When Zits Are the Pits
There are at least ten different forms of acne, two of which are extremely important: acne vulgaris (meaning "common," not "vulgar") and acne rosacea (adult acne). The former is the subject of this chapter.
Acne vulgaris is a skin disorder that plagues most teenagers and young adults. It starts in puberty and can persist into young adult life. Some 80 percent of us develop the pimples and bumps of acne vulgaris some time or another while we're growing up. In most cases, the pimples (often referred to as zits) and their variantsblackheads, whiteheads, pustules, and cystsas a rule clear up by the mid to late twenties, but they can last longer. They are not usually severe, but can have a serious impact on physical or emotional health when they recur and persist in large numbers on the face, the shoulders, the neck, and the upper back.
Acne vulgaris runs in families; if any of your close family members have it, chances are you do, or will, too. More young men are affected than women, but the ratio changes when acne continues into adult life.
Despite great progress in its treatment, the most important advance in dealing with acne has been the debunking of the many myths that have for so long surrounded it. The following beliefs were inviolable until fairly recently and are unfortunately still held by many:
How Acne Develops
Why does acne begin at puberty? Why does it affect younger men more commonly than women? Why does it usually clear up as we get older? The answers lie in our hormones. In adult life each gender has some of the other's hormone. (Thankfully, men have lots of androgenstestosteroneand only nominal amounts of estrogen, and vice versa for females. That's why I shave and my wife doesn't.) But when the body first produces its sex hormones at puberty it makes large amounts of both in boys and girls, in order to ensure adequate bone growth and sexual maturation. The high concentration of male hormones in both causes acne in both genders. Here's why:
Copyright 2002 by Isadore Rosenfeld, M.D.
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