Acne is a skin problem that usually begins in the young teenage years and can last until the early 20s or even later. It consists of mild to severe outbreaks of pimples and cysts - mainly on the face, but also on the back, arms and chest. Cysts are lumps under the skin that have pus and other tissue in them, but do not come to a head like pimples do. These can sometimes cause scarring and blotchy, uneven skin colour. Unfortunately, acne hits people at a time when they most want to look their best. Acne can make teenagers feel embarrassed and bad about themselves. There are treatments that can help if acne is causing distress. If you are concerned about skin problems or skin care, you should talk to your doctor or chemist for information about possible treatments.



Hormones and genetics

At the start of puberty, a whole lot of hormones are released into the body. One of these hormones is androgen. Both boys and girls have androgen, but boys have more of it. Androgen affects oil glands in the skin of the face, neck, back, shoulders and chest. It makes the glands grow bigger and produce more oil (sebum). Bacteria on the skin make this oil thicken so that the pores become blocked, resulting in blackheads, pimples and cysts. A teenager is more likely to get acne if one of their parents had it during adolescence. But even in the same family, some people may get worse acne than others. Girls tend to get it at a younger age than boys and it can worsen or ?break out? at certain times of a girl's menstrual cycle, such as just before a period. Boys often have more outbreaks than girls, and they often seem to get worse pimples and more cysts.

Self-help strategies

Suggestions for managing acne include:

* Washing - cleaning the skin can help, but even people with very clean skin can have problems with acne. Try washing the affected areas two to three times per day. Don't overdo it. Too much washing can cause other skin problems, such as dryness or skin irritations. Try to keep hair clean and off the face and neck, since oil from the hair can make acne worse.

* Make-up - choose water-based, oil free products. Make-up worn during the day should be thoroughly removed at night.

* Don't squeeze - do not pick or squeeze pimples. This can get germs into the skin around the pimple and make things a lot worse. It can lead to scarring of the skin too.

* Stress - Stress can trigger an outbreak of pimples. Stress causes the release of chemicals into the brain that can make oil glands release more oil onto the skin. This is why pimples seem to magically appear on stressful days, such as at the time of an exam or special date. Usually it is difficult to control things like tests or special events, but it's important to know that the stress has brought on the outbreak. The outbreak is not a sign that the treatments do not work.

* Diet - many people think that lollies or chocolate cause pimples. Research has not been able to prove any such link, but some people find that it works this way for them. It is possible that a person eats chocolate when they are under a lot of stress, and that it is actually the stress that causes the pimples. However, healthy eating may help.

Acne treatment from your pharmacy

Some acne treatments can be bought over the counter at chemists or supermarkets. These work by cleaning the skin and drying up excess oil. If you are using any form of treatment and your skin becomes very dry or irritated, stop using it straight away. It is a good idea to talk to the chemist before you buy a product to find out which treatments are the most useful. Don't rely on advertisements or the advice of friends.

Medical treatment

If the acne is bad, your doctor may prescribe medication or arrange a referral to a dermatologist. Medications can lead to huge improvements in how the skin looks and can reduce the number of new pimples. Medical treatment can include:

* Antibiotics to kill the germs, which are part of the cause

* Medications to reduce the amount of oil being produced

* Medications to reduce the amount of androgen in the body.

Where to get help

* Your doctor

* Your local chemist

* Dermatologist.

Things to remember

* Acne is a skin problem consisting of mild to severe outbreaks of blackheads, pimples and cysts.

* The triggers of acne include some of the hormones associated with puberty and stress.

* Self-help strategies include washing the affected areas regularly, using water-based make-up and resisting the urge to squeeze or pick at spots.

* See your doctor or chemist for information about possible treatments.