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Acne - FDA article
Health Guide
Tonight's your first date with the person of your dreams. You're standing in front of the mirror, coaxing your hair into a more sophisticated style when there it is -- right on the tip of your chin -- a big fat zit! You look at your face more closely and see another smaller pimple on your cheek. Lifting your hair, you spot several on your forehead, too.

Why did this have to happen just when you want to look your best? And, while we're at it, why you?

No one knows for sure exactly what causes acne vulgaris, the technical name for the zit attack. But researchers do know that it usually starts in adolescence and that heredity plays a big role. If one of your parents had acne, there's a good chance you'll develop it. If both of them had serious pimple problems, then your chances are even higher.

If you have acne, you have lots of company -- about 85 percent of the U.S. population between ages 12 and 25 develops some form of the skin condition. Most teens who get acne have the milder form, called noninflammatory acne, and get just a few blackheads or whiteheads every now and then. But some people suffer from the more severe form, called inflammatory acne, and have a constant outbreak covering the face, and sometimes also the neck, back, chest, and groin. These pus-filled pimples and cysts can cause deep pitting and scarring.

Acne develops when glands that produce an oily substance called sebum begin to work overtime, possibly due to hormone changes that are at their peak in the teen years. One of the jobs of the sebum is to carry cells shed by the glands to the surface of the skin. But because the excess sebum is blocking the openings of the glands, called ducts, both cells and sebum accumulate, forming a plug called a comedo. If the plug stays below the surface of the skin, it is light in color and called a whitehead. If the plug enlarges and pops out, the tip looks dark and it's called a blackhead. This isn't dirt and it won't wash away. The darkness is due to a buildup of melanin, the dark pigment in the skin. If the process continues, a pimple forms.

What is acne?

Acne develops when glands that produce an oily substance called sebum begin to work overtime, possibly due to hormone changes that are at their peak in the teen years. One of the jobs of the sebum is to carry cells shed by the glands to the surface of the skin. But because the excess sebum is blocking the openings of the glands, called ducts, both cells and sebum accumulate, forming a plug called a comedo.

If the plug stays below the surface of the skin, it is light in color and called a whitehead. If the plug enlarges and pops out, the tip looks dark and it's called a blackhead. This isn't dirt and it won't wash away. The darkness is due to a buildup of melanin, the dark pigment in the skin. If the process continues, a pimple forms.

What causes acne?

Acne most often starts at around age 11 for girls and 13 for boys. A hormone called androgen may play a role in acne. Among other things, androgen stimulates the sebum-producing glands. After puberty, boys produce 10 times as much androgen as girls, and so it's not surprising that more boys than girls develop severe cases of acne. Also, bacteria called corynebacterium acnes, which cause skin fats to break down into irritating chemicals, can directly contribute to an outbreak.

Other things that can cause acne, or make it worse, are certain drugs, such as those used to treat epilepsy or tuberculosis; exposure to industrial oils, grease, and chemicals; and stress and strong emotions (which may account for the big date breakout). Some oily cosmetics and shampoos can, on rare occasions, trigger acne in people who are prone to get it.

Many young women notice that they get more pimples around the time of their menstrual periods. In fact, some studies have shown that up to 70 percent of women notice their acne worsening the week before their periods.

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