At least 90% of adolescents have acne — it affects teens of every size and shape, in every country from America to Zimbabwe. A recent study by the American Medical Association revealed (not surprisingly) that acne is one of today’s teenagers’ biggest worries. “Acne can, without question, affect self-esteem,” says Diane Berson, MD, Assistant Clinical Professor of Dermatology at New York University School of Medicine. “Some kids have it so severely that they don’t even want to go out of their house. They make excuses for not going to social functions.”1

It seems unfair, doesn’t it? Just when you’re beginning to grow up and get some ideas about exactly who’s behind the face in your mirror, you’re staring at a minefield of bumps and blemishes. It can be downright depressing — but since everyone has acne, you’re supposed to suck it up and suffer through it… right? Wrong! Today we know more about fighting acne than ever before. And the best way to stop acne is to find out why it starts when it does — during adolescence. Get rid of your acne with Proactiv® Solution – GO NOW!

Why does acne strike teens? At the onset of puberty, the body begins to produce hormones called androgens. These “male” hormones are a natural part of development for both boys and girls, but boys tend to produce more of them — and therefore tend to have more severe breakouts. Why? Our faces and bodies are covered with tiny hairs, each one fitting snugly into a hair follicle, sometimes called a pore. Deep within each follicle, oil glands are hard at work producing sebum, which travels up the hair and out onto the surface of your skin. Sebum’s job is to form a protective layer between your skin and the world, keeping it soft and smooth.

But when androgens enter the picture, your oil glands go into overdrive. They produce extra oil, which can clump together with the dead skin cells on the top layer of your skin. When this sticky mixture finds its way into your pores, it acts just like a cork in a bottle — trapping oil and bacteria inside. Unfortunately, your oil glands just don’t know when to stop; they keep producing oil, and the follicle becomes swollen. Your body’s natural defense system, white blood cells, rush to the area to clean up the mess. The result? Red, painful bumps. Yucky black spots. Zits. Blackheads. Pimples. Acne. It has nothing to do with what you eat, or how often you wash your face.

How can I strike back against teen acne? The best way to zap zits is to prevent them from showing up in the first place! Following are a few simple practices than can help you minimize your breakouts.

A Tip on Avoiding Teen Acne – Keep it clean. Since teenagers produce more oil, it’s important to wash twice a day with warm water and a mild cleanser. Since your skin does need some sebum in order to stay healthy, don’t be tempted to overwash; your glands could pay you back by producing more oil.

Teen Acne Advice – Skip harsh scrubs. It’s okay to exfoliate, but be sure to use a gentle formula with small, smooth grains. Avoid products with almond or apricot shell fragments; they can irritate or even tear your skin and further aggravate your acne.

Avoiding Teen Acne – Say no to alcohol. If you use a toner, avoid products with high concentrations of isopropyl alcohol, or common rubbing alcohol. Alcohol strips the top layer of your skin, causing your glands to produce more oil. The result? Dry, flaky skin — and possibly more blemishes.

Ways to Avoid Teen Acne – Don’t squeeze or pick. Squeezing or picking your blemishes with fingernails, pins or anything else can force bacteria deeper into the skin. This can cause greater inflammation and infection, increasing the chances that your pimple will leave a permanent scar. Remember, a zit that’s bugging you today will go away if treated properly; if you pick at it, it may stick around forever.

Being Smart about Teen Acne – Hands off! The bacteria that causes acne, Propionibacterium acnes, hangs out on your skin all the time; it doesn’t lead to acne until it gets trapped inside the hair follicle. Touching your face, including rubbing or even resting your chin in your hands, can drive bacteria into your pores — where it can begin its dirtywork.

Dealing with Teen Acne – Choose products wisely. If you wear make-up, be sure it’s oil-free and non-comedogenic — that means it won’t clog your pores and make your breakouts worse. The same goes for your sunscreen and even your hair products; sticky sprays, gels and pomades can aggravate acne, too.

Getting Ahead of Teen Acne – Be smart about sun. If you think tanning helps your acne, you’re right — and wrong. Small amounts of sun exposure may improve acne for a few days. But suntans (and burns) also make you shed your dead skin cells faster, so in the long run, you’ll end up with more clogged pores. And that means more acne. Another thing you should know: some kinds of acne medication make skin more sensitive to the sun. So if you’re headed outside in sunny weather, be sure to slather up with sunscreen. Look for sun protection products that are oil-free and have a “sun protection factor” (or SPF) of at least 15 for both UVA and UVB rays.

Avoiding Teen Acne – Accessorize wisely. Heat and friction (rubbing) can cause acne flare-ups. So steer clear of hats and headbands — and if your sports team requires you to wear a helmet or any other equipment that might rub against your skin, try lining it with a layer of clean, soft cotton. And remember to shower immediately after exercising — don’t sit around in a sweaty uniform, no matter how cool you look.

Teen Acne Treatment – Find a regimen and stick with it. Most cases of mild acne can be improved with “over-the-counter” products, or products that don’t require a prescription from your doctor. There is a wide range of treatments available, and there’s a good chance one of them will work for you. If you start treatment before your acne gets severe, you’ll have a better chance of avoiding physical and emotional problems down the road. But if your acne gets worse or lasts more than a couple of weeks, see a dermatologist. Here’s a quick listing of the most common products used to treat acne — click on the links that interest you for more information on that course of treatment.

• Benzoyl Peroxide: Kills the bacteria that causes acne.

• Proactiv® Solution: A dermatologist formulated Combination Therapy® acne management system. Click Here and receive 2 free bonuses when you try Proactiv® Solution Risk-Free for 60 Days!

• Salicylic Acid: Unclogs your pores and encourages skin renewal.

• Tretinoin (Retin-A®): Promotes healthy sloughing.

• Antibiotics: Kill bacteria and reduces inflammation.

• Oral Contraceptives: Help regulate hormone levels.

• Anti-Androgens: Inhibit the body’s production of acne-causing hormones.

• Isotretinoin (Accutane®): Treatment for severe cystic or nodular acne.

Relax — it’s not your fault. The most important thing to remember about acne is that it’s not your fault. You didn’t make your face break out by eating too many french fries, wearing make-up or daydreaming about your crush. Now you know a few of the things that can aggravate acne in teenagers. But since acne is different for everyone, you should watch your own skin carefully for things that trigger breakouts — and avoid them. If your acne still hangs around, see a doctor.

Kerwin Chang writes for http://www.acnestuff.net where you can find out more about acne and other skin care topics.

Part Two – Causes, and Natural Prevention

Who Gets Acne? Nearly 50% of adults and more than 90% of all adolescents are affected by acne. No wonder people are concerned because it is one of the most wide spread medical conditions in the world.

Causes of Acne

The condition – Acne – is influenced by a variety of factors, many of them are simplely out of your control. There is no one cause of acne.

Acne usually begins at puberty, in both males and females, when the body begins to produce male hormones called androgens. These hormones cause the sebaceous glands to enlarge – a natural process of the body’s development. With acne sufferers, the sebaceous glands are over stimulated by androgens – often continuing well into adulthood.

When the sebaceous glands are stimulated by androgens, it produces extra sebum. During the journey up the hair follicle pore to the skin’s surface, sebum mixes with natural skin bacteria and dead skin cells that have been shed from the lining of the hair follicle. This process is normal, but the presence of the extra sebum in the pore increases the chances of clogging and can cause acnr.

On your face there can be as many as 500,000 bacteria per square centimeter. This bacteria is present in all skin types and is part of the skin’s natural environment. Once the pore is plugged however, the bacteria can multiply quickly in a closed space which fosters the development of acne.

The body sends white blood cells to attack the unwanted bacteria. This process is called chemotaxis. It results in pimples that become red, swollen, and painful.

Pollution has been proven to be one of the major causes of acne. This is because particles that become trapped in pores will block the pores and the result will in most cases be infections.

Prevention

There are lots of ways to control acne. Cleanse your skin up to three times a day with products containing the mangosteen fruit that will not strip your skin of all its natural oils but will stimulate skin turnover and exfoliation. Change your pillow cases and bed sheets often. The buildup of dirt on your face after a long day adds to the toxins on your face. Also the moisture from sweaty or wet cloths can irritate your skin and cause blemishes. Many don’t realize that some of the acne on other areas of the body are worse than the arne on your face.

The sun is not a cure for acne as believed by many people. Small amounts of UV light are essential for skin health, but getting a tan can cause unbalanced skin cell shedding which causes even more acne to appear and it can easily out weigh the benefits of UV light. Cosmetics are another common cause of acne. A lot of the products not only contain dangerous toxins but they plug the pores and most cleaning products are unable to remove the pore plugging debris of the makeup. Smoking is also harmful because it reduces collagen in your skin, this makes acne wore and scaring more likely.

Treatment

The first step is to cleanse the skin with natural plant compounds which stimulate skin growth and help exfoliate old cells. If you have particularly oily skin you may need to cleanse three times a day (morning, afternoon and bedtime).

Using liquid compounds capable of penetrating deep into the pores of the skin to dissolve sebum and dislodge debris is the next step. A product having the mangosteen fruit as a main ingredient will have remarkable natural antibiotic compounds which have been laboratory tested and proven to control p-acne and staphylococcus aureus, – the two bacterial strains known to be involved with acne.

Also products with the mangosteen fruit contain large quantities of anti inflammatory phytochemicals which reduce the severity of acne skin lesions. If these phytochemicals can remain on the face over night in the form of a moisturizer it can be a further benefit. If possible acne sufferers should use a gel moisturizer and not a creamy moisturizer since the high secretion of sebum which is a natural moisturizer may be sufficient.

Conclusion

Acne can be very emotionally and socially damaging whether it is confined to adolescence or continues through adulthood. Studies have shown acne can leave people to feel ugly, dirty, angry and depressed.

Fortunately you do not have to live with acne. There is always something you can do to help the health of your skin. One of the newest plants to be incorporated into skin care products is the mangosteen. The mangosteen fruit has been shown to exhibit anti inflammatory properties, anti bacterial properties and is a potent anti oxidant which are ideal properties to have in the prevention of acne.

Acne Scarring

A detailed and comprehensive discussion of acne scars starts with causes of scarring, prevention of scarring, types of scars, and treatments for scars.

Before talking about scars, a word about spots that may look like scars but are not scars in the sense that a permanent change has occurred. Even though they are not true scars and disappear in time, they are visible and can cause embarrassment.

Macules or “pseudo-scars” are flat, red or reddish spots that are the final stage of most inflamed acne lesions. After an inflamed acne lesion flattens, a macule may remain to “mark the spot” for up to 6 months. When the macule eventually disappears, no trace of it will remain—unlike a scar.

Post-inflammatory pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people, but occasionally is seen in people with white skin. Early treatment by a dermatologist may minimize the development of post-inflammatory pigmentation. Some post-inflammatory pigmentation may persist for up to 18 months, especially with excessive sun exposure. Chemical peeling may hasten the disappearance of post-inflammatory pigmentation.

Causes of Acne Scars

In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair. In the case of acne, the injury is caused by the body’s inflammatory response to sebum, bacteria and dead cells in the plugged sebaceous follicle. Two types of true scars exist, as discussed later: (1) depressed areas such as ice-pick scars, and (2) raised thickened tissue such as keloids.

When tissue suffers an injury, the body rushes its repair kit to the injury site. Among the elements of the repair kit are white blood cells and an array of inflammatory molecules that have the task of repairing tissue and fighting infection. However, when their job is done they may leave a somewhat messy repair site in the form of fibrous scar tissue, or eroded tissue.

White blood cells and inflammatory molecules may remain at the site of an active acne lesion for days or even weeks. In people who are susceptible to scarring, the result may be an acne scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others. Scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin. But, scarring also may arise from more superficial inflamed lesions. Nodulocystic acne that is most likely to result in scars is seen in these photos:

(Photos used with permission of the American Academy of Dermatology

National Library of Dermatologic Teaching Slides)

The life history of scars also is not well understood. Some people bear their acne scars for a lifetime with little change in the scars, but in other people the skin undergoes some degree of remodeling and acne scars diminish in size.

People also have differing feelings about acne scars. Scars of more or less the same size that may be psychologically distressing to one person may be accepted by another person as “not too bad.” The person who is distressed by scars is more likely to seek treatment to moderate or remove the scars.

Prevention of Acne Scars

As discussed in the previous section on Causes of Acne Scars, the occurrence of scarring is different in different people. It is difficult to predict who will scar, how extensive or deep scars will be, and how long scars will persist. It is also difficult to predict how successfully scars can be prevented by effective acne treatment.

Nevertheless, the only sure method of preventing or limiting the extent of scars is to treat acne early in its course, and as long as necessary. The more that inflammation can be prevented or moderated, the more likely it is that scars can be prevented. (Click on Acne Treatments for more information about treatment of mild, moderate and severe acne). Any person with acne who has a known tendency to scar should be under the care of a dermatologist. (Click on Find a Dermatologist to locate a dermatologist in your geographic area).

Types of Acne Scars

There are two general types of acne scars, defined by tissue response to inflammation: (1) scars caused by increased tissue formation, and (2) scars caused by loss of tissue.

Scars Caused by Increased Tissue Formation

The scars caused by increased tissue formation are called keloids or hypertrophic scars. The word hypertrophy means “enlargement” or “overgrowth.” Both hypertrophic and keloid scars are associated with excessive amounts of the cell substance collagen. Overproduction of collagen is a response of skin cells to injury. The excess collagen becomes piled up in fibrous masses, resulting in a characteristic firm, smooth, usually irregularly-shaped scar. The photo shows a typical severe acne keloid:

(Photo used with permission of the American Academy of Dermatology

National Library of Dermatologic Teaching Slides)

The typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter, but some may be 1 centimeter or larger. Keloid scars tend to “run in families”—that is, abnormal growth of scar tissue is more likely to occur in susceptible people, who often are people with relatives who have similar types of scars.

Hypertrophic and keloid scars persist for years, but may diminish in size over time.

Scars Caused by Loss of Tissue

Acne scars associated with loss of tissue—similar to scars that result from chicken pox—are more common than keloids and hypertrophic scars. Scars associated with loss of tissue are:

Ice-pick scars usually occur on the cheek. They are usually small, with a somewhat jagged edge and steep sides—like wounds from an ice pick. Ice-pick scars may be shallow or deep, and may be hard or soft to the touch. Soft scars can be improved by stretching the skin; hard ice-pick scars cannot be stretched out.

Depressed fibrotic scars are usually quite large, with sharp edges and steep sides. The base of these scars is firm to the touch. Ice-pick scars may evolve into depressed fibrotic scars over time.

Soft scars, superficial or deep are soft to the touch. They have gently sloping rolled edges that merge with normal skin. They are usually small, and either circular or linear in shape.

Atrophic macules are usually fairly small when they occur on the face, but may be a centimeter or larger on the body. They are soft, often with a slightly wrinkled base, and may be bluish in appearance due to blood vessels lying just under the scar. Over time, these scars change from bluish to ivory white in color in white-skinned people, and become much less obvious.

Follicular macular atrophy is more likely to occur on the chest or back of a person with acne. These are small, white, soft lesions, often barely raised above the surface of the skin—somewhat like whiteheads that didn’t fully develop. This condition is sometimes also called “perifollicular elastolysis.” The lesions may persist for months to years.

Treatments for Acne Scars

A number of treatments are available for acne scars through dermatologic surgery. The type of treatment selected should be the one that is best for you in terms of your type of skin, the cost, what you want the treatment to accomplish, and the possibility that some types of treatment may result in more scarring if you are very susceptible to scar formation.

A decision to seek dermatologic surgical treatment for acne scars also depends on:

* The way you feel about scars. Do acne scars psychologically or emotionally affect your life? Are you willing to “live with your scars” and wait for them to fade over time? These are personal decisions only you can make.

* The severity of your scars. Is scarring substantially disfiguring, even by objective assessment?

* A dermatologist’s expert opinion as to whether scar treatment is justified in your particular case, and what scar treatment will be most effective for you.

Before committing to treatment of acne scars, you should have a frank discussion with your dermatologist regarding those questions, and any others you feel are important. You need to tell the dermatologist how you feel about your scars. The dermatologist needs to conduct a full examination and determine whether treatment can, or should, be undertaken.

The objective of scar treatment is to give the skin a more acceptable physical appearance. Total restoration of the skin, to the way it looked before you had acne, is often not possible, but scar treatment does usually improve the appearance of your skin.

The scar treatments that are currently available include:

Collagen injection. Collagen, a normal substance of the body, is injected under the skin to “stretch” and “fill out” certain types of superficial and deep soft scars. Collagen treatment usually does not work as well for ice-pick scars and keloids. Collagen derived from cows or other non-human sources cannot be used in people with autoimmune diseases. Human collagen or fascia is helpful for those allergic to cow-derived collagen. Cosmetic benefit from collagen injection usually lasts 3 to 6 months. Additional collagen injections to maintain
the cosmetic benefit are done at additional cost.

Autologous fat transfer. Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to elevate depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring from nodulocystic acne. Because the fat is reabsorbed into the skin over a period of 6 to 18 months, the procedure usually must be repeated. Longer lasting results may be achieved with multiple fat-transfer procedures.

Dermabrasion. This is thought to be the most effective treatment for acne scars. Under local anesthetic, a high-speed brush or fraise used to remove surface skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; for example, it may make ice-pick scars more noticeable if the scars are wider under the skin than at the surface. In darker-skinned people, dermabrasion may cause changes in pigmentation that require additional treatment.

Microdermabrasion. This new technique is a surface form of dermabrasion. Rather than a high-speed brush, microdermabrasion uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. Only the very surface cells of the skin are removed, so no additional wound is created. Multiple procedures are often required but scars may not be significantly improved.

Laser Treatment. Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions. The type of laser used is determined by the results that the laser treatment aims to accomplish. Tissue may actually be removed with more powerful instruments such as the carbon dioxide laser. In some cases, a single treatment is all that will be necessary to achieve permanent results. Because the skin absorbs powerful bursts of energy from the laser, there may be post-treatment redness for several months.

Skin Surgery. Some ice-pick scars may be removed by “punch” excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus elevating a depressed scar.

Skin grafting may be necessary under certain conditions—for example, sometimes dermabrasion unroofs massive and extensive tunnels (also called sinus tracts) caused by inflammatory reaction to sebum and bacteria in sebaceous follicles. Skin grafting may be needed to close the defect of the unroofed sinus tracts.

Treatment of keloids. Surgical removal is seldom if ever used to treat keloids. A person whose skin has a tendency to form keloids from acne damage may also form keloids in response to skin surgery. Sometimes keloids are treated by injecting steroid drugs into the skin around the keloid. Topical retinoic acid may be applied directly on the keloid. In some cases the best treatment for keloids in a highly susceptible person is no treatment at all.

In summary, acne scars are caused by the body’s inflammatory response to acne lesions. The best way to prevent scars is to treat acne early, and as long as necessary. If scars form, a number of effective treatments are available. Dermatologic surgery treatments should be discussed with a dermatologist.