While acne may be a rite of passage for most teenagers, knowing that fact certainly doesn’t make it any easier to deal with. In the past, however, it used to be an unavoidable scourge. Now there are many treatments available to help your teen get clearer skin and maintain a positive self-image.

Being a teenager with pimples, that was bad. I knew I wasn’t popular. I knew I wasn’t attractive to girls. There was a lot of anger and humiliation. I wanted to avoid social activities and stay home and hide. But I went out anyway. I had to get over myself. I had to put myself out there, pimples and all. One of the things I did was volunteer at the animal shelter. The animals didn’t care how I looked. They licked my face, welts and Page 66

It is clear that people with acne face many challenges. But by dealing with emotional issues and carefully protecting and caring for their skin, they can meet these challenges and live happy, productive lives.

Hot, humid environments, which cause people to perspire excessively, also exacerbate acne symptoms by causing perspiration that traps bacteria on the skin. Indeed, many acne patients report increased acne outbreaks when they travel to hot, humid places on vacation. Consequently, they often choose to vacation in cooler, drier environments. Many people with acne who live in hot, humid environments try to stay indoors in an air-conditioned environment as much as possible. When they do go outdoors, they take special care to remove excess perspiration from their skin as quickly as possible.

Sunlight can also cause problems for people with acne. Although sunlight helps dry out oily skin, for patients who are using Accutane, antibiotics, or retinoids, exposure to sunlight can be dangerous. Many acne medicines cause photosensitivity, which makes the skin burn easily when it is exposed to sunlight. Therefore, many people with acne avoid exposure to sunlight.

Just as touching the face can worsen acne symptoms, so can using makeup that contains oil. Lanolin, petroleum jelly, and other oils in oil-based makeup can clog the pores, causing acne outbreaks. Even lipsticks with moisturizers and hair products such as gel and mousse can clog the pores along the lip line and forehead, respectively. Since many people with acne use cosmetics to conceal acne lesions, the oil in these products can be a problem. Therefore, in an effort to hide acne blemishes without worsening their acne, many acne patients use specially labeled, water-based, noncomedogenic makeup. Unlike oil-based makeup, such makeup does not clog the pores. And, in order to keep from spreading oil and bacteria, acne patients should wash their makeup brushes and sponges often.

Unfortunately, even noncomedogenic products sometimes contain a small amount of oil that makes the product easier to apply. This can aggravate acne outbreaks in some patients. In order to test how much oil is in a product, many acne patients place a dab of makeup on a piece of white paper and wait to see if an oil ring forms. The larger the oil ring, the more oil in the product. Many acne patients report being surprised by the size of the oil ring that many popular cosmetics form. But by doing the test, acne patients learn which products they should avoid.

When patients switch from oil-based cosmetics to water-based products, they are usually quite happy with the results. They report water-based cosmetics work well at concealing their complexion flaws and cause fewer acne outbreaks. Beauty and skin care expert Bobbi Brown agrees. “Don’t even think of wearing anything except an oil-free [makeup] formula,”⁵¹ she advises her clients with acne.

When acne lesions are squeezed, some oil and pus can be squeezed out. But at the same time, squeezing an acne lesion puts pressure on both the surface of the skin and the underlying layers. This pressure forces oil and bacteria deeper into the skin, leading to the formation of painful cysts. Moreover, squeezing the skin causes the skin to swell. Swelling puts pressure on the upper part of the hair follicles, which leads to the follicle becoming inflamed and the formation of new acne lesions.

Worse still, squeezing acne lesions damages skin tissue, and in the case of cysts, causes them to break and bleed. The result is a scar that forms where the skin tissue was damaged or the cyst was broken. Los Angeles skin care expert Arcona Devan warns her clients: “Don’t pick at your skin. It’s one of the worst things you can do. Squeezing blemishes injures your skin and can create scars.”

Although specific foods have not been proven to cause acne, many scientists believe that certain foods may worsen acne symptoms. For instance, eating a diet high in linoleic acid, a fatty acid found in many fast foods and processed foods such as potato chips and donuts, may trigger the production of chemicals in the body that worsen inflammation. For this reason, people with acne are urged to limit their consumption of foods high in linoleic acid.

In addition, scientists have also linked foods high in iodine with increased acne outbreaks. For reasons that are yet unknown, the body cannot use excess iodine for energy. Nor can iodine be broken down effectively by the liver. Instead, it is excreted through the pores, where it can block hair follicles and cause irritation, inflammation, and worsening of acne symptoms.

Foods high in iodine include iodized salt, shellfish, and milk. In fact, a liter of milk contains anywhere from 450 to 1,000 micrograms of iodine, which gets into the milk through milking equipment and medication given to cows. According to Dr. James Fulton, the head of the Acne Research Institute in Newport Beach, California, “In some who are acne-prone, I’d say 1,000 micrograms or 1 milligram of iodine a day could be a problem.”⁴⁸ Therefore, in order to reduce acne outbreaks, many people with acne avoid foods rich in iodine.

As beneficial as exercise is, people with acne must take special care after they exercise to remove excess perspiration from their skin in order to prevent acne outbreaks. The reason for this is that perspiration can trap bacteria on the skin. If it is not washed off, the bacteria will eventually get trapped in hair follicles and aggravate acne symptoms. Tight-fitting athletic clothing can trap perspiration and rub and chafe the skin, which irritates and inflames acne lesions. Such garments as sweatbands, bicycle shorts, chin guards, and shoulder pads, to name a few, can exacerbate acne symptoms. Therefore, people with acne must take special care when they wear these types of garments and shower immediately after exercising to remove perspiration from their bodies.

In addition, a 2003 study conducted by the Endocrine Society in Chevy Chase, Maryland, found that a loss of just two hours of sleep per week increases the body’s production of inflammation-causing chemicals by 60 percent. The result is a worsening of inflammatory acne. A former acne patient describes how lack of sleep affected his skin: “When I pulled an all-nighter my face erupted like a volcano; and not with little blackheads either, but with big red welts. As a teenager with acne I needed to get at least eight hours of sleep a night.”

While getting adequate sleep is important, acne outbreaks can be exacerbated if the bedding on which acne patients sleep is not Page 58 changed often. When people sleep, oil, bacteria, and dead skin cells rub off their skin and accumulate on their bedding. The bedding absorbs these items, which then find their way back onto the skin, clogging the pores and causing new acne outbreaks. Therefore, it is important that people with acne change their sheets and pillowcases often. An acne patients explains: “I have found that changing my bedding, especially my pillowcase, every few days has helped my skin stay clear.”

Water carries waste material out of the body. This includes harmful chemicals, fats, and excess hormones. Without adequate water, the kidneys cannot produce enough urine to flush out wastes. Therefore, impurities that cannot be eliminated through urination are eliminated through the skin. This can cause toxins to build up in the pores, worsening acne outbreaks. In addition, without adequate water the liver, whose job it is to clear excess hormones out of the body, cannot function properly. As a result, excess hormones remain inside the body, where they stimulate the production of sebum and worsen acne. According to author and skin care expert Jennifer Thoden:

Water… is quite possibly the single most important contributor to healing and preventing acne flare-ups.… If not enough water is consumed, toxins can build up causing breakouts. Water flushes these toxins out.… By drinking at least 8 glasses of water a day, you are flushing out the toxins that would normally escape through the pores of your skin… thus preventing acne breakouts.