Q. I have been using Retin-A for four months. My somewhat oily skin has become more and more oily, especially on my nose. I feel I have made very little progress. The red bumps have minimized only somewhat. Is there something else I can try? I have small raised red bumps (no pus), and only a very occasional cystic type. This is not youthful acne; it is middle-aged acne.

A. I need a little bit more information to be able to give a full response. Middle-aged acne can be related to the classic youthful acne you describe. However, there are a few other things that it can be, too. One, called perioral dermatitis, responds quite well to an antibiotic called tetracycline. Another problem, rosacea, requires a much different kind of management.

I suggest you go back to the doctor who prescribed the Retin-A and show him or her the progress that has been made. With this new information, more may be known about your particular diagnosis and how to best manage your case.

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