Your skin is made up of three basic layers: the epidermis (the surface of the skin), the dermis (middle layer), and the subcutaneous (bottom layer), which is mostly fat tissue.
Click to view Mayo Clinic graphic of the skin's layers
It's in the dermis, just below the skin's surface where a lot of the problems begin. Within the dermis are the follicles of your hair. The pore that surrounds each follicle can easily be clogged with oil created by the connecting sebaceous gland. The oil, called sebum, is supposed to be there. Ideally this lubricant would travel up from the follicle along the hair shaft and out through the pores of the skin. Often though, the gland will overproduce the sebum, which, when combined with dead skin cells can solidify as a soft, white plug (yup, the stuff you can squeeze out of your face).
If the plug prevents the escape of the necessary sebum, the pore bulges out causing a whitehead.
Blackheads happen when the pore stays open and traps dirt and smoke. The top of the plug then darkens, hence the name blackhead.
Pimples then, are the infected or inflamed blockages that turn red and develop a white center.
It's also entirely possible to develop cysts, which occur when the blockages happen deep inside the hair's follicle. Cysts reveal themselves as lumps beneath the skin's surface.
According to the Mayo Clinic's web site, four out of five people between the age of 12 and 24 have acne, but it is not uncommon for it to occur right into your 30's. Occasionally it may even last into your 40's and 50's.
Unfortunately it isn't known what causes the increase of the sebum.
Fortunately it IS known that foods play little to no effect on acne. Despite the rumors that chocolate or french fries lead to increased acne, it really isn't the case (unless you are the type that wipes french fries across your face). From a modelling standpoint, there are many other good reasons to limit your intake of such foods, but acne isn't one of them.
Wash your face regularly to clear away harmful bacteria and dead skin cells. Do not use soap (instead use a cleanser designed for your skin type). Harsh scrubbing agents can actually irritate the skin and make your acne worse. The Mayo Clinic recommends not using facial scrubs, astringents and masks, as they also may irritate the skin, however if your skin isn't sensitive to such things, they may prove beneficial to your overall appearance.
Be careful what touches your face. Everything from greasy sunscreens to the products you use to style your hair can contribute to acne formation. Not surprisingly, cosmetics (including acne concealers) also aggrevate the problem.
It is advisable then, to use products labeled "water-based," or "non-comedogenic."
One of the more common and effective methods of controlling acne is oral contraceptive. Certain types of "The Pill" have been recommended by doctors not only to prevent pregnancy, but also to control the menstrual cycle and yes, to maintain healthy skin. In most places a prescription is required to obtain the pill because of side effects. It is very important to discuss the pill with a qualified health professional before starting on it.
Acne lotions can help the skin exfoliate (remove the dead cells), reduce the amount of sebum and kill bacteria. There are many over-the-counter topical treatments available, most of which are mild and will work to treat ordinary acne. If they don't do the trick, you may elect to consult a dermatologist who may prescribe a stronger lotion, or antibiotics.
Antibiotics are for more severe cases of acne. Usually available by prescription, these antibiotics fight the bacteria and reduce inflammation. Often these antibiotics are required for months at a time, and may need to be used in conjunction with lotions.
The other alternative is cosmetic surgery. Lasers are often the first thing one would think of when cosmetic surgery is mentioned, however there are also alternatives such as chemical peels to remove damaged skin, or a freezing method which, when successful has a similar effect. Dermabrasion is usually reserved for more severe acne scarring. It involves removing the top layers of the skin with a wire brush rotating quickly.
Keep in mind that the information we provide is not meant to replace the wisdom, knowledge and personal contact a health professional can provide. Factors such as pregnancy, climate and allergies/sensitivities may be crucial to determining what course of acne control you should choose.