Acne is so common among teenagers—about 80 percent of young men and women develop pimples, half of them severe enough to require physician treatment—it is considered a natural rite of passage. Adolescents get acne because hormones called androgens, which increase the amount of oil the skin produces, circulate at higher levels in their blood.
Yet teenagers aren't the only ones plagued by nasty skin eruptions. Acne can also bedevil women in the midst of hormone changes triggered by menstruation, birth control pills, pregnancy, even early menopause.
"Women can have flare-ups at 25 or 35 years old and even older," says James E. Fulton Jr., M.D., Ph.D. "In fact, my mother was still breaking out when she was 62."
Acne is really a catchall term for a variety of symptoms, including pimples, whiteheads, blackheads, and skin cysts, says Peter E. Pochi, M.D. "It's a condition where the pores of the skin become clogged and you get inflamed and noninflamed lesions."
Contrary to popular misconceptions, chocolate and dirty hair or skin do not cause acne outbreaks. Usually, it's hereditary, says Dr. Fulton.
If both of your parents had acne, three out of four of your brothers and sisters will also get it. But if your sister is pimple-free while your face is a war zone, it's because other factors can aggravate an acne outbreak, says Dr. Fulton, including stress, sun exposure, seasonal changes, and climate. Certain types of makeup, as well as oral contraceptives, can also cause breakouts.
"Working women are especially vulnerable," adds Dr. Fulton. They're prone to lots of stress, plus they tend to wear more makeup than non-working women.
Here's some advice to help you become blemish-free.
No doubt that a huge pimple on the end of your nose can make you feel like Rudolph. But acne can get much more serious than a simple blemish.
Acne is classified in four grades, the first being a mild bout, with a few whiteheads and blackheads. At the other end of the spectrum, grade four cases are often accompanied by severe inflammation that becomes red or purple. Consider it a flashing light to see a dermatologist.
Severe acne can result in permanent scarring if it isn't treated properly, says Peter E. Pochi, M.D. A dermatologist can offer prescription medications that will take care of severe acne very well, including topical creams, gels, or lotions with vitamin A or benzoyl peroxide to help unblock the pores and reduce bacteria.
James E. Fulton, M.D., Ph.D., is a dermatologist and founder of the Acne Research Institute in Newport Beach, California. He is also co-author of Dr. Fulton's Step-by-Step Program for Clearing Acne and codiscoverer of Retin-A (synthetic vitamin A), a prescription drug used to treat a variety of skin problems.
Thomas Gossel, Ph.D., R.Ph., was formerly a professor of pharmacology and toxicology at Ohio Northern University in Ada. He is an expert on over-the-counter drugs.
Peter E. Pochi, M.D., is a professor emeritus of dermatology at Boston University School of Medicine.
Maurice Stein is a cosmetologist and Hollywood makeup artist who has worked on more than 200 film and television projects. He is the owner of Cinema Secrets, a full-service beauty supplier for the public and a theatrical beauty supplier for the entertainment industry in Burbank, California.
"When I cover a pimple on an entertainer's face, I use two thin layers of foundation with a layer of loose translucent powder between each layer," Stein says. This helps set each layer.