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All About Acne

Seeing Spots
How Breakouts Happen
Caring for Acne-Prone Skin
How to Pop A Pimple
Medications for Acne
Do's and Don'ts for Acne-Prone Skin

Seeing Spots
Some people are born with perfect, zit-free skin. Most of us, however, are not. More than 17 million people suffer from some form of acne - blackheads, whiteheads, pimples, and cysts. As a teenager, you're hardest hit—a fact that experts blame on hormones. Other than your age, causes of acne include your family's history of acne, stress, certain medicines (including lithium), and some birth control pills. This is a little confusing because some birth control pills are actually used to treat mild cases of acne.

In spite of what you've probably heard, chocolate and greasy foods have nothing to do with acne. But eating a well-balanced diet and drinking lots of water may help your skin look better (and it sure can't hurt!). back to top

How Breakouts Happen
Acne is caused by a combination of bacteria on the skin and clogged pores. Pores get clogged when the sebaceous glands produce more oil than usual. These oil-producing glands are located on your face, back, and neck. That's why acne occurs on the face, back, neck, and shoulders.

During your teenage years, hormone levels increase the production of sebum, waxy stuff that comes out through your pores to lubricate the hair and skin. When too much sebum is produced, it combines with dead skin cells to block the pores partly or all the way. Partly blocked pores are called blackheads (or open comedone). Fully blocked pores are called whiteheads (or closed comedone). By the way, blackheads are not caused by poor cleansing habits or dirt trapped in the skin.

When the sebum and other clogged materials are exposed to the air, they turn black (a process called oxidation). Bacteria can grow in the blocked pores and produce an inflammation, otherwise known as a zit. If there are pimples, blackheads, and whiteheads, but no deep cysts, it's called superficial acne or acne vulgaris. If the pimples project down into the skin, and there are cysts filled with pus, it's called deeper acne. You usually need to see a health professional for help with any type of acne because it can leave scars if not treated properly. back to top

Caring for Acne-Prone Skin
Thanks to some new products, most cases of acne can be controlled. Follow these steps if you have acne-prone skin (skin that seems to get pimples and blackheads easier than other types of skin) or any skin that could be clearer and healthier:

  • Wash twice a day with a mild cleanser. You might see products labeled antibacterial. This means that the product works to kill bacteria, but it can also be harsh on sensitive skin.
  • Apply an acne medication to the entire area you're having problems with, not just the pimples. The idea is to prevent future pimples from rearing their ugly heads.
  • Use an antibacterial wash on the affected areas. Remember that antibacterial cleansers can be harsh on sensitive skin.
  • Apply an acne medication containing benzoyl peroxide, sulfur, or salicylic acid to the entire affected area, not just existing blemishes. Be careful not to use too much of these medications because they can irritate your skin. Acne on the body is often harder to treat than acne on the face, so you may have to wait longer to see results. back to top
How to Pop A Pimple
Generally, a hands-off policy is best when it comes to your skin. But if you absolutely must bust a blemish, follow these guidelines. A word of caution, though: Only use this method on a pimple that has a yellow, pus-filled center. Don't try to remove whiteheads; they'll go away by themselves in a few days anyway.
  1. Take a warm shower or bath to soften your skin.
  2. Wash your face and remove all makeup.
  3. Wash your hands to prevent spreading germs and infecting the pimple.
  4. Sterilize a needle by running it through a flame (a dirty needle will cause an infection and maybe a bigger pimple).
  5. Gently prick the tip of the pimple with the needle.
  6. Take a clean tissue or piece of toilet paper and wrap it around your index fingers.
  7. Gently apply pressure to the sides of the pimple to ease out the pus. Stop when blood or clear fluid comes out. back to top
Medications for Acne
The following medications are all useful for treating acne on a variety of skin types and colors. If you have darker skin, be especially careful about what you use on it. Some acne treatments such as Retin-A (for preventing blackheads and fighting more serious cases of acne) and 10% benzoyl peroxide gel (for getting rid of pimples) may irritate your skin and cause it to darken. If you're not sure, ask a dermatologist before using anything new on your face.
  • Benzoyl peroxide works by fighting the bacteria that causes acne. It causes an exfoliating effect that might cause some slight peeling. It's good for mild cases of acne, and you can get it without a prescription.
  • Salicylic acid dries out the skin and helps exfoliate it to make dead skin cells fall away faster. It's good for mild cases of acne, and is available without a prescription.
  • Birth control pills have many risks associated with them, and it's not clear how well they work to treat acne. Talk to your health professional to see if taking birth control pills will help the kind of acne you have.
  • Topical antibiotics work by killing the bacteria that cause acne, and by reducing inflammation. Topical antibiotics are often used along with oral antibiotics. Some examples of topical antibiotics are erythromycin and clindamycin. Antibiotics are available only with a prescription.
  • Oral antibiotics are usually used for moderate to severe acne, especially on the back or chest. The ones most commonly used are tetracycline and erythromycin. Like all antibiotics, they can cause yeast infections and can interfere with the action of birth control pills. If you are taking birth control pills and antibiotics at the same time, you will need to use another form of birth control while you're taking the antibiotics. Antibiotics are available only with a prescription.
  • Tretinoin is an acid made from vitamin A. It's used to help unblock pores and reduce the bacteria that cause acne. A common brand is Retin-A®. It works best on blackheads and whiteheads, and is available only with a prescription.
  • Isotretinoin (Accutane®) is used in severe cases of acne when nothing else works. It does work very well, but it also has many side effects, including dry lips, eyes, and skin. It causes severe birth defects, so you have to use birth control while you take it. It also can cause depression in some people. It's available only with a prescription. back to top
Do's and Don'ts for Acne-Prone Skin
  • Don't wash your face too much. Wash it twice a day and no more. Over-cleansing can irritate your skin and make your acne worse.
  • Don't use harsh cleansers or soaps. Instead, use a mild cleanser. If you have very oily skin, use products made for your skin type.
  • Don't use exfoliating scrubs because they can irritate inflamed skin.
  • Don't pick, pop, squeeze, or otherwise mess with your skin. Squeezing blemishes or whiteheads can lead to infection or scarring. It almost always makes the acne you have worse. You should never tangle with a whitehead—they'll go away on their own in a few days anyway. If you have a pimple with a yellow, pus-filled center and you must pop it, see How to Pop A Pimple.
  • Do look for face-care products and makeup with the words noncomedogenic and nonacnegenic. No product can guarantee you trouble-free skin, but these are better choices because they're less likely to irritate your skin.
  • Do use an antibacterial soap or a benzoyl peroxide wash on your back and other areas where you have acne.
  • Do see a dermatologist to remove blackheads. They have the tools and the know-how to safely remove blackheads without causing scarring or infection. If you have just a few blackheads, use a comedone extractor, available at a beauty supply store. Using your fingers to squeeze them out can spread bacteria and can cause scarring. It's best to remove blackheads after a warm shower or bath, when your skin is soft. And always disinfect any tools with rubbing alcohol before you use them on your face.
  • Do wait 20 to 30 minutes after washing your face to apply a Retin-A cream. That will make your skin feel less sensitive to the Retin-A.
  • Do apply topical acne medications to the entire problem area, not just the zits you have now. The idea is to stop new zits from forming.
  • Don't pick at dark skin. Picking can leave dark spots on the skin that can take a while to fade away. It can also cause keloid scars.
  • Do wash your pillowcase every night and always use clean face towels if you have acne-prone skin. Dirty towels and pillowcases can harbor bacteria and germs that can make acne worse. back to top
Last Modified Date: 4/4/2001
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