Still struggling with acne in college? We’re here to help!

Did you come to college hoping to leave the battle with acne behind you in high school? I know I did. Fortunately, there are many treatment options for mild acne available at the Student Health Services Pharmacy that do not require a prescription. If you are experiencing more severe breakouts (>10 pimples at once) you should make an appointment with your doctor or dermatologist before treating yourself.

General Skincare Advice:

Make sure you wash your face twice a day with a gentle cleanser, such as Cetaphil. It is also important to take off any makeup before going to bed. Try and avoid touching, picking, or squeezing any pimples as it may cause permanent scarring. There are some studies that suggest dairy and diets high in sugar may cause acne, but no specific dietary changes are currently recommended for acne control.

Over-The-Counter (OTC) Options for Acne:

Benzoyl Peroxide (BP)

How does it work? BP kills bacteria that typically causes acne and helps unclog pores.

What’s out there? BP comes in washes, foams, creams, and gels in a variety of strengths.

What side effects does it cause? You may experience redness and peeling while using BP.

What else should I know before trying it? BP can bleach fabrics or hair, so wash your hands after use and avoid contact with with clothing and furniture. You will also want to make sure that you put on sunscreen while using it because it may make you more sensitive to the sun. BP can be used alone or in combination with a topical retinoid.

Topical Retinoids

How do they work? Retinoids help to keep your pores unclogged.

What’s out there? Several options exist, but only adapalene (Differin) 0.1% gel is currently available without a prescription.

What side effects does it cause? Retinoids can cause dryness, peeling, redness, and irritation. If you experience any of these side effects, cutting back use to once every other day may help.

What else should I know before trying it? You may see an initial increase in acne and redness, but these side effects should get better after a few weeks. Make sure to wear sunscreen while using because retinoids can cause sun sensitivity. Adapalene gel and other retinoids can be used alone or in combination with benzoyl peroxide.

Salicylic Acid (SA)

How does it work? SA helps to remove top layers of skin and unclog pores.

What’s out there? SA comes in washes, cleansers, creams, gels, and lotions in a variety of strengths.

What side effects does it cause? Salicylic acid may cause dryness or peeling.

What else should I know before trying it? Increased contact time on the face may help with how well salicylic acid works (meaning that cleansers and washes may not be as effective as other formulations).

Alpha Hydroxy Acids (AHAs)

How do they work? AHAs work as exfoliating agents for the skin.

What’s out there? Citric, glycolic, and lactic acids are the most commonly seen AHAs.

What side effects does it cause? AHAs may cause irritation or skin sloughing.

What else should I know before trying it? AHAs are also included in many anti-aging skin care regimens.

Topical Sulfur

How does it work? It is still unknown how sulfur helps with treatment of acne.

What’s out there? Several creams and lotions are available. Sulfur is sometimes found in combination with salicylic acid or resorcinol.

What side effects does it cause? Sulfur has the potential to cause some skin scaling, especially on darker skin tones.

What else should I know before trying it? Sulfur products may be more useful for short-term spot treatment. Some older sulfur products have a strong odor that can be bothersome.

Complementary Alternative Medicine (CAM): tea tree oil

How does it work? Tea tree oil kills bacteria that typically causes acne and helps with inflammation.

What’s out there? Tea tree oil comes in creams, gels, sprays, and patches.

What side effects does it cause? A small percentage of people may develop a rash when using tea tree oil.

What else should I know before trying it? Tea tree oil has been shown to work as well as benzoyl peroxide in some studies, but it may take up to 12 weeks to see the full effects. Only use tea tree oil topically because it can be toxic if ingested.

This is just a short list of what skincare options are out there for the treatment of acne. Many products are prescription only, such as oral and topical antibiotics, hormone therapy, azelaic acid, and isotretinoin (Accutane). If your acne is severe enough you may need to see a doctor for one of these medications.

Don’t forget that your doctors and pharmacists at the Student Health Center are here to help if you have any questions or want a recommendation!

Allison Carr, PharmD Candidate 2019


  1. Adapalene (topical), alpha hydroxy acids, benzoyl peroxide, salicylic acid, sulfur (topical), and tea tree oil. Lexi-Drugs. Lexicomp. Wolters Kluwer. Hudson, OH. Available at Accessed June 5, 2018.
  2. Zaenglein MD, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol . 2016;74(5):945-973. doi: 10.1016/j.jaad.2015.12.037.


Medical Mythbusters – Poison Ivy!

poison ivy

rashes caused by poison ivy

Now that we are in the dog days of summer, an old friend is rearing it’s ugly, leafy head.  Yes, it’s poison ivy season, my friends, and while most of us think we know all there is to know about this itch-inducing plant, there are some medical myths lurking around it that need to be busted!

First, the facts:  Poison ivy, poison oak, and poison sumac plants are all coated with a colorless oil called urushiol.  Urushiol is a very sticky, colorless substance present in the leaves, stems, fruit, and roots of the plant. After contact with urushiol, about half of us will develop intense itching, swelling, and skin redness. Then, we will develop fluid-filled blisters that are often arranged in a line or streak.  (See photos)  The symptoms are usually most severe within 1 to 14 days after exposure to the plant, but can occur up to 21 days after exposure if someone had never been exposed to urushiol before.

Technically speaking, poison ivy usually resolves within 1-3 weeks without treatment, but without something to control the itching they will be the longest 3 weeks of your life.  Cool wet compresses can be placed on the affected areas for 15 to 30 minutes at a time.  A group of medications called antihistamines are very good at reducing the itching: diphenydramine (Benadryl) is good for night time because it makes you sleepy and loratadine (Claritin) and cetirizine (Zyrtec) are good for daytime because they don’t.  Oatmeal baths, calamine lotion and hydrocortisone cream are also sometimes helpful, but the best way to knock out the rash and itching is to see your primary health care provider to get a prescription steroid treatment.  Sometimes you can get by with just a shot, but that often does’t last long enough (1-2 days) so you can take a course of pills over a couple of weeks.

Now, on to the myth…

TRUE OR FALSE: Poison Ivy is contagious


Poison ivy is not contagious and can not be passed from person to person.  Only contact with urushiol will cause someone else to get poison ivy – the fluid that leaks from blisters does not contain the oil and can not cause symptoms.  Once you’ve washed the urushiol off of your skin (and clothes and fingernails and gardening tools and pets…) you can not spread poison ivy to someone else or yourself.  The rash sometimes appears to be “spreading” from one part of the body to another, but this is because blisters develop at different rates in different parts of the body – any real spreading that went on happened before you realized you had the urushiol on your skin.  This explains why poison ivy has such an unfortunate predilection for our privates.  Please believe me – if you’ve been weeding in the yard, or camping in the woods, make sure you wash your hands before you go to the bathroom as well as after…

John Vaughn, MD – Student Life Student Health Services

Updated by Maribeth Mulholland, MD – Student Life Student Health Services

Free skin cancer screenings Oct. 6 at Martha Morehouse Medical Plaza

The OSUCCC-James is offering free skin cancer screenings on Monday (10/6) from 1-4:30 p.m. at Martha Morehouse Medical Plaza, Tower Building, Fourth Floor Clinic. Call The James Line at 293-5066 or (800) 293-5066 to schedule an appointment if you have any of the following conditions: moles that are changing in color, size, or shape; new growths on your skin; skin lesions that are painful, itchy, or bleeding; or sores on your skin that won’t heal.

Melanoma – Some Advice from Family Nurse Practioner Students

Protect your skin from the sun

ABCD pattern:  A - Asymmetrical

ABCD pattern:  B - Irregular Borders

ABCD pattern:  C - multi-colored

ABCD pattern:  D - diameter

Ohio State Family Nurse Practitioner Students Promote Melanoma Awareness:

According to the CDC, skin cancer is the most common form of cancer in the United States. If diagnosed and treated early, skin cancer is very curable. Unfortunately, if skin cancer is not diagnosed until later stages, it can result in disfigurement and even death. Each year over 60,000 Americans are diagnosed with melanomas of the skin.  Please be aware of the amount of sun exposure you receive this year. You can help prevent skin cancer and still have fun in the sun outdoors by protecting your skin. Protection includes seeking shade, applying sunscreen, and wearing protecting clothing, hat and sunglasses. Remember the amount of sun exposure you get in your youth directly impacts your risk for skin cancer later in life.

The Skin Cancer Foundation recommends that you perform a full body skin exam on yourself once a month and that you have one done by your doctor/dermatologist once a year. Schedule an appointment with your doctor/dermatologist if you notice any mole or skin changes following the ABCD pattern of melanoma.

For additional information, please visit

Submitted by Ohio State Family Nurse Practitioner Students:  Jennifer Ashton, Shannon Brown, Christopher Daughtery, and Amanda Warner

Help us spread the word, like our Facebook page:

Reviewed by Tina Comston, M.Ed.

Photo Credit:

Spring Break – Feeling the Burn


And more sunscreen!!


If you are fortunate, you will be leaving Ohio soon to travel to a warmer (and sunnier) destination down south. After spending months hibernating in your room from the dreary winter weather, sunscreen is the last thing on your mind. Without fail, you head out to the beach or pool the instant you arrive and are lucky if you remember to grab your towel. Upon returning to your room hours later, you notice a distinct reddening of your skin and feel the heat radiating from the area. Because it’s the first day of your trip, you panic and wonder what can be done to minimize the pain and redness; a bright red face wasn’t the look you were going for on spring break.

Though time is the best component of the healing process, there are a few things you can do to minimize the pain and help the healing along. First of all, an over-the-counter pain medication such as Motrin (ibuprofen) or Tylenol (acetaminophen) will help decrease overall pain, redness, and swelling. As for topical relief, you may want to try cool compresses or aloe to soothe the stinging. Additionally, it is important to stay hydrated (with a bottle of water, not a bottle of another favorite spring break beverage) because the burn tends to draw fluids out of the skin and make you more dehydrated. Keep in mind that alcohol also dehydrates your body, which is why we don’t recommend trying to hydrate with it. Moisturize your skin with lotion or cream to decrease the look of peeling and flaking skin (using a product with Vitamin C or E may have additional healing benefit). Calamine lotion or Benadryl (diphenhydramine) may help reduce itching.

If the sunburn has caused nausea, vomiting, blistering, heat stroke, or confusion it is best to seek medical attention. Stay away from products containing benzocaine or lidocaine because they may cause further irritation to your skin. Also avoid products containing petroleum (i.e. Vaseline) because this may trap the heat. To prevent further burning of your skin (more redness, more pain) stay indoors or if you just can’t stay away from the sun, wear clothing that will cover the area and slather on that sunscreen that was wedged into the bottom of your suitcase.

Some medications may cause you to burn more easily. Check out this past blog post if you think your medication might be one of them.

Of course, the best way to treat a sunburn is to not get one in the first place.  Check out this past blog post for tips on prevention.

Submitted by Emily Burns, PharmD Candidate 2014

Reviewed by Jason Goodman, PharmD, RPh

A Spot is not always just a Spot

Actinic Keratosis

Squamous Cell Carcinoma

About three months ago, when I was drying off after taking a shower, I noticed that there was an area on my face that felt tender.  Not sore, just that when I moved the towel across it I noticed.  I checked it out in the mirror and saw that I had a slight pink spot on my face.  I really didn’t give it too much thought and went about my day.  I would totally forget about the spot until the next day, in the shower, it would again feel tender. 

As time went on the spot became more noticeable, changing from a slight pink to more of a red and it appeared to have a scale or dry skin over it.  I thought that perhaps there was something in there that just wasn’t healing so I put some peroxide on it in the morning after getting out the shower – bad idea!  This just made it even redder and the spot became bigger.  I stopped the peroxide. 

I switched from peroxide to lotion and that did seem to help.  The spot shifted back from red to more of a pinkish hue and decreased a bit in size, but three months later and I still had the spot.  My mom has horrendous psoriasis and so I was concerned that I too may be heading that direction and I scheduled an appointment with a dermatologist. 

Five minutes into my appointment I had the diagnosis – Actinic Keratosis.  This is a small, scaly patch caused by too much sun and it can be an early warning sign of skin cancer, specifically Squamous Cell Carcinoma.  The treatment was easy enough.  The dermatologist brought out a can of liquid nitrogen and froze the area on my face.  The process was quick, taking just a minute or so, relatively painless, and I was told that it should be healed in 8-10 days.  No more Actinic Keratosis and no more risk of skin cancer.

These types of patches typically occur on the head, neck, or hands, but can be found elsewhere.  Fair-skinned, blond, or red-haired people with blue or green eyes are most at risk.  If you discover an area on your body that just doesn’t seem to heal, don’t wait three months like I did.  Schedule an appointment with a dermatologist and have it checked out.  It may be nothing, but then again, it may not.  Better to be cautious than cancerous.

Submitted by Tina Comston, M.Ed.

Sunscreen advice from a dermatologist to prevent skin cancer

KevinMD, “social media’s leading physician voice” has a great guest post by a dermatologist at the MD Anderson Cancer Center about how to use suncreen and other measure to protect yourself from skin cancer.  What better way to celebrate the last week of May!

We’ve talked about the risks of skin cancer before, and we know that for most of you out there in the world of college and grad/professional school, cancer is a remote topic that is only relevant to old people.  So let’s put it in terms that may be more relevant for you.  Sun damage to the skin not only puts you at risk for skin cancer down the road, but in the short term, it will set you up for wrinkles and other signs of premature aging of the skin.  So it’s not just about your health, it’s about looking good too.

If you have any problems with your skin – moles that you’re worried about, rashes, bumps, you name it – come in and see us.  If we can’t figure it out, we can set you up with a dermatologist who can.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Can a wart on my finger spread to my genitals?

common wart

plantar wart

Q: Can a wart on my finger spread to my genital area?

A:  All warts (or “verrucae”) are caused by Human Papilloma Virus (HPV).  On the hands, they’re referred to as common warts; on the bottom of the feet they’re called plantar warts; around the fingernails they’re called periungual warts; on the genitals or around the anal area they’re called genital warts.

Take a deep breath… I know those 3 little letters strike fear in the hearts of all college and grad students, especially those who are sexually active, but there are over 150 distinct strains of HPV and they all prefer certain body parts and skin types.  For instance, HPV-1 has a foot fetish and causes plantar warts while HPV 6 and 11 prefer to hang out in the “junk yard” and cause genital warts. 

So while you technically have HPV on your finger – which I know is creepy to think about – it really likes the neighborhood and has no plans to move down to the “Short North” so to speak.  I know the blogosphere and wiki-land is ripe with people who swear that they got genital warts from fingers (either their own or someone else’s) – and while the mysterious nature of life (and fear of lawyers) preclude me from “never saying never” – the odds of that really happening are extremely small.

On the surface (ha ha) warts seem like a silly thing to worry about, but they can become a serious emotional issue – the thought of being “infected” by anything can make you feel gross and the fact that they are visible and are spread by skin-to-skin contact can make them especially embarrassing and even affect relationships.  But it’s very important to remember that besides the strains of HPV that cause cervical and some other extremely rare types of cancer, warts are only a cosmetic issue.  They are not a threat to your health or the health of your partners, and they almost all clear on their own within a year or two.

And the good news is that if you don’t want to wait that long, there are pretty good treatment options available at the Student Health Center to get rid of them quicker.  I’ll talk about them in my next post, but for now, rest assured that you don’t need to wear gloves every time you go to the bathroom!

All photos:

John A. Vaughn, MD
Student Health Services
The Ohio State University

What can I do about my eczema?

Click to enlarge

Q: What’s the deal with this eczema? It’s even on my face.
A: Eczema, the “itch that scratches”, is a chronic inflammatory skin problem that causes a characteristic red, itchy rash. It commonly occurs on skin overlying joints and other areas that stretch and fold, but can occur anywhere on the body.

The cause of eczema remains a mystery. We know a couple of things, though. It often occurs in families. When one identical twin is affected there is an 80% chance the other will have eczema too. Overall, about 20% of the population in the US has eczema. It typically starts before five years of age, affects city folk more than rural inhabitants, and females a little more than males.

Eczema can be mild and limited or there can be diffuse involvement over a lot of the skin surface. Often eczema is worse in the winter, when skin tends to be drier by virtue of the harsh environment. While we don’t know what causes eczema, we know that the top layer of the skin-the thin epidermal line that protects you from the environment-becomes disrupted. The tissue can’t retain moisture effectively and leaves you susceptible to infection. 

The mainstays of therapy to protect the barrier involve both medication and lifestyle modification. Steroid creams are first line treatments. They work like a charm but can be tricky to use in the long run: they make skin thinner (which restricts their use on the face and neck where skin is already thin); they can cause a rash that looks like acne; can leave skin discolored and can also cause stretch marks.  When we have to use a steroid, we try to use one with the lowest potency for the shortest amount of time necessary to keep the eczema under control.

The other equally important part of treatment has two parts: avoiding triggers and adding moisture to the skin. 

  • Anything that might make already inflamed skin more irritated should be avoided. For example, perfumes, lotions with alcohol base and fragrance, certain detergents, deodorant soaps, or wool clothes can be quite irritating to somebody with eczema.
  • Long hot showers dry the skin (especially in the winter) and they release histamine from the mast cells in the dermis, making you itch and scratch like a fiend, which further disrupts the barrier.
  • Use bland soap without lye base. As noted above, avoid deodorant soaps.
  • A good, thick emollient is key. Petroleum jelly is the gold standard, but it’s hard to use. It stains clothes and bedding and covering your whole body in it is, well, icky and sticky. The thicker the emollient, though, and the sooner you use it after bathing the better. Ointments are generally better than lotions at moisturizing. Eucerin, Cetaphil, and Nutraderm are good products.
  • Antihistamines like loratadine (Claritin) or diphenhydramine (Benadryl) are sometimes helpful in controlling the itch during severe exacerbations.
  • Phototherapy (light treatments) or oral immune-modulators (i.e. chemotherapy) under a physician’s supervision can be helpful with severe chronic disease.

Schedule an appointment here at Student Health Services if you’ve having problems with your eczema, or any other skin problem.

John A. Vaughn, MD
Student Health Services
The Ohio State University

What can I do to prevent chapped lips?

click to enlarge

Q: Why are my lips so chapped and what can I do about it?

A: Ah winter, that time of year when the freezing wind whips past your face and dries out your skin. Lips have a very thin layer of skin compared to the rest of the face, so they are especially susceptible to drying out in the cold wind and low humidity of winter. Add to that your natural tendency to lick your lips to rewet them, and you’ve set yourself up for dry, cracked and painful lips.

So what can you do to prevent and/or treat your chapped winter lips? Keep ‘em covered!  Balms and ointments containing petrolatum or beeswax are the best for sealing in moisture and creating a barrier between your skin and the elements, although if you have acne you might want to look for petrolatum-free products as these are less likely to cause blackheads and breakouts.  Try to look for one with some SPF protection as well, especially if you spend a lot of time outdoors. You can get burnt even when it’s cloudy!  In general, ingredients such as eucalyptus, menthol, and camphor tend to be irritating so try to stay away from them.

Make sure to apply treatment before you go out into the cold and especially before going to bed, as many of us tend to sleep with our mouths open, which leads to lips drying out. You may also want to consider investing in a humidifier to use during the winter, when the heater tends to dry out the air indoors. Also, make sure you drink plenty of water and stay hydrated.  If you’re doing all of the above and still have trouble with chapped lips, take a look at your cosmetics and skin care products – sometimes, the ingredients can cause an allergic reaction that irritates your lips.

There are some common lip ailments that may be confused with chapping, the most common of which are cold sores and angular cheilitis.  Cold sores are caused by a herpes virus and may be improved with oral antiviral medications.  Angular cheilitis is a painful inflammation of the corners the mouth.  It can be caused by Vitamin B deficiency, mechanical irritation or a fungal infection.  It is treated by correcting the underlying cause and/or antifungal medication.

If you have persistently chapped or irritated lips that do not improve with the simple steps listed above, make an appointment at Student Health Services – we are always happy to see you!

John A. Vaughn, MD
Student Health Services
The Ohio State University