Q: I am a 24 years old female and my both kidneys failed seven years back. After that I was on dialysis for one and half years after that my mother decided to donate me a kidney, which was successful. I am taking Imusporin, Omnacortil, Dilzem sr 90 and Amlogard 5. But there are still some problems. I am not gaining weight and my face is full of pimples. Lot of pus comes from pimples. Can I get married?

A:Patients with a kidney transplant are usually maintained on immunosuppressive drugs such as corticosteroids (Prednisone), azathioprine, cyclosporine and sirolimus which have been associated with development of acne (pimples).

General skin care recommendations for a kidney transplant patient with acne include:

• Wash acned area(s) by applying a gentle synthetic detergent cleanser (e.g. Cetaphil) and rinse with warm (not hot) water twice daily. Synthetic detergent cleansers possess a lower pH (5.5 to 7) that approximates the normal pH of the skin, than soaps (9 to 10). So, using gentle cleansers minimises skin irritation and dryness.
• Gentle massage with the fingertips is sufficient for cleansing. Do not aggressively scrub the skin.
• Use water-based (not oil-based) lotions, cosmetics, and hair products as they are less prone to cause acne.
• Do not pick the acne lesions, as this may exacerbate scarring.
• Do not use Retin-A or Retino-A (tretinoin cream) as it aggravates the sun sensitivity caused by prednisone.

Patients with advanced lesions may need treatment with topical antimicrobial gels (benzoyl peroxide), topical anti-bacterial gel (clindamycin, erythromycin), oral antibiotics (tetracycline, doxycycline, erythromycin, minocycline) and/or hormonal agents (oral contraceptives). A dermatologist should be consulted prior to using these agents.