I am 18, and have noticed that I am beginning to get painful pimples on my face. I used to have flawless skin. I drink enough water all through the day but the pimples are still there.

The start of acne at the age of 18 is uncommon. Usually, this condition begins to present itself in boys and girls in their early teens. Also, the fact that you mention that your “pimples” are painful in such a short period of time after their onset is a bit uncommon. This leads me to suspect that you are suffering from folliculitis (infection of the hair follicles on the face) or furunculosis (larger sized folliculitis), as these lesions look very similar to acne and, therefore, can easily be mistaken for acne vulgaris.

Folliculitis can be caused by trauma to the hair follicle, for example, during face waxing, hair threading or beauty facials at salons where a poorly-trained beautician gets aggressive in so-called “extractions” of white and blackheads. This can lead to traumatic folliculitis.

Use of poorly sterilised or even totally non-sterilised instruments, too, could be the culprit as they become a source of spreading infection from one client to another.

Whatever may be the case, the first line of treatment will include a course of oral antibiotics together with topical antiseptic facial cleansers and antibacterial gels, creams or lotions.

I advise you to see an experienced dermatologist at the earliest.

The dermatologist might need to take a skin swab from the lesions for bacterial culture and drug sensitivity.

This action can prove highly helpful and valuable in cases of treating folliculitis or furunculosis, as it enables the treating dermatologist to select the most appropriate and effective antibiotic for you, based on the laboratory results.

As for drinking enough water – while hydrating the system is important, believing that this alone will prevent or cure a skin ailment, particularly acne or folliculitis, is a myth.