a chronic viral condition. Please don't just tell me to go to a dermatologist. I'm looking for a differential diagnosis...what could all of the possibilities be? I want to educate myself so if I go back to a different Dermatologist, I can ask intelligent questions and get the treatment it takes to resolve this issue. All of my other vital signs are normal: no fever, no other symptoms. In fact I just had a complete and pretty comprehensive physical with blood and urine tests and nothing showed up. Any ideas? Thanks

[loiloi]

Don't squeeze your spots as this will spread the infection and could cause permanent scarring. Most acne treatments, including anti-biotics take at least three months to clear your skin. Best results will be seen if you combine anti-biotics with topical treatments.

[Alan Rockoff, MD]

I think you probably have acne that you are aggravating and perpetuating by squeezing and popping.  You are not helping yourself in any way by doing that.  I don't know why you think that a course of antibiotics will take care of acne just like that, in a few days.  It actually takes weeks or months and even then only if you leave the spots alone.  That's what you need to do, and follow your dermatologist's advice.

Best.

Dr. Rockoff