It doesn’t seem fair. Just when you begin to appreciate a smooth complexion, raging hormones set the stage for the Great Breakout–otherwise known as acne.

Through no fault of yours, blackheads, whiteheads, papules, and pustules pop up seemingly overnight. To make matters worse, the dots and spots mostly blotch your face, that very place where everyone can see them. Is there any help?

You, as did acne-prone age groups before you, have every right to ask, “Why me? Why now? Will my strawberries-and-cream complexion ever be more cream than strawberries again? Should I treat acne myself or see the family doctor or a dermatologist (a physician who specialize in treating skin,hair and nail disorders)?”

Rest easy. Even if your mirror already reflects zits and more, you don’t have to just grin and bear them. (Although grinning’s fine. A bright smile draws attention away from imperfections of any kind.)

More important, recent medical and pharmaceutical discoveries are making acne, the skind disease troublesome to 90 percent of junior high and high school students, easier to manage. Unlike your grandparents or parents, you don’t have to work around myths and folk tales to find the right treatment.

What’s to Blame?

Researchers now know for certain what causes or doesn’t cause acne. It isn’t gender, diet, or dirt. Those misconceptions have been put to rest by years of scientific studies that can trace the formation of acne to the biological changes taking place in your body during adolescence.

Specifically, a rising hormone level stimulates the oil (or sebum) production of sebaceous glands buried deep below the skin. Normally, sebum travels through tiny tubes called follicular ducts and surfaces easily through pores to lubricate the outer skin layer. With increased hormonal activity, however, the oily substance thickens, collects skin cells, and forms plugs that block pores.

Sebum’s journey to the surface is now blocked. To get there, it breaks duct walls, irritates skin surrounding the plugged pores and, in general, creates an environment in which whiteheads, blackheads, pimples, and boil-like lesions thrive.

Since acne symptoms commonly crop up where sebaceous glands are most commonly located, the face gets the most blemishes. The forehead, for example, has as many as 2,000 oil glands per square inch. Other major acne sites are the upper back and chest.

Check Before You Buy

The ongoing development of medicines to reduce the number of acne lesions and dry up those that appear also makes it easier for the acne-prone person to control the disease. Before stocking up on lotions and oitments, however, it’s wise to have your condition diagnosed by a physician. Some skin diseases mimic acne but need different treatment.

Through the years, mild cases of acne such as blackheads and an occasional pimple have responded to preparations containing the peeling agent benzoyl peroxide. Applied directly to the skin, these topical oitments and lotions help dry up lesions, cut greasiness, and prevent bacterial growth. Many are obtainable without prescription and most pharmacists can help you make a choice.

Severe acne, characterized by inflamed and pus-filled pimples, calls for more severe measures. The most traditional weapon against the bacteria that create havoc in the oil glands is antiobiotics you take either by mouth or apply directly to the skin. Both kinds are safe and effective when used faitfully and according to a doctor’s prescription. (Previous problems with antibiotics or sideeffects after taking them should be reported to your physician.)

Extra Strength

Newer medicines known to clear up even the most difficult cases of acne include:

* Vitamin A (retinoic acid), formulated into a gel, loosens skin cells trapped in the follicular duct, brings them to the surface, and peels them away. (Some 286 patients with mild to moderate acne in a 1987 study showed, on average, a 50 percent improvement after using the gel for two weeks. Side effects of facial redness and peeling were considered insignificant by the majority of patients.)

* Isotretinoin (Accutane), a powerful form of Vitamin A, is taken orally by victims of severe, nodular cystic acne or those who haven’t responded to all other treatments. Improvement is dramatic but the treatment can hurt a pregnancy or cause birth defects. Anyone taking the drug must be monitored closely by a physician.

* Even more promising, an experiment with gelatin showed good results in treating acne scars. The gelatin was mixed with a clotting agent and injected below a scar. This triggered a regeneration of skin tissue in all subjects. Very few side effects were noted.

With all this good news, there’s a catch, of course. Even the mildest case of acne needs attention, and a severe case even more so. You have to take charge of restoring your skin to health.

Expert Advice

To make the passage from acne to clear skin less aggravating, skin specialists suggest that you:

* Cleanse your face gently at least twice a day with soap and warm water.

* Forget that harsh soaps, brushes, and abrasive sponges or pads exist.

* Use only water-based cosmetics, lotions, and hair products.

* Stay out of the sun as much as possible.

* Wear your hair off your face.

* Stop leaning your face into your hands and make sure that sports equipment touching your upper chest or back doesn’t aggravate the condition.

* Eat a balanced diet but avoid any food you think you are allergic to.

* If you’re a male, shave a seldom as possible and always use a sharp blade.

* Follow your doctor’s instructions faithfully.

At one time all you ever wanted was your two front teeth. You got them. With the same degree of patience and a lot of diligence you’ll have your clear complexion back sooner than you think.

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