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Bursting myths about acne

October 6, 1999
Web posted at: 1:26 PM EDT (1726 GMT)


In this story:

The root of the problem

The stress controversy

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By Sarah Allen

(WebMD) -- Ben Grant woke up depressed the morning of his high-school graduation. That day, he would be commended for his musical talents, academic achievements, admission to Columbia University and triumphs on the varsity volleyball team. But looking in the mirror, he saw not a bright young man with an even brighter future, but a boy who had acne -- severe acne.

"I showered all the time, sometimes even four times a day," Grant, now 26, remembers. "My doctor told me to stay squeaky clean and stop eating chocolate and french fries and greasy food like that because he said that makes acne worse."

It wasn't until college that Grant got fed up enough to find a new doctor, and new advice. Grease and grime don't cause acne, she told him -- hormones and heredity do. And good medicine can go a long way toward smoothing a marred complexion.

"At first, I thought she was putting me on," Grant says. "I had been hearing that mantra for so long -- no fast food, no chocolate." But Grant's new doctor had done her homework. Scientific developments in the past decade have exposed the diet-and-acne correlation as a myth.

The root of the problem

By a ratio of 3-to-2, young men are more likely than young women to have severe and long-lasting forms of acne, according to a 1998 study by Roche Laboratories in New Jersey. In boys, acne tends to be persistent and unvarying, whereas in girls it tends to flare up intermittently in response to hormone fluctuations.

The medical name for the acne most adolescents have is acne vulgaris. Mild acne usually appears as open comedones (blackheads) and closed comedones (whiteheads) on the face, neck and upper body.

With more severe acne, red pimples that are either papules (red, inflamed spots) or pustules (red pimples with white centers) appear. As acne worsens, nodules develop. Nodules are large, painful lumps under the skin that contribute to scarring.

While acne sufferers can't change their genes, they can do a lot to banish their blemishes. "The theory that teen-acne sufferers should just 'wait it out' is just as preposterous as the french-fries myth," says Dr. Diane Berson, assistant clinical professor at the New York University School of Medicine and a practicing dermatologist who helped Grant overcome his acne years ago. "If a person is concerned about or feels personally affected by acne, it is important to seek medical advice."

While over-the-counter medications may work for mild cases of acne, Berson emphasizes that more difficult cases usually require prescription antibiotics, both topical and oral, which are available only through a physician. She often recommends Benzamycin, which combines benzoyl peroxide, an antibacterial, and erythromycin, an antibiotic.

"This combination has been shown to be more effective than either medication used individually and to produce results in as little as two weeks," Berson says. (As with other acne medications, local irritation has been reported with Benzamycin use.)

The stress controversy

Some doctors believe that acne sufferers can also improve their condition by reducing their anxiety. "Stress has been shown to help trigger the physiological changes that lead to an outbreak," says Dr. Gail Robinson, immediate past president of the American Counseling Association. "In addition to meeting the medical concerns of teen-age acne sufferers, we also need to address their emotional concerns."

"Of course I was stressed," Grant says. "I wouldn't go eat at McDonald's with my friends, and then I would feel left out. That added to the stress I already felt about the acne." Just knowing that his diet wasn't to blame for his condition went a long way toward calming Grant's anxiety.

Not all doctors are convinced that stress contributes to acne inflammation, but most seem to agree that oily foods have no relation to acne whatsoever.

"A poor diet, worry and various bad habits are often blamed for acne, but they have very little to do with the disorder," says Dr. James F. Adams, psychiatrist and dean of the graduate college at the University of Nevada, Las Vegas, and editor of the book "Understanding Adolescence." "A balanced diet, enough sleep and exercise, and regular washing are good for the complexion and general health but cannot prevent or cure acne."

All three doctors advise teens against squeezing or popping pimples. They also suggest keeping skin clean, but not overdoing it. Harsh soaps, vigorous scrubbing and rough washcloths can irritate the skin and make acne worse.

"But go ahead and have cheeseburgers and fries once in a while," says Berson. "You're a kid. Enjoy it."

Grant woke up the morning of his college graduation feeling exuberant. He would later be commended for his academic, musical and athletic accomplishments at Columbia University. And while he would still get a pimple once in a while, he would never feel powerless against his acne again.

Copyright 1999 WebMD, Inc. All rights reserved.



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