Zoe couldn't wait for school to start to see all her friends again. She had just had her long hair trimmed and picked out the perfect outfit to wear. But when she walked past the hall mirror that morning, she noticed a bump on the side of her nose. As she peered in the mirror, a giant, red pimple glared back at her. She panicked. What would her friends say? Surely, they'd never seen anything this horrible! Finally, with some coaxing from her mother, Zoe gently washed her face, applied an acne cream, and was dressed in time for the school bus.
If there's one thing you can count on as a teen, it's acne. More than 85% of teenagers suffer from this skin problem, which is marked by clogged pores (whiteheads, blackheads), painful pimples, and, sometimes, hard, deep lumps on the face, neck, shoulders, chest, back, shoulders, and upper arms.
If your mom and dad had acne, the chances are good that you will, too. But there are many ways to prevent (and treat) acne today to keep the condition minimal, prevent scarring, and leave your skin glowing.
What Causes Acne?
To understand acne, you need to know how your skin works. The pores in your skin contain oil glands. At puberty, there is an increase in sex hormones called androgens. The excess hormones cause the oil glands to become overactive, enlarge, and produce too much oil, or sebum. When there is too much sebum, the pores or hair follicles become blocked with skin cells. The increase in oil also results in an overgrowth of bacteria called Propionibacterium acnes.
If blocked pores become infected or inflamed, a pimple -- a raised red spot with a white center -- forms. If the pore clogs, closes, and then bulges, you have a whitehead. A blackhead occurs when the pore clogs, stays open, and the top has a blackish appearance due to oxidation or exposure to air. (This has nothing to do with skin being "dirty").
When bacteria grow in the blocked pore, a pustule may appear, meaning the pimple becomes red and inflamed. Cysts form when the blockage and inflammation deep inside pores produce large, painful lumps beneath the skin's surface.
Hormonal changes related to birth control pills, menstrual periods, and pregnancy can trigger acne. Other external acne triggers include heavy face creams and cosmetics, hair dyes, and greasy hair ointment -- all of which can increase blockage of pores.
Clothing that rubs the skin may also worsen acne, especially on the back and chest. So can heavy sweating during exercise, and hot, humid climates. Stress is known to trigger increased oil production, which is why many teens have a new crop of pimples on the first day of school or just before that big date.
What Are the Symptoms of Acne?
While the symptoms of acne vary in severity, you will notice these signs on areas of the body with the most oil glands (the face, neck, chest, back, shoulders, and upper arms):
- Clogged pores (pimples, blackheads, and whiteheads)
- Papules (raised lesions)
- Pustules (raised lesions with pus)
- Cysts (nodules filled with pus or fluid)
The least severe type of acne lesion is the whitehead or blackhead. This type is also the most easily treated. With more extensive acne, prescribed medications are often needed to reduce the inflammation, bacterial infection, redness, and pus.
What Is the Treatment for Acne?
The treatment usually depends on how serious the problem is. For instance, if you have an occasional inflamed pimple, you may use skin compounds containing:
- Retinoids (medications that come from vitamin A)
- Azelaic acid
- Lactic acid
- Glycolic acid
- Salicylic acid
- Various fruit acids
- Benzoyl peroxide
Benzoyl peroxide reduces oil production and has antibacterial properties. But use it carefully, as it might leave your skin dry and flaky. For most people, it should be used just before bedtime.
Resorcinol and sulfur, as well as prescription retinoids and antibiotics applied to skin, can reduce blackheads, whiteheads, and inflamed pustules.
When many pustules or cysts appear on the face and upper body, you'll need an oral antibiotic. Health care professionals also can inject cysts with anti-inflammatory steroid solutions to help decrease their size.
For persistent acne, antibiotics (taken by mouth or applied to the skin) are generally used. Some antibiotics have both antibacterial and anti-inflammatory properties. These are often prescribed for short-term use (usually a few months).
Spironolactone, a hormone blocker, can be used for teenage girls who have acne.
Isotretinoin, a prescription medication you take orally, may help control severe acne, which is characterized by many large cysts on the face, neck, and upper trunk and severe scarring.
Pregnant women or women who might become pregnant cannot use this medication, as it is linked with birth defects. Isotretinoin can give people very dry skin, eye dryness, and irritation and requires blood tests to monitor for liver inflammation. It is also very expensive. So its use is restricted to the most severe cases for which other treatments have not worked.
Can I Prevent Acne?
There are some steps you can take to prevent acne. To prevent oily skin that can contribute to acne, keep your skin clean. Wash your face and neck twice daily with mild soap and warm water. But never scrub your face! That can irritate your skin and worsen acne.