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Send zits packing

Acne is the unwelcome cousin of adolescence that can hang around into adulthood, but dealing with it can be daunting with so man

Acne is the unwelcome cousin of adolescence that can hang around into adulthood, but dealing with it can be daunting with so man

March 02, 2004|by ANDREA ROWLAND

andrear@herald-mail.com

Here's the bad news: You can wash your face five times a day and still get acne. You can avoid fried foods and still end up with zits. You can drink eight glasses of water a day and still have bumpy skin.

The good news is that you aren't alone - acne is a normal byproduct of adolescence and a skin disorder that also can affect adults. It's also a treatable condition that you'll likely be able to control by following a few simple guidelines.

About 45 million young adults between the ages of 12 and 24 have acne, said dermatologist Audrey Kunin, founder and president of DERMA

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doctor.com. She said a strong genetic predisposition is the source of most acne, exacerbated by hormonal changes and stress.

Male hormones - which are more plentiful in boys but present in girls as well - go nuts during puberty. These hormones - called androgens - stimulate and enlarge the oil glands in the skin, which produces an oily substance called sebum. The oil, or sebaceous, glands are connected to follicles, the canals that hold hair. Sebum makes its way to the skin through follicle openings, called pores. The oil causes the cells lining follicles to shed more quickly, stick together and clog pores - resulting in inflammation and acne.

Acne can take the form of red, raised lumps on the skin, plugged pores known as blackheads and whiteheads, and larger, pus-filled sacs called nodules and cysts. Nodulocystic acne is the most serious form, said dermatologist Ella L. Toombs, medical director of Aesthetic Dermatology of Dupont Circle in Washington, D.C.

It's most common for teens to find their faces infiltrated by a mix of acne lesions, the dermatologist said. No matter what type of zit pops up, don't squeeze it.

"That is the worst thing, in fact, they can do," Toombs said.

Squeezing zits can force infected material deeper into the skin, causing additional inflammation and possible scarring. Picking at whiteheads and blackheads can cause "icepick" scars, Hagerstown dermatologist James A. Schiro said.

"Most kids will scar with surface-type acnes because they pick," he said.

Deeper acne scars - which resemble craters in the skin - are caused by the body's inflammatory response to sebum, bacteria and dead cells in the plugged sebaceous follicle. White blood cells try to remedy infection by leaking enzymes into the skin at the site of nodular cystic acne. Those enzymes actually digest skin, sometimes leaving depressed areas, or scars, Schiro said. It is hard to predict who will scar, how extensive or deep scars will be, and how long scars will persist, according to information from the American Academy of Dermatology's AcneNet Web site at www.skincarephysicians.com on the Web. The only foolproof way to prevent or limit scars is to treat acne early in its course, and as long as necessary, Schiro added.

Scrubbing at zits also can make acne worse, Toombs said. It's best to use your hands, not a washcloth, to gently clean your face with mild soap and water. Another important way for acne-prone individuals to rein in the disorder is to avoid cosmetics and skin-care products that contain oils, Toombs said.

"You have to be a more discriminating consumer," she said. "Read ingredient labels carefully ... If it shines when you put it on the back of your hand, certainly it contains oil."

Look for products labeled "noncomedogenic," Kunin added. Heavy skin-care products, such as cocoa butter, are notorious for clogging pores and causing acne. Hairstyling products, such as hairspray and gels, applied too close to the forehead also can trigger zits, she said.

"Throughout the day these have an amazing way of finding their way to the face despite your best efforts, so do avoid product use on the bangs if at all possible, wash your hands - which carry product to the face due to unconscious touching of hair, and wash your face three times daily," Kunin said.

Local drugstores contain plenty of acne-fighting creams and cleansers. Over-the-counter topical preparations include either benzoyl peroxide, salicylic acid or some form of sulfur. Toombs suggested trying a combination of products - cleansers and lotions, to find the best remedy for acne without a prescription. Moisturizing cleansers without oil can help combat the skin-drying effects of most acne treatments, she said. Give over-the-counter acne medications a few months to work; see a doctor if your acne does not respond to such treatments within a reasonable amount of time, Toombs added.

Individuals with cystic acne should visit a dermatologist early, experts said. Kunin recommended making that appointment when more than five cysts are present at the same time.

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