Acne is a common and treatable skin condition that causes pimples or "zits" and other skin problems. About 80-90% of teens (girls and guys) will have some kind of acne breakout during their adolescent years. Acne can begin as early as age 8 but usually improves when a girl reaches her twenties. If you’re a teen, chances are you’d like to know what to do about it. Read on to find out what causes acne, what kind of treatments are available, and how you can care for your skin.
Clogged pores or follicles - Acne is caused by clogged "pores" or "follicles" (small openings in the skin) that contain a hair and sebaceous (oil) gland. The medical term, "acne vulgaris" is the most common kind of acne. It can show up anywhere on the body but it is usually found on the face, back, shoulders, and chest. Follicles become clogged by dead skin cells and oil (called sebum) made in the pore.
Hormones and extra sebum - When you become a teenager and go through puberty, your body makes more hormones (especially androgen hormones) that can cause too much oil or sebum to be made. Sebum is supposed to carry dead skin cells up to the surface of the skin, but when there is too much of it, it clogs the pores leading to whiteheads, blackheads, pimples, and cysts.
Some people believe chocolate, soda, greasy foods, and dirt can cause acne, but these are just myths – not true at all. There is no such thing as an "acne diet", but if you notice a certain food seems to make your acne worse, just avoid it.
We have hundreds of hair follicles, or pores, on the surface of our skin through which hair grows. Deep inside each follicle is a hair shaft attached to small glands called "sebaceous glands". These glands make an oily substance called sebum to moisten our hair and skin. Sometimes when too much sebum is made, it can mix with dead skin cells (that we are constantly shedding) to create a sticky plug.
Trapped bacteria grow very fast in these plugged follicles and make chemicals that can cause swelling, redness, and pain. Eventually the plugged follicle can burst and spill everything – oil, dead skin cells, and bacteria – onto the skin surrounding other follicles.
Increased hormones (androgens) lead sebaceous glands to enlarge,
causing an increase in sebum (oil), resulting in clogged pores: acne
Eight out of ten teens will get acne sometime during their teen years because puberty is the time when there are many hormonal changes. Hormones are chemicals that are responsible for all of the physical changes that happen when you go from being a child to an adult. Teens who have a family history of acne (their parents had acne when they were teens) are more likely to get it, but keep in mind that most teens who get acne will be free of it by the time they are young adults.
Young women often complain of acne just before their periods. The medical term for this is called "premenstrual acne" and it is usually due to the hormones that are active before your period. Some girls are more sensitive to these hormones than others. So even if you are careful about taking good care of your skin, chances are you may have a mild to moderate breakout before your period. The good news is that once your period is over the acne usually goes away.
Acne is also common in girls who have polycystic ovary syndrome (PCOS). PCOS can cause weight problems, acne, excess hair growth and irregular periods. So check with your health care provider if you have any of the symptoms.
Over-the-counter (no prescription is required) acne medicine that contains benzoyl peroxide (such as Clearasil®, ProActiv® and Oxy®), resorcinol, salicylic acid or sulfur often help with mild acne. Each product works slightly differently. Products come in soaps, cleansing pads, creams, gels, or lotions. Acne preparations may cause a rash or redness. Your skin may sting or burn if the medicine is too strong.
Makeup and foundation that claims to clear acne while making your pimples less visible may just cover them up. Sometimes the ingredients in some kinds of make-up can actually cause pimples. Look for oil-free, "non-comedogenic" products.
Your health care provider may prescribe products with benzoyl peroxide, retiinoid products such as Retin A®, Differin®, Avita®, Tazorac®, and antibiotics such as tetracycline, erythromycin, minocycline, doxycycline, and bactrim.
Benzoyl Peroxide - Health care providers who prescribe this kind of medicine usually tell teens to start out slowly, using it 2-3 times a week and working up to every night. Wash and dry your face completely before applying it. You should use a very small amount-about the size of a pencil eraser. It’s common to have red or dry skin at first. If your skin becomes so dry that it peels, your health care provider will probably tell you to cut down on the number of days/week that you use it. Because benzoyl peroxide has a "bleach-like" quality, make sure you rinse your face completely after using it so you don’t lose the color in towels, pillowcases, and shirts. If you are leaving on the medication overnight, sleep on a white pillowcase.
Retinoid products are very helpful for mild acne (whiteheads and blackheads). Apply a thin layer of this medicine after you have gently washed and dried your face. People who use this medicine sometimes say that their acne got slightly worse before it got better. For moderate to severe acne (pimples, cysts, and scars); your health care provider may prescribe additional medication.
Antibiotics may be applied directly to your face (lotion or gel) or taken by mouth. In some products, benzoyl peroxide and a topical antibiotic are mixed together. They help treat the bacteria that can cause pimples and cysts. If you are taking oral antibiotics, follow the instructions on your prescription bottle. Some antibiotics require that you take them on an empty stomach while other kinds say you can take them any time. If you are taking oral antibiotics you are slightly more likely to get a yeast infection.
Oral Contraceptive Pills may be prescribed for moderate to severe acne when over-the-counter and prescription medications don't work. The hormones in oral contraceptive pills can help stop acne from forming.
Stop your acne medication right away and contact your health care provider if you get a rash, hives, severe stomach pains, diarrhea, dizziness, or headaches. Antibiotics and other acne medicine can make your skin burn faster from sun exposure or tanning beds/booths. If you get bad sunburn, call your health care provider!
If your acne doesn’t get better with over-the-counter medicine or the usual prescription medicines, your primary care doctor or dermatologist may consider prescribing Accutane® (the brand name) or Isotretinoin (the generic name). It is a pill that is swallowed once a day for 15-20 weeks. Accutane® is reserved for the severe acne that doesn’t improve with other treatments.
If you have acne and you’re a teen, you are not alone. Most teens will have a breakout at some point during their teen years. Taking good care of your skin, and avoiding things that can irritate it, will help. If you are worried about your skin, talk to your health care provider or see a dermatologist (skin specialist). There are treatments for acne!
Updated: 6/16/2011
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