Almost everyone experience an occasional flare-up of acne—usually just a few blackheads and pimples, less often deep, scarring cysts. Although acne can occur at any age, it is most prevalent during adolescence, afflicting 85 percent of all teenagers to a varying degree.
Dermatologists stress that diet and other lifestyle factors, including cleanliness and sexual activity, do not cause acne. Still parents, and even some teens magazines keep their diet myth alive by insisting that eating chocolate , French fries, sweets, and other high-fat food, sugary teen favorites can lead to acne. In rare instances, sensitivity to a food may exacerbate exiting acne, but it is unlikely that any food actually causes it.
Hormones are responsible for most cases of acne. The surge of androgens (male sex hormones) that occurs during puberty prompts the skin’s oil (sebaceous) glands to enlarge and increase the production of sebum, the oily substance that lubricates the skin. Boys are more severely affected by acne than girls. Still, even adult women fnd that acne flares up in periods of hormonal change, such as just before the menstrual flow, during pregnancy, or at the time of menopause.
Androgens also stimulate the growth of body hair, resulting in increased shedding of keratin, a protein in hair, which then clogs pores and blocks the flow of sebum; the resulting swollen glands form a whitehead, or closed comedo. If parts of the pore remain open, the sebum exposed to oxygen darkens and becomes a blackhead; any inflammation will result in a pus-filled pimple. Cystic acne, the most severe form of the condition, develops when the blackhead glands become infected by bacteria that normally inhabit the skin.
Because severe acne tends to run in families, heredity is suspected of playing a role in causing it. A number of medications can also cause acne; major offenders include steroids and other hormonal agents, iodine preparations, lithium, anticonvutants, and drugs used to treat tuberculosis. The use of oily make-up can further clog pores and worsen acne; exposure to industrial oils and chemicals, such as naphthalenes and niphenyls, can provoke acne too.
Stress often triggers a flare-up of acne, most likely by altering hormone levels. In turn, hormonal changes can stimulate food cravings, especially for chocolate and other sweets. Consequently, the acne sufferer may erroneously attribute the acne to gorging on chocolate and sweets, rather than stress, the real culprit for both.
Clear, glowing skin reflects overall good health. This requires, not only a balanced diet but also regular exercise, adequate sleep, and avoiding such detrimental habits as smoking and excessive exposure of the skin to sun. Vitamin A and C are essential for building and maintaining healthy skin; a daily diet that provides five or more servings of fruit and vegetables will provide adequate amounts of these nutrients. B vitamins are thought to regulate sebum production; whole-grain cereals and breads, dried beans and other legumes, and lean meats are excellent sources of these vitamins. These foods also provide good amounts of zinc, a mineral hat some studies link o skin health.
Some teenagers attempt to self-treat acne with high-dose vitamin and mineral supplements, an approach that can actually worsen the condition. Recent studies show that high doses of vitamin B1, B6, and B12 can trigger acne, and high doses of vitamin A can cause dry, flaky skin and hair loss.
Once or twice a day, gently wash the skin with a mild, non-medicated unscented soap, rinse with cool water, and pat dry. Avoid scrubbing or using abrasive pads or grains—these irritate the skin and can even worsen the acne. If the skin is very oily, wipe it gently with a cotton ball soaked in witch hazel. Use water-based, unscented cosmetics.
Most persistent mild to moderate acne can usually be controlled with nonprescription drug such as 2.5 or 5 percent strength benzyl peroxide gel, lotion, or ointment. Start with a nightly application, and after a week, add a morning application as well. Improvement should occur within 3 weeks; if not, try a stronger 10 percent solution.
A dermatologist may prescribe tretinoin, a topical medication derived from vitamin A; an antibiotic, in either topical or pill form, may also be tried. Isotretinoin, a potent oral drug, is reserved for severe cystic acne.