ACNE – commonly called zits, is so common that, among 16- to 17-year-olds, it affects more than 95% of boys and up to 87% of girls. By age 23-25, it has usually disappeared. It occurs in areas where there are lots of oil-producing glands, usually on the face, but it can also affect the shoulders, chest and back. It results in red, raised pimples, pustules and larger nodules, and blackheads, whiteheads and larger cysts.

Acne seems to run in families and is caused when dead skin cells and sebum, the oily secretion that normally keeps the skin supple and healthy, block the opening of the oil glands in the skin. Excessive sweating can make acne worse, as can certain drugs such as corticosteroids and oral contraceptives, face creams and oily cosmetics.

There is no guaranteed cure, but treatments can control it effectively, and early treatment
helps prevent scarring. Long term maintenance therapy may be required. If your acne is
severe or doesn’t respond to treatment, your doctor may refer you to a dermatologist.
Acne pimples may seem to pop up overnight but, in fact, they take up to two to three months
to form, so any treatment must be used for at least that long. Washing twice daily can help.
People with acne should opt for products usually marketed as ‘oil-free’ or ‘non-comedogenic’
that don’t clog the pores. Any cleansers used should me mild and any sunscreens oil-free.

External treatments include lotions, creams and gels that contain benzoyl peroxide, salicylic
acid, alpha hydroxy acids, azelaic acid or prescription retinoids (from Vitamin A), including
tretinoin, isotretinoin and adapalene. These aim to unblock pores, remove sebum and return
skin cell growth to normal. Topical antiseptics and antibiotics can reduce any inflammation.
For more resistant or severe acne, oral antibiotics may be prescribed.

Hormone therapy is often used effectively in women because certain contraceptive pills
improve acne. For severe cystic acne, (a painful and disfiguring condition), dermatologists
may prescribe a form of Vitamin A called oral isotretinoin, marketed as Accutane or Roaccutane,
which can be highly effective. A dermatologist will recommend moisturising creams and other
products to control side effects. (Women must not be pregnant or become pregnant when
taking isotretinoin because of the risk of birth defects.)

Most acne scarring improves with time but, as some people age, it can become more noticeable.
Surface scars can be treated with resurfacing via dermabrasion, lasers or chemical peels. Deeper
scarring may be treated by the implanting of collagen or other fillers.

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