HIT WITH A ZIT

Over-the-counter and prescription medications can help to treat acne.
By KYLE CURRY
KNIGHT RIDDER NEWSPAPERS
How familiar is this scenario?
You wake up one morning and start preparing to give a class presentation. As you plan your speech, you glance in the mirror and spot that cursed sign of teen angst: a zit.
Almost 85 percent of people between 12 and 24 years old suffer from acne, "making it the most common skin disease in America," according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Why those years in particular? Hormones.
"Acne is a hormonally driven skin condition in both males and females," says John Rupp, a dermatologist in Kansas City, Mo.
How it starts
The process begins when hormones, typically testosterone, cause glands in the skin to be clogged, resulting in the formation of blackheads, pimples and cysts. These glands, called sebaceous glands, ordinarily help oil the hairs in the skin, keeping them lubricated.
What happens is this: Material, usually dead cells or skin oils, blocks the pore, called a follicle, for the sebaceous gland. When the follicles are covered by this collection of cells and oils, it is known as a blackhead. When the follicle is covered by pus, it is known as a whitehead. These are the typical pimples.
Worse conditions, such as cysts, result from pockets of liquid building up under the skin. If not treated, cysts can cause infection.
Things to do -- and not
What can be done about acne?
For starters, if you pop your pimples -- stop! Not only can it leave an unsightly mess on the mirror, but it also can cause acne scarring.
Don't depend on tanning to prevent the skin from creating pimples, Rupp says. Tanning can create another problem -- skin cancer.
Various acne medications use different methods to prevent redness, reduce pustule presence or counter the effects of acne-causing hormones. Those meds that tackle redness and whiteheads attack the problems in the skin itself. Those that counter the hormonal effect work inside the body.
People who are using several products at once should "be mindful of irritation effects," Rupp says. Dryness from taking several medications at the same time can damage the skin more than acne.
As for alternative medications, ranging from acupuncture to lasers, Rupp says they are effective but generally cost more than pills or creams.
Making choices
When it comes to buying acne medication, choices can be made between name-brand and generic products.
"Some generics are as equally effective as name brand," Rupp says. Also, prescriptions are made for individual cases, while over-the-counter material is generalized for everyday use.
In most cases, prescription medications should be sought for more extreme cases. Check with a physician or dermatologist before taking any meds and know what to look for as possible side effects.
Accutane, one of the better-known prescription drugs, works by flushing the system of potential acne-causing material. Amnesteem, a new generic based on Accutane, works in a similar way. These represent the "pill" variety of medications that usually require a prescription.
Clearasil, Plexion, BenzaClin and Triaz Pads represent the "face wash" variety. These affect the skin itself, whether by hiding redness or targeting the bacteria in inflamed areas. Some are strong enough to require a prescription.
Scarring remains
When acne is gone, often the worst part remains: scarring. Different methods for repairing scarred areas include laser resurfacing, skin fillers and microdermabrasions. Skin fillers involve putting a substance into the skin, but effects are temporary compared to laser resurfacing.
Laser resurfacing has the best odds of restoring skin to the fullest potential by having a laser slowly remove each layer of scarred skin until the nonaffected layers are on the surface.
Microdermabrasions involve high-pressure spraying of a fine layer of sandlike crystals on affected areas. A vacuum is then used to remove both the crystals and outermost layer of skin.
As much as anything else, acne is a psychological dampener that can cause depression and lower self-esteem.
"Acne is the one unavoidable stumbling block in the teenage years," says Hunter Sheaks, a junior at Leavenworth High School in Leavenworth, Kan. "It is how we handle its presence that shows our character."
XKyle Curry is a junior at Leavenworth High School in Leavenworth, Kan.