Your skin is your largest organ, and it does a lot more than simply prevent you from spilling out all over the place. Skin cells are constantly replacing themselves, making a journey from the inner edge of your epidermis (your skin's outermost layer) to the outside of your skin. As a skin cell ages and approaches the skin's surface, the dying cell flattens out. Once on the surface, it joins countless other dead skin cells and forms a protective layer that helps protect you from bacteria and viruses.
Inside your hair follicles, there are small glands producing oil called sebum. This oil mixes with skin cells in the follicle and joins them on the journey outward. But when there's too much sebum, too many dead skin cells or something on the surface that blocks their exit from the follicle, a blockage can occur. Bacteria joins the party, and the result is acne vulgaris, the most common form of acne.
While acne usually affects teenagers and 20somethings the most, anyone of any age can get acne, even babies. Our instinctual response -- picking at it, rubbing it and canceling our social engagements -- doesn't help in the least, but fortunately, there are some treatments available that can.
So what can we do to get rid of acne? Let's talk more that instinctual response next.
Keep Your Hands Off Your Face
Here's a simple tip: If you want the skin on your face to look lovely, stop touching it.
Sounds easy, right? Well, good luck with that. Most of us aren't aware of how often we touch our faces. We relieve itches, wipe our lips and scratch our ears. Once you pay attention to how often you paw at your face, you may feel downright feral.
Hands are the body's primary tool to interact directly with the world around us. There's plenty of blame to go around, but the world is pretty dirty. Sweat, grime and oil (not to mention bacteria and viruses) spread from person to person through use of frequently touched surfaces like door knobs, store counters and gas station pump handles.
Needlessly touching your face at some point in the day is inevitable, so try to wash your hands throughout the day as well.
Speaking of washing, let's move on to our next tip.
Wash Your Skin Twice a Day
Taking a moment to thoroughly (but gently) wash your face is one of the simplest and most effective ways to prevent breakouts. Grime and grease build up on your face all day, and residue from cigarette smoke, air pollution and daily living winds up there, too.
Don't go overboard with the washing, however. Twice a day should do it -- once in the morning, and once at the end of your day. Use a clean washcloth, warm water and a mild soap or cleanser. This simple regimen will be effective at ridding your skin of dust, dirt, dead skin cells and bacteria. You don't want to dry out your face by stripping away all of its oil, and you can do more harm than good by agitating or weakening your skin by scrubbing too hard.
Next, we'll learn about an activity that gets your hormones in order.
Work Up a Sweat
A great way to improve your skin's appearance -- not to mention your physical, mental and emotional health -- is to get some regular exercise. Half-an-hour's worth of exercise three to four times a week is preferable, but any amount is better than none.
Stress prompts your skin to crank up oil production, so anything you can do to reduce stress (taking a yoga class, for example) helps with breakouts. Working out also restores order to fluctuating hormone levels, which in turn reduces sebum production in the follicles.
That's not the only skin benefit you get from exercise -- sweating helps clear out your pores, ushering those dead skin cells to the surface where they can't cause as much trouble.
But unless you want to undo all the benefits that a healthy sweat gives your skin, you should pay attention to the next page.
Loosen Up When You're Working Out
We're all familiar with acne on our faces, but some of us break out pretty much anywhere on our bodies. One major cause of this is acne mechanica, a form of acne caused by friction, heat, and constant contact between skin and clothing or athletic gear. Headbands and helmets are likely to cause acne on the hairline, and chin straps will leave their mark as well. If you have athletic gear that rubs against your skin, try loosening it up or removing it during those times it's not in use.
Many jogging suits or yoga outfits can cause acne problems as well. This is usually because they're too snug-fitting or made of synthetic fibers. Switch to looser-fitting clothes made of cotton, and you should soon start to see an improvement in your skin.
Clothing isn't the only thing you need to worry about when you're working out -- find out what else you should keep in mind on the next page.
Don't Forget to Shower
Perhaps the only thing that feels better than going to the gym is leaving it. With that post-workout endorphin high still lingering, it's easy to wrap up a workout, go home and find a comfortable place to collapse. But when you get comfy making dinner or checking your e-mail, you're forgetting something important.
When you exercise, the sweat that leaves your body through your pores takes dead skin cells with it. This is a very good thing -- it's the accumulation of these dead skin cells that can lead to blockages. However, once that sweat evaporates, it leaves salt behind on your skin. If you don't wash these dead skin cells and salt off in short order, they'll block recently cleared pores. One of the best ways to get rid of this salty build-up is to use a moisturizing body wash. Not only will it clean the salt off of your skin, but it will help replenish the moisture lost during your workout.
If your pores are already clogged, what can you do? See the next page and find out.
Buy Some Benzoyl Peroxide
Many people who have had trouble with acne have gotten good results from using benzoyl peroxide. Although prescription versions are available (mostly for cleansers or lotions), most products with benzoyl peroxide can be obtained over the counter.
There are a number of products available, but most involve a cream or gel that is applied to broken-out portions of the face. Benzoyl peroxide kills the P. acnes bacteria that causes inflammation in a blocked pore. It may take about three weeks for results to occur, so be patient.
Benzoyl peroxide not doing it for you? See the next page for another substance that might come in handy.
Stock Up on Salicylic Acid
Though it doesn't kill bacteria or have any effect upon sebum production, salicylic acid can be useful in your efforts to get rid of acne. Salicylic acid causes your skin to shed its outermost layer. By getting rid of this layer of dead skin cells, your skin will be better able to keep pores nice and clear of blockages.
You'll want to avoid putting this peeling agent on any irritated or sensitive skin, or any skin that has cuts or sores. And you have to keep using it -- once you stop, the benefits cease.
Now you know what to put on your face to make it better. But what should you be taking off of it?
Take a Look at Your Makeup
When you're looking for the cause of your acne breakouts, you might want to consider your makeup. Makeup alone doesn't necessarily cause breakouts, but it certainly doesn't help. In some cases, people may notice a significant increase in facial blemishes when wearing a certain brand or type of makeup. If this is the case, switch brands or select products labeled "oil-free" or "noncomedogenic." Give it a few weeks to see if there's any difference. This definitely takes patience, which isn't always in such large supply when our skin is waging war against us. But it's worth it to switch out products (and behaviors) methodically, keeping track of what works and what doesn't.
Regardless of what type of makeup you wear, always wash it off when your day is finished. Leaving makeup on overnight is a good way to make sure you'll need more of it when you wake up.
If you've followed all our tips so far and your acne still hasn't cleared up, you might need to take a hint from the next page.
Ask for Antibiotics
If over-the-counter treatments don't work, you may need to bump it up a notch and try antibiotics. These medications damage or destroy bacteria, helping the body battle infections great and small. When used to treat acne, antibiotics (which are available in pill or topical form) kill the P. acnes bacterium, thus helping to reduce existing inflammation while preventing future bacterial growth through continued use. Tetracycline is commonly prescribed for acne, and it works by taking away the bacteria's ability to produce proteins.
Watch out, though -- it's not all clear skies (and skin) from here. Antibiotic treatment for acne sometimes causes dryness or scaling. Oral antibiotics can also make your skin sensitive to light, so you'll want to stock up on sunscreen or risk a very nasty burn.
There's another pill that might help some of us with acne. Read on to find out what it is.
Consider Birth Control Pills
Women who are dealing with acne can look to an unconventional source of relief: birth control pills. Not only can oral contraceptives help regulate menstrual cycles and prevent pregnancy, a prescription for these once-a-day pills may also be your ticket to clearer skin.
The reason our skin goes crazy during adolescence (this is true for both genders) is that our bodies are cranking out high levels of hormones such as androgen and testosterone. These sex hormones prompt glands in the skin to produce higher levels of an oil called sebum. Acne results when this excess sebum clogs up the pore along with dead skin cells.
The FDA has approved three different birth control pills for treatment of acne. All three contain a mix of the hormones estrogen and progestin. These hormones seem to lower sebum production in women, resulting in less acne. This form of treatment is usually only considered once other treatments -- such as topical options -- have failed.
There are drawbacks, however. For one, there's no guarantee it will work. Also, anyone on birth control pills runs the risk of potential side effects, from headache to nausea to high blood pressure. Women with certain health conditions (heart diseases and trouble with blood clots, for example) shouldn't take oral contraceptives at all.
If you're not into hormone treatments, we have a more natural remedy on the next page.
Manage Stress (and Sebum)
If you're not careful, all this worrying about acne is going to give you acne. Many people notice a link between feeling stressed out and experiencing acne breakouts. Some stress behaviors certainly contribute to bad skin: lack of exercise, nervously touching your face, not bathing or maintaining proper hygiene and maybe even poor diet (researchers go back and forth on diet's role in acne).
But the body's chemical reaction to stress itself can play a major role in your skin's appearance. When we undergo stress, the hypothalamus prompts other cells to produce and release stress hormones, one of which is cortisol. These hormones prepare you for a "fight-or-flight" situation -- your heart rate quickens, your perception becomes sharper, and your skin produces more oil. This oil -- sebum -- is produced by glands found inside hair follicles. It travels up and out of the hair follicle, taking with it dead skin cells. When it reaches the surface, it forms a protective coating. When sebum and dead skin cells get backed up in the follicle, this is due largely to one of two reasons: something on the skin's surface has blocked the pore (like makeup or dirt), or there is an increased production of sebum (which occurs during puberty). When you get stressed out, you boost sebum levels, and your skin pays the price.
Even if you have your stress levels in check, you might have acne that just hasn't responded to any of the treatments we've listed. What else might help? See the next page.
Occasionally, people will find that no matter how hard they try, common treatments such as salicylic acid don't produce the hoped-for results. Fortunately, there's a stronger oral medication available that your doctor can prescribe to you: isotretinoin.
Isotretinoin is known by a variety of brand names (Accutane, for one), and it's been proven to be effective for treating severe acne. Interestingly, nobody is quite sure why isotretinoin works to reduce acne, but it's believed that it reduces the amount of sebum production. For some people, this drug will end their association with acne forever more; for others, it may significantly reduce the number and intensity of future outbreaks. While there's no guarantee it will work at all, isotretinoin's anti-acne effects are usually achieved after four to five months of treatment.
The drug isn't a step you should take lightly, though -- some of the side effects are scary, such as birth defects if a woman taking it becomes pregnant (or is already pregnant).
On the next page, learn about a rather surprising acne treatment.
Follow the Light (and the Heat)
Some acne treatments require significantly more hardware than others. Various forms of low-intensity light (colored blue, red, green-yellow or a combination) seem to be effective in killing the P. acnes bacteria. This is helpful in treating acne because when pores get partially or fully clogged, bacteria on the scene is attracted to the blockage and then multiplies, causing inflammation. By using a wandlike device, a doctor can painlessly apply the light treatments, which are only effective for as long as the treatments continue. There's a chance of mild skin irritation, but otherwise there are no side effects.
Using a special heat wand, a doctor can treat your acne in a similar fashion as through light treatment. However, instead of eradicating bacteria, the use of heat shrinks the size of the sebaceous glands. This results in less sebum production, and, with any luck, less acne.
Let's say your acne is gone, but you still have scars as mementos. What can you do? See the next page.
Some of us have more or less unencumbered ourselves of the acne scourge only to still display the scarring it left behind. Many people have acne scarring, and one way to get rid of it is through microdermabrasion.
This isn't dermabrasion, which brushes away a comparatively thick layer of skin. Microdermabrasion is less intense than that, and way cooler. A doctor using a wandlike device bombards your face with tiny particles of aluminum oxide. It sounds painful, but it doesn't hurt. Simultaneous to the bombardment, the device vacuums up the particles from your skin, so you won't leave the clinic looking like you just fell asleep face-down on the beach.
This only affects the outermost layers of skin, leaving your skin looking and feeling smoother. Microdermabrasion isn't a one-time treatment, but usually requires one treatment a week over the course of several months to achieve optimal results. You may experience a little short-term redness, but should enjoy less redness overall in the long run.
What's the most high-tech acne treatment? See the next page.
If you're looking to exact revenge against your uncooperative sebaceous glands, you may choose to take the battle to the next level: lasers.
Lasers utilizing pulsating lights can be focused on problematic parts of the skin, producing heat beneath the skin's surface. This heat causes thermal damage to the sebaceous glands but doesn't damage the surface of your skin. Laser treatment reduces acne by half after just two sessions [source: Friedman].
Be warned that it's not all fun and games, though -- even with a topical painkiller, the treatment may still cause discomfort or pain. You might also experience swelling and redness for a day or two.
Want more on acne and skin care? We've got plenty more links to articles on the next page.
HowStuffWorks talks to experts to find out why some people love to pop zits — or even watch zit-popping videos on YouTube.
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- American Academy of Dermatology. "What is Acne?" (Oct. 30, 2009) http://www.skincarephysicians.com/acnenet/acne.html
- American Academy of Dermatology. "Studies Show Combination Laser Therapy Effective At Clearing Acne, Reducing Oil Production." Mar. 5, 2009.http://www.reuters.com/article/pressRelease/idUS252597+05-Mar-2009+PRN20090305
- Burkhart, Craig G., MD, MPH. "The Role of Soap in Acne." July 11, 2006. (Oct. 30, 2009)http://www.medscape.com/viewarticle/537366
- Friedman, P.M.; et al. "Treatment of inflammatory facial acne vulgaris with the 1450-nm diode laser: A pilot study." Dermatologic Surgery. Feb. 2004.http://dermatology.jwatch.org/cgi/content/full/2004/511/1
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- Mayo Foundation for Medical Education and Research. "Birth control pills for acne?" Sep. 22, 2009. (Oct. 31, 2009)http://www.mayoclinic.com/health/birth-control-pills-for-acne/AN02016
- MedicineNet. "Definition of Propionibacterium acnes." July 29, 2004. (Oct. 30, 2009) http://www.medterms.com/script/main/art.asp?articlekey=38136
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. "Acne." Aug. 2006. (Oct. 31, 2009)http://www.niams.nih.gov/Health_Info/Acne/acne_ff.asp
- New Zealand Dermatology Society. "Antibiotics for acne." June 15, 2009. (Oct. 30, 2009) http://dermnetnz.org/acne/acne-antibiotics.html
- Ogbru, Omudhome, PharmD. "Isotretinoin." Apr. 16, 2008. (Nov. 4, 2009)http://www.medicinenet.com/isotretinoin/article.htm
- WebMD. "Benzoyl Peroxide." (Oct. 31, 2009)http://www.webmd.com/drugs/drug-1344-Benzoyl+Peroxide+Top.aspx?drugid=1344&drugname=Benzoyl+Peroxide+Top
- WebMD. "Understanding Acne -- Treatment." (Oct. 31, 2009)http://www.webmd.com/skin-problems-and-treatments/acne/understanding-acne-treatment