High Life: A WEEKLY FORUM FOR HIGH SCHOOL STUDENTS : Facing Facts on Woes of Teen Acne

Acne, the bane of many teen-agers, responds to a number of face-saving treatments. It begins with a small change in the way the skin works, marked by the development of a comedo, better known as a blackhead or a whitehead.

By the time it can be seen by the naked eye, it is well enough along in its course to merit concern. Comedones--especially whiteheads--can eventually become inflamed and turn into pimples, or even painful cysts.

When a blackhead or a whitehead appears on the skin, its presence points to a blockage in a small hair-containing gland of the skin.

There are millions of these small glandular structures all over the body, but they are highly concentrated around the face, chest and back.

The gland secretes an oily material known as sebum through the opening of the hair follicle onto the surface of the skin.

When this gland is totally blocked, the result is a whitehead or closed comedo. If the tiny exit of the gland remains slightly open, it leaves a blackhead in its wake. Blackheads usually don’t become inflamed.

There’s a tendency to associate blackheads with dirt and acne with diet, but neither of these associations is true.

A blackhead is thought to be either sebaceous material that turns dark when exposed to oxygen, or melanin, the pigment that imparts color to each person’s skin.

And diet has nothing to do with blackheads, whiteheads or inflammatory acne.

Normally, the skin constantly sheds cells that flake off without notice. But researchers believe that this shedding process is defective in acne and that instead of flaking off, the skin cells remain around the sebaceous glands and allow oily material to accumulate inside, creating a situation that leads to acne.

Further compounding the problem is the possible presence of bacteria that dwell inside the oil-producing glands.

The combination of blocked glands, the buildup of oily material and bacteria inside the sebaceous gland can work together to produce some degree of acne.

In teen-agers and adolescents, acne is often brought on by hormonal changes during puberty. The condition affects young women more commonly but tends to be more severe in men.

For the most part, acne appears, runs its course, and then clears up. But sometimes, the problem persists into adulthood.

Depending on the type of acne and its severity, there are many different treatments available.

Blackheads and whiteheads can be removed by a dermatologist.

A medical evaluation can determine which over-the-counter topical or prescription medication would be best for acne.

There are topical antibiotics to help decrease inflammation, and oral antibiotics may be prescribed for some people with acne. There also are medications that help prevent new comedones from forming.

The proper treatment of acne not only improves the condition, but also helps prevent scarring.

To keep blackheads, whiteheads, and the pimples of inflammatory acne from getting worse, don’t manipulate or squeeze them. People who pick at their faces run the risk of making acne worse by causing even more inflammation and permanent scarring.

--Dr. Seth Orlow, assistant professor of dermatology and pediatrics, New York University Medical Center

“A man in love mistakes a pimple for a dimple.”

--Japanese proverb