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I have a few bumps that started out as pimples and then turned into red bumps that are really hard. I have had them for months and they won't go away. They look like they have a hard skin around them.

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replied December 30th, 2009
Acne and Skin Disorders Answer A8775
Hi, welcome to the ehealth forum and I am glad to help you.

You seem to be concerned about the acne vulgaris which is usually a self limiting disorder primarily of teenagers and young adults but in 10 to 20% of cases, it may persist into late adulthood.

The typical lesions are comedones or pimples which are small cysts formed in hair follicles due to blockage of the follicular orifice by retention of sebum and keratinous materials.

Certain patients may have hard nodular lesions which may result in scarring on scratching and trauma.

Mild disease may respond to topical therapy with retinoic acid, benzoyl peroxide or salicylic acid. Topical antibacterial agents such as azelaic acid, erythromycin or clindamycin are useful in decreasing inflammation. Severe acne with a prominent inflammatory component may require systemic therapy with tetracycline or erythromycin. Hormonal therapy(with oral contraceptives containing ethinyl estradiol and norgestimate) is also useful in females who do not respond to oral antibiotics. If nodulocystic acne does not respond to above therapies, isotretinoin may be useful though side effects like teratogenicity, depression, dry skin, cheilitis and hypertriglyceridemia should be kept in mind and toxicity monitored. In females who present hirsutism and menstrual irregularities, PCOS should be ruled out as the cause of acne.

You can discuss all the treatment options with your dermatologist who will suggest the best treatment for you as same cannot be done online and no treatment suggested above should be taken without consultation with your dermatologist.
I sincerely hope that helps. Take care.

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