Acne
Acne may seem like a minor ailment on the surface, but it can have a considerable impact on adolescents. This includes poor self-esteem, scarring, and skin infections from picking at it. Often we find that teens are too stoic to admit that it bothers them, but don't be fooled; it usually does.
Acne is caused by accumulation of sebum (skin oil) and cells in pores. Puberty (specifically the hormones produced during puberty) causes increased pore activity, increased sebum production, and clogged pores. Bacteria (p.acnes) invade these pores and cause an inflammatory reaction, hence the "zit". Chocolate, greasy foods, inadequate face washing, and all the other commonly heard explanations are NOT causes of acne, nor do they make acne worse.
There are excellent topical and oral prescription medications available for acne withproven effectiveness. Most have antibiotic properties that kill p.acnes. Some reduce pore clogging. Which medication we give depends on the type and severity of acne. A female with menstrual irregularities and unwanted body hair may benefit from oral contraceptives for acne treatment. Accutane® is indicated for only the most severe acne due to its potential for severe side effects and risk of damage to a fetus. Generally a patient who needs to be on Accutane® should be under the care of a dermatologist.
Over-the counter benzoyl peroxide products (e.g. Clearasil®) may help with mild acne, and are worth a trial in such cases.
It is important for people to realize that no acne medication works its magic overnight. This misconception probably comes from those misleading acne commercials where the pretty girl gets rid of the zit just in time for prom the next night. Generally you will see improvement in 2-3 months, so do not give up on the medications early. Use them consistently.
One note on Proactive® and herbal remedies. As opposed to the above-mentioned prescription medications, there are no good studies demonstrating the effectiveness of Proactive® and herbal remedies.