Dermatologist disputes Milk of M acne remedy

Q. As a dermatologist, I am dismayed by your article suggesting that milk of magnesia could treat cystic nodular acne. This is not a recommended treatment, and the false belief that it might be helpful could cause great harm by delaying proper treatment.

Accutane will cure all acne when used properly for eight to 10 months. Keeping the dose low can prevent side effects.

I am willing to bet that the person who said milk of magnesia worked better than prescribed treatment was making this up or did not see a dermatologist for appropriate care.

A. The mother who contacted us said that her son had been under a dermatologist’s care for many years, and the thousands of dollars they had spent had not cleared his condition. She was pleased that milk of magnesia applied to his face at bedtime had been helpful.

This home remedy has not been tested for acne and might not help other people. Nevertheless, it is inexpensive and accessible.

Accutane has been a revolutionary treatment for cystic acne. It is, however, quite expensive (a five-month supply could cost more than $5,000) and highly controversial.

Some side effects listed in the prescribing information include depression, suicidal thoughts, aggressive behavior, inflammation of the pancreas, hearing loss, inflammatory bowel disease, high triglycerides, hair loss, dry lips and itching.

Physicians are specifically warned not to prescribe Accutane for more than five months at any one time: “Long-term use of Accutane, even in low doses, has not been studied, and is not recommended.”

Q. I am 43 years old and have had high blood pressure for 15 years. I have taken atenolol to control it until recently, when my doctor changed me to a water pill, hydrochlorothiazide.

I had a fasting blood sugar test and it was high (150) for the first time ever. Could my new blood pressure pill be causing diabetes?

A. Diuretics like HCTZ (hydrochlorothiazide) can raise blood sugar and trigger diabetes in susceptible people. Such drugs may also raise uric-acid levels and bring on a gout attack.

Atenolol is a controversial first-line treatment for high blood pressure because of questions about effectiveness. There are, however, many other options to control blood pressure.

We are sending you our Guide to Blood Pressure Treatment so you can discuss both drug and nondrug approaches with your physician. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (58 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q. I have a cure for stinky feet. Wash them, dry them well and apply Mitchum unscented solid antiperspirant to the toes and the area between them. I applied it every day for about a month, then every other day, then once every few weeks. I now apply it just once a month, and it works very well. I use a separate applicator for my feet instead of the same one I use under my arms.

A. Reducing perspiration on the feet is a good way to discourage bacterial growth. This contributes to foot odor. Other strategies include foot soaks with Epsom salts, baking soda or diluted vinegar.