The main event that accompanies acne is increased oil and sebum production and a change in the hair follicles caused by hormone activity. The face, neck, and upper back have the greatest concentration of oil glands, and that’s where zits tend to sprout. Then why doesn’t everyone get acne? And why is it worse for some teens than others?

Unfortunately, no one really knows. Sometimes a tendency to develop acne runs in families. Some people might have less resistance to bacterial action. Stress might make things worse.

In the past, people were convinced that diet was to blame – nuts, chocolate, cola drinks, and greasy food were taboo. Now, no one’s saying that a steady diet of these foods is good for you, but most experts believe they don’t cause acne or even make it worse.

Poor¬†hygiene¬†also was seen as a cause – blackheads were assumed to be pores clogged with dirt. Although washing away oil and dead skin cells that accumulate on the surface of the skin is a good idea, doing so won’t guarantee a clear complexion.

Then what will? Well, the biggest thing is: time. Most teens’ skin will clear up by the time they reach young adulthood. The big hormone burst stabilizes and with it, oil production. But sometimes skin problems persist into adulthood. And in the meantime, the physical and emotional scars of acne can take a heavy toll.

What You Can Do

Here are some do’s and don’ts to keep in mind:

* Wash your face morning and night, with a mild soap and lukewarm water. This is enough to wash off oil that has accumulated and dirt and other particles from air that have settled in the oil. It’s not necessary to use a medicated soap – the “medicated” ingredients don’t stay on your face long enough to make a difference.

* Keep hair clean and away from your face. Covering up a blotchy forehead with bangs may seem like a good idea, but if your skin is oily, chances are your hair is too, and that will only make matters worse. Wash hair at least every second day. Rinsing with cool water will temporarily squelch oil production. Avoid oil-based hair products.

* Keep hands off face. It’s not so much dirt on your hands as pressure on pores, which will make clogging more likely. And then there’s always the temptation to pick at blemishes.

* Try an over-the-counter (that means you can buy it without a doctor’s prescription) acne preparation. Many of these combine oil-blotting ingredients with a fleshtoned coverup. Those containing benzoyl peroxide may help keep bacteria under control. Use with care since the coverups may stain and benzoyl peroxide will bleach clothing and other fabrics.

* Shave with caution if you shave at all. An electric razor may be more comfortable if you are very broken out. if you use a blade, be sure it is very sharp (nicks and slips are more likely with a dull blade) and soften your beard with soap and warm water or a shaving gel. Thick shaving foam makes it more difficult to see the bumps you want to avoid.

* Ask your parents if you can visit a dermatologist (a doctor specializing in skin problems) or your family doctor to discuss your skin. A single visit may be all that’s required, or the doctor may determine that your problem is big enough to warrant more help.

* Get enough sleep, fresh air, exercise, and healthful food.

* Avoid using abrasive scrubs, washcloths, or brushes on your skin. Rather than cleaning out clogged pores, this harsh treatment will irritate already sensitive skin and may promote scarring.

* Don’t use hot water, which tends to stimulate oil production and reddens skin by increasing the flow of blood near the surface.

* Control picking, squeezing, or scratching your zits. The result can be a serious infection and permanent scarring.

* Avoid sunlight or sunlamps. Sometimes acne is aggravated by sunlight. And exposure to ultraviolet radiation puts you at risk for developing skin cancer.

* Don’t try to cover up with heavy makeup. This will clog pores, providing a fertile ground for bacteria to grow more zits. Water-based makeup labeled noncomedogenic (won’t clog pores) is the best choice if you wear any makeup at all. Be sure to remove it completely as soon as possible, but certainly at bedtime.

* Don’t let skin problems take over your life. Chances are you’re not the only person in your school whose skin has broken out. Focus on the positive things about yourself and your friends. This is a time for watchwords like: “Beauty is only skin deep” and “You can’t judge a book by its cover.”

What a Doctor Can Do

A doctor may periodically clean out clogged pores. In a sense it amounts to “squeezing blackheads,” but it is done with sterilized instruments and by someone trained to do the job, Trying it yourself if a very bad idea.

The doctor may prescribe Retin-A, a derivative of vitamin A that is applied to the skin. It is a safe and effective acne treatment. (Vitamin A from foods and in vitamin pills does not have the same effect.) On the downside, Retin-A can be very irritating to the skin and will make it particularly sensitive to sun exposure. It must be used with care and is not for everyone.

Another relative of vitamin A taken in pill form can help very severe cystic acne, but this drug (called Accutane) causes birth defects if a pregnant woman uses it. For that reason, doctors are reluctant to prescribe it for any female of childbearing age.

Sometimes oral antibiotics will be prescribed, but they are not always effective. Many experts believe it is a bad idea to dose the entire body with a powerful drug that should be reserved for more serious infections. Topical antibiotics also might be used.

The fact is that when it comes to medical problems, acne is not considered a serious one – it’s not fatal, though you may sometimes feel you’ll die of embarrassment. But the great acne breakthrough hasn’t happened yet.