Little deformations of the skin, blemish and pimple, are characteristic "flaws" of the adolescents; they can also appear at other ages, although less frequently. The word "acne", of Greek origin, is a pertinent expression that means an inappropriate bump; and indeed nobody can joyfully accept the hideous little elevations on the face.

Increased oil production of the sebaceous glands starts at the time of puberty, and it is part of our growing into adulthood. The determination and development of gender characteristics start in the teen-age years and are completed by the age of twenty. Sebaceous gland systems are greatest in number on the face, outer ear, chest, between the shoulder blades, on the upper arms, and scalp. The sebaceous glands in the folds of the groin, and genitals along with those in the armpits should be separately mentioned. These signal primarily the initiation of puberty.

The oil generated by the sebaceous glands, is in a liquid state at the natural skin temperature. Production is determined by inherited traits, but there is a close relationship with periodical changes, and with the ratios of female-male hormones, too. Dry skin is typical for low levels of oil secretion, while the presence of seborrhea, a condition of overactivity of the sebaceous glands, indicates the excess of male hormones. The worsening of this state can be influenced by mental and emotional factors as well as long-lasting anxiety.

The development of pimply skin starts by clogging of the canals that lead the oil out to the surface. At the opening of the hair-containing canal, the hair follicle, dark colored "comedones" can be easily removed, while the grey colored hardened lumps, which are deeper in the skin, are more difficult to remove. Untreated acne can leave permanent little scars – often in proximity of each other –, causing unevenness on the surface of the skin. Therefore, it is important that the teenager get treatment with the appearance of pimples. Facial masks and alcoholic face wipes can help in opening clogged follicles so the oil can spontaneously pour out, and be wiped off the surface of the skin. The removal of "comedones" – especially if there are several - should be left to an expert, although, it is quite difficult to take an adolescent boy to the cosmetologist.

No young adult, wishing to be attractive, feels "cool" if his/her skin is shiny or the hair is oily and clinging together despite frequent shampooing. Many of them become withdrawn and lack confidence in this age, and thus along with skin treatment their inner emotional life must be attended, too.

The severity of the acne determines the manner of handling and treatment. Some smaller areas of skin unevenness can be prevented and local treatment can make them disappear. Some skin types are completely improved by summer's sunlight, and symptoms can worsen due to the bad weather in the fall, and especially in the winter. In the winter, in conjunction with the local skin care, light therapies: solarium, quartz, etc. are also recommended.

In serious cases, when the surface of the cells of the sebaceous glands binds androgen male hormones, external treatments do not help much and the progression of the condition as well as the appearance of scars cannot be stopped. To impede the overproduction of androgens, suggested products are anti-androgen birth control pills or those of isotretinoin that have an effect over the symptoms and can make them disappear. The size of the sebaceous glands can be decreased by up to 90%.

Changes in lifestyle along with exterior and interior treatment are required in cases of severe acne. Although no specific diets influencing overproduction of oil in the sebaceous glands has been proven, according to certain surveys young people eat more chocolate and sweets, and so are more prone to acne.

Pimples appearing in puberty can cause disturbances in the emotional and mental development. Young persons should not be left alone in this age; they should be helped in time so that they become uninhibited in their appearance and relationships. Building a proper lifestyle and diet keeps a balance in spiritual and physical life to allow the adolescent to go through this tough time of cosmetic imperfection. Skin care started in time can prevent the development of a more severe state. Ask an expert or doctor in treatment of special cases.

Dr. Endre Major
Dermatologist