DR. WALLACE: I have a simple question that might require a complex answer. Why are teenagers burdened with complexion problems and how can they be avoided? — Nameless, Galesburg, Ill.
NAMELESS: Here are the facts provided by a licensed dermatologist:
"Almost everyone gets some form of acne during adolescence, whether it is an occasional blackhead or long-term eruptions. About 5 percent of teenagers develop a severe form of the disease. Generally, girls get acne earlier than boys.
The peak age for acne outbreaks occurs at age 14 for girls and at age 16 for boys. The most severe forms of the disease generally peak three to five years after the symptoms first appear.
Boys generally have worse or longer-lasting cases of acne than girls. But girls, who are more worried about appearance, seek treatment more often than boys.
For most people, acne subsides by age 20. For some, however, it does not; for some, the condition persists into their 30s and even their 40s.
Basically, acne treatment involves measures aimed at: 1) reducing the rate at which sebum is produced; 2) unblocking the canal through which sebum flows to the skin's surface; 3) controlling bacterial involvement; and 4) reducing inflammation caused by the progression of the disease.
Drugs taken orally and those applied to the skin may be helpful. Since there is no cure for acne, the goal of treatment is to relieve symptoms and prevent complications. The crucial thing is getting a treatment program tailored for each patient by a dermatologist.
One of the most important developments is the availability of antibiotic solutions that are applied to the affected areas. These prescription drugs are effective against the bacteria that can contribute to acne. Topical antibiotics have the advantage of concentrating medicine at the site of the acne without the potential disadvantage of putting significant levels of drugs into the body itself.
Some cases of acne, however, are unresponsive to topical treatments and in these cases antibiotics must be taken orally. In severe cases, experiments have combined antibiotic therapy with a hormone treatment aimed at suppressing androgen (a steroid hormone).
Many of the cleansing agents advertised for acne are ineffective, apart from the cosmetic value or removing excess oil from the face. Abrasives and astringents have not been proven to be medically beneficial, and some may cause acne to get worse.
Because they are concerned about how they look, acne sufferers may squeeze facial blemishes; this is a potentially harmful habit. Popping and squeezing pimples is not only no help, but also can cause infection and possible scarring.
Even when acne disappears on its own, as it usually does, it can leave behind unsightly blemishes that will not go away. For this reason, even mild cases of acne should be treated under medical supervision. No form of acne is too mild or too severe to be helped by treatment.
Dr. Robert Wallace welcomes questions from readers. Although he is unable to reply to all of them individually, he will answer as many as possible in this column. Email him at [email protected] To find out more about Dr. Robert Wallace and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.