Acne is a rite of passage for teenagers, experienced by just about all of them, as well as adults into their 40s and 50s. In fact, the American Academy of Dermatology says every teenager will develop at least a few pimples by the age of 17. For some, this is rare and short-lived, but 85 percent of adolescents have full-blown acne, and a little under half of them—40 percent of all teens—have such severe acne as to merit medical intervention.
The hormonal changes of puberty produce the oils that, combined with the dirt, cause breakouts. Adolescence is when the sebaceous glands on the skin expand and produce more of what is called sebum, which keeps the skin from trying out. It is this sebum, combined with the dirt, that gets into the pores and causes breakouts and acne. Oral contraceptives can also contribute—possibly leading to a vicious cycle in women taking certain acne medications which can cause severe birth defects, and which are recommended to be prescribed with contraception. Corticosteroids and lithium—the latter of which is prescribed for bipolar disorder—are sometimes also factors. In addition, frequent or excessive use of cosmetics is associated with acne breakouts.
Merely dirty skin, on the other hand, is not. While gentle cleaning can prevent acne from occurring, harsh scrubbing will only make it worse, by irritating the skin and drying it, triggering the production of more sebum. Oil on the face is connected with zits, but dirt on the face is not. The idea that greasy or fatty foods lead to pimples is also wrong; while diet can play a part, it is dairy products and carb-heavy foods such as bread products that should be eaten in moderation.
Usually, over-the-counter creams and other topical treatments are enough to keep blemishes at bay. These products often contain benzoyl peroxide, salicylic acid, or similar ingredients. A paste made from crushed aspirin tablets—also a form of salicylic acid—can also help. If needed, there are stronger topical products available by prescription which use derivatives of vitamin A to keep the pores open. Topical antibiotics can also help get rid of bacteria that make blemishes and whiteheads worse. In severe cases isotretinoin may be prescribed, though it has serious side effects. As mentioned, it can cause birth defects, and it is also linked with higher rates of depression. Hormonal contraceptives, while they can exacerbate acne in some cases, can clear it up in others.