GRAEDONS | The People's Pharmacy Low-carb diet might curb daughter's acne problem

Q. My 14-year-old daughter has had moderate acne for nearly two years. There are always five to 10 small pimples on her forehead, and now she has 10 to 20 pimples on her cheeks as well.
Clearasil left bleach stains on her clothes. Antibiotics the doctor prescribed didn't help, and even seemed to make matters worse. The doctor suggested birth control pills, but that seems ridiculous, and it's not an option we'd entertain.
Are there any topical or natural remedies that might work? What about diet?
A. Any link between acne and diet is controversial. Teens once were told to avoid chocolate and high-fat foods. That turned out to be unhelpful.
Research published in the Archives of Dermatology (December 2002) suggests, however, that diet might make a difference. Populations on low-carb diets that don't make blood sugar rise quickly might be less prone to blemishes. Your daughter might try avoiding foods like candy, cookies, French fries, potato chips, sugar and white flour to see if it helps her complexion.
Ask your pharmacist about a topical treatment that contains a B vitamin. Nicomide T Gel worked about as well as the topical antibiotic clindamycin in one controlled study.
Q. Can you take Sarafem with Strattera?
A. Sarafem (fluoxetine) is another name for the compound in Prozac. It is prescribed for premenstrual problems rather than depression.
Strattera (atomoxetine) is a relatively new drug for the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adults.
If you need both drugs, your doctor will probably have to reduce the dose of Strattera significantly. The body uses the same enzyme (CYP 2D6) to process both of them. Sarafem could boost blood levels of Strattera and trigger side effects such as temper tantrums, irritability, nausea or sedation (Medical Letter, Aug. 16, 2004).
Q. Getting a good night's sleep is difficult for me. The pain of arthritis and fibromyalgia keeps me awake most nights.
My doctor prescribed Ambien, which works well, but he doesn't want me taking it indefinitely. Over-the-counter sleep aids are worthless. Any information you can send me on sleeping problems associated with fibromyalgia would be appreciated.
A. Ambien is an effective sleep aid, but it might not provide the restorative sleep essential for combating fibromyalgia. This condition is characterized by fatigue, tenderness and pain, especially in the back, shoulders and neck.
You may want to ask your doctor about a controversial new drug called Xyrem. This medication has been approved for narcolepsy. Although the Food and Drug Administration has not cleared it for fibromyalgia, sleep expert Martin Scharf, Ph.D., has found that Xyrem is helpful for this condition (Journal of Rheumatology, May 2003).
We are sending you our Guide to Getting a Good Night's Sleep and our hour-long CD radio interview with Dr. Scharf about fibromyalgia and sleep so you can learn more about this unusual approach. Anyone who would like copies, please send $15 in check or money order to: Graedons' People's Pharmacy, No. CD-70, P.O. Box 52027, Durham, N.C. 27717-2027.
Q. Is Splenda safe, or does it have side effects? I really cannot take Equal. My body hates it.
A. Splenda (sucralose) is a noncaloric sweetener made from sugar. Research we have seen suggests it is safe.
XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, N.Y. 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org. Their latest book is "The People's Pharmacy Guide to Home and Herbal Remedies" (St. Martin's Press).
& copy; 2004 King Features Syndicate, Inc.