Growing up has its benefits. As we move past our teenage years, we gain autonomy, confidence and liberation from the throes of unsightly orthodontics and parentally induced embarrassment. Unfortunately for some, reminders of our teenage years can linger with us well into adulthood. And I'm not just talking about that ratty Hootie & the Blowfish T-shirt in the back of your closet (let it go!). Acne can be an embarrassing and debilitating problem, especially when you feel like you should have outgrown it years ago.
For most, acne begins in the teenage years. Most of your body is covered with pilosebaceous units, which are basically little colonies consisting of a hair follicle, a hair and a sebaceous gland. When stimulated by hormones, the sebaceous glands pump out sebum, an oil meant to lubricate and protect your skin.
This causes no problem unless these glands get clogged by oil and debris, at which point comedones (aka blackheads and whiteheads) form, inevitably the night before school picture day. Oddly, comedones (singular: comedo) comes from the Latin word for glutton, which is attributed to the idea that ancients thought they were full of the remains of a gluttonous worm. Why? I haven't the foggiest idea. Anyway, blackheads are open comedones, which means skin debris and oil have accumulated in the widened follicle, but the surface is still open to the air. As a result, an oxidation reaction occurs, and the product is the characteristic black color. The black color is not dirt, so even the most heroic efforts at scrubbing it away will not help. Whiteheads, or closed comedones, only have a microscopic opening to the surface of the skin, so the reaction cannot occur and they remain white. Often, they cause the walls of the hair duct to rupture, leading to inflammation (i.e. red pimples) and possibly infection.
A second contributor to acne is a bacteria called Propionibacterium acnes, which inhabits your skin and feeds on sebum (there is truly no accounting for taste). As with any bacteria, their presence attracts white blood cells, which start an inflammatory reaction, damaging the follicle and leading to the formation of pustules and other hallmark manifestations of acne. As your teenage hormones subside, taking with them your Joey Lawrence obsession, your body's production of sebum dwindles as well.
As you've undoubtedly learned by now, acne is not made worse by chocolate or greasy food, providing neither is being directly applied to your face (hey, you never know); however, stress, hormones and oily cosmetics can aggravate acne, especially among adults.
Many of the products used for adolescent acne can be used for adult acne. While most teenagers with acne have overtly oily skin, many adults have dry or combination skin, yet are still plagued with pimples, acne's nasty henchmen. Just as you (might have) graduated from counting Pop-Tarts as breakfast, your treatment for acne as an adult might be slightly different. First of all, washing your face is a good idea, but don't scrub too often or too hard, or you could actually make things worse. A gentle exfoliant with alpha-hydroxy acids might help, but stay away from harsh, grainy products if possible. Use oil-free cosmetics and lotions. And I know it's tempting, but if a pimple pops up, try to resist the urge to pop it. Albeit sickeningly satisfying, this can spread bacteria and lead to more breakouts. Topical solutions such as benzoyl peroxide and the treatment system Jessica Simpson is hawking nowadays may help, but if not, see your dermatologist. They have an unbelievable armamentarium of products at their disposal (as well as many samples) that can clear you up and prevent scarring.
The social anxiety caused by adult acne can whisk you back to your days as a gawky middle schooler; however, there is hope, and with the proper treatment, you can leave the bothersome problem of acne behind once and for all.
Emily is a University Medical student. She can be reached at egraham@cavalierdaily.com.
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