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How to treat a difficult case of pimples?

Q: I am 30 years old. My skin was always oily and I used to get some pimples when I was in my teens. I had a good skin in my early 20s and till 28 yrs of age. But now my skin has become oilier and I get pimples on my chin, cheeks and around eyebrows. My problem is whiteheads instead of blackheads and when I try to extract them with a blackhead remover, they just dont get out and then they become pimples the very next morning. These pimples leave ugly black marks on my fair skin which are very visible but I am lucky that I don't get pits. I had a sudden breakout in the 1st week of May 2002. I still get them but things are very much in control. Now I get 2-3 pimples at a time. I took Zincovit tab and Dexorange cap. I still take them. For local application I applied Pernox 5% gel. Earlier too I had a sudden breakout in May 2001, just a year ago but I contolled them by Nov 2001 by applying Retino-A and Eslite in 1:1 proportion and I got rid of the marks but for some months only and again had these pimples in May 2002 and I am still fighting with them. I wash my face twice a day with lifebouy soap and use a homemade astringent with alum in it. I want to know what causes these pimples/could it be because of summer weather or hormonal imbalance or acidity? What role does acidity play in having pimples? Can taking blood purifiers like neem tablets help? Can you suggest me some natural therapy to prevent breakouts? I'm not fond of oily or sweet food but my eating habits are irregular and I eat less than normal. Can irregular eating habits and lack of essential nutrients in food cause harmonal imbalance and pimples?Can having 2 nimbu or a teaspoon vinegar in a glass of water a day help? How effective is soyabean? What is the daily requirement of zinc and what foods have it the most? Now-a-days, I use Benzac-AC at night. Once I get rid of pimples, I will switch to Retino-A with Eslite, but my pimples don't seem to go. Also, please tell if Eeslite and Melalite are greasy?

A:Pimples normally resolve spontaneously by mid twenties. Very small number of individuals can however have significant acne even at the age of 40 years. Recently, mature acne, i.e. acne starting after age of 25 has been documented. Majority of the patients do very well on conventional therapy. Difficult cases may require higher doses of medicines and maybe even therapy with hormones and/or oral retinoids. In some women, endocrinological disorders may have to be sought and corrected. Some studies indicate that saturated fats adversely affect acne. However, majority feel that diet has no role in acne. Self treatment is not advocated.

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