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Acne 101: Tackling troubled teen skin

Most of us are hit with zits at some time in our lives. Blemishes and acne can pop up on our face, neck, back, chest and shoulders. It isn’t a serious health risk, but severe cases can cause permanent scarring on the outside — and inside.

Woman washing her face

Battling chronic acne can lead to emotional stress, particularly in adolescents who already face the turmoil of physical and psychological changes. The stress of acne can lead to poor self-image, social inhibition and anxiety.

Types of acne

Acne can occur in the following forms:

  • Comedones: Non-inflammatory papules that can be open (blackheads) or closed (whiteheads).
  • Whiteheads: White dots that are pores impacted with oil and covered by skin layers.
  • Blackheads: Black bumps that are impacted pores in which material pushes out through the follicles. The black color is not from dirt. It may be from bacteria and matter that reacts with oxygen.
  • Papules: Lesions that are inflamed and can be tender to the touch. These usually appear as small, pink bumps on the skin.
  • Pustules: Lesions that are inflamed and filled with pus. They may be red at the base.
  • Nodules: Solid lesions that are large, painful and lodged deep within the skin. Papules, pustules or nodules are more serious lesions appearing red and swollen due to inflammation or infection of the tissue around the clogged follicles.
  • Cysts: Pus-filled lesions deep under the skin. These may cause scarring and pain.

What causes acne?

Several key factors contribute to acne development.

Hormones: Androgens elevate during puberty causing sebaceous glands to get larger and produce more sebum. Hormonal changes also occur during pregnancy or after starting or stopping birth control pills. Hormones affect the skin’s oil glands (sebaceous glands) which create sebum, an oily substance that spills onto the skin through hair follicle openings (pores). The blend of oil and cells allows bacteria that normally live on the skin to grow in the follicle openings. As a result, the pores become clogged and pimples develop.

Genetics: Researchers believe that there may be a genetic predisposition to developing acne, inherited from parents. This doesn’t mean a teenager is destined to repeat their parents’ acne misery, but they may be more likely to have issues with problem skin.

Medications: Some drugs — anti-epilepsy medication, prednisone, androgens and lithium, for example — can cause acne, even in adults.

Cosmetics: Anything with a greasy consistency can change the cells of the follicles, causing them to stick together which results in a plugged pore. Water-based products are less likely to cause acne.

Stress: High levels of stress can be rough on your skin. CRH (Corticotropin-Releasing Hormone) is released into the blood from the brain during times of stress and creates cortisol (stress hormone) that causes oil glands to produce more oil — which leads to pores getting blocked. Deep breathing, exercise, joining a teen support group or talking to parents, clergy or a trusted counselor can all help teens deal with stress.

Friction: Irritation of your skin caused by leaning on or rubbing the skin, or even harsh scrubbing, may cause acne. Bike helmets, backpacks or tight collars can also irritate the skin and lead to a breakout.

Next up:  Acne treatments and prevention

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