It has been the brunt of jokes for years.
But acne isn't funny.
Treating acne _ a lone pimple or a face full of them _ is possible and can make a tremendous difference in a person's life. Here's a bit of what else we know about acne, from the experts on the topic: dermatologists.
What about the chocolate connection?
Diet has no effect on ordinary acne, or acne vulgaris. A Hershey bar or a slice of pepperoni pizza or the super-size fries may not be good for you, but it won't cause acne.
But if there's a certain food or drink that seems to aggravate your acne, stay away from it.
Do over-the-counter products work?
Yes, in many cases. They're quite safe and are effective in mild cases. (Technically, even one pimple is acne. People have different tolerance levels, so there's no rule about at what point acne should be treated.)
Look for one with a 2.5 percent to 10 percent concentration of benzoyl peroxide, which kills bacteria on the skin. The most likely side effect is dryness.
How about taking vitamin A?
The bottom line is that for the vast majority of people, vitamin therapy doesn't work. You'd have to take so much vitamin A to get any help that you'd have all sorts of side effects from it. Too much vitamin A can be deadly!
What is the "T-zone"?
The area you're likely to have the most whiteheads, blackheads and acne: the brow, down the nose and onto the chin. That's where there is a higher concentration of sebaceous glands, which secrete a lubricating substance into hair follicles. When the hair follicles and sebaceous glands are inflamed, you get acne.
What makes me break out?
The primary factor is genetics.
If you have a tendency toward acne, it can be set off by a number of aggravating factors:
Androgen (male) hormones, which cause excessive oil production. That's why puberty, with its excess of hormones, usually is the time acne appears.
Heavy cosmetics. Makeup is lighter than it used to be, but hair spray and mousse can cause problems on foreheads, and the pomades and gels that African-Americans use to combat dryness will do the same thing.
Physical activity. Heat, sweat, friction and increased circulation may increase inflammation.
I know you're not supposed to pick at pimples, but . . .
Nine times out of 10, you'll make things worse by picking, squeezing or poking. Let the medicine do the work. Whiteheads and blackheads can be removed mechanically, but don't try this at home.
It seems that heat doesn't do much good, either. Remember, heat increases blood flow to an already inflamed spot, which can make the inflammation worse.
What about scrubs?
Gentle cleansing is best. The problem is under the skin, not on it, so you can't scrub it away not with a Buf-Puf, not with an apricot scrub, not with a Brillo pad.
What's the next step if the over-the-counter stuff doesn't work?
First, a doctor probably will have you try topical treatments.
Benzoyl peroxide, for example, comes in prescription strength. Topical antibiotics, in the form of gels or lotions, may be in order. About half the mild cases of acne can be successfully treated with creams alone.
And if they don't work?
The next choice is oral antibiotics. These must be taken for six to eight weeks. Of any 100 people with acne who take antibiotics, 75 will get better.
However, some medical experts believe antibiotics damage the immune system and should only be taken in case of severe illness.
What about Accutane?
It's considered the gold standard when it comes to acne. Other treatments are just that _ treatments. Accutane can cure acne, though it doesn't work for everyone. Patients take it for five or six months; it cures about half. Of those who aren't cured, most still show improvement, and the course of medication can be tried a second time if necessary.
So why isn't it the first line of defense?
Because of its side effects. It causes birth defects _ not may cause, but does cause. Patients of child-bearing potential are to use two forms of birth control a month before starting on Accutane, while on it, and for a month afterward, even if they're a 12-year-old. They have to sign a form saying they'll do that. And if they won't, doctors aren't supposed to give them Accutane.
Accutane also can cause dry skin, cracked lips, dry eyes and muscle and joint aches.