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After what felt like a decades-long uphill climb, you’ve finally put your adolescence behind you. Your allowance is bigger, getting dates is easier, and you can have a martini pretty much any time you want one. So how come you haven’t been able to shake the very worst part of puberty?  There’s no escape from acne. It is—despite all those pubescent promises that we’d eventually grow out of it—a common skin problem that experts say will dog us to our graves. What’s more, most of the stories we’ve heard about its causes and cures are bogus. The scary science—like where acne comes from and how it’s exacerbated by exercise and sunbathing—is nothing compared to the math: In the past ten years, the number of adult-acne sufferers has more than quadrupled, growing from 17 million to 70 million.
That’s a lot of little red bumps, all of them originating in the oil-producing structures of the skin called pilosebaceous follicles, which are present in large quantities on the face, chest, shoulders and upper back. Each of these follicles consists of a hair follicle and a sebaceous gland, which secretes an oily mixture called sebum onto the surface of the skin. Acne occurs when sebum’s route to the surface of the skin is blocked by dead skin cells, or bacteria. This obstruction leads to swelling and the development of blackheads, whiteheads, or tender red lumps.
The myth that our complexion is a reflection of our eating and hygienic habits is an unfortunate one. Acne, experts say, is an inevitable result of natural hormonal imbalances and secretions. While much of what causes acne is plain old science, there are several factors that can exacerbate it. High on the list is stress, according to Manhattan dermatologist Debra Jaliman, M.D. “Stress causes changes in hormone levels,” she says, “which leads to break outs, because the skin goes berserk when our hormone levels are off.” (Hershey fans will be glad to hear that it’s not chocolate that causes pimples, according to Jaliman, but the stress we feel after eating a food we’re told will harm our skin.
Another revelation that no health-conscious adult wants to hear is that exercise can exacerbate acne. Because we perspire more when we’re active, a good workout can
increase the bacteria content on our skin. Workout togs made of Lycra and other synthetic fabrics that don’t “breathe” can trap moisture (and therefore bacteria) against the skin, resulting in repeated breakouts.
“I see a lot of skin problems on the backs and at the waistband area of a lot of athletes,” says Jaliman, who recommends exercise apparel made of cotton or other natural fabrics that will absorb perspiration during a workout.
Unfortunately, switching to a nice pair of linen sweatpants won’t help you tackle facial acne. Naming the beast is the first step in handling hickeys, according to Laurie Polis, M.D, a New York-based dermatologist.
“A lot of men approach skin problems very generally,” she says. “They want to act like eczema, acne, and tight skin are all the same. I get them to define a goal: What are they trying to get rid of? Then I aim their therapy in that direction.”
Once that therapy cures the immediate problem, Polis goes for an uncomplicated cleansing regiment that includes anti-aging and anti-cancer properties. Washing
the skin once or twice a day with a face cleanser that contains either benzoyl peroxide or glycolic acid is usually sufficient to remove surface oil, dead skin and dirt, and to keep the skin moderately dry. The best way to treat acne is to control the growth of bacteria and slow down the activity of the oil glands in the skin. An anti-bacterial soap or gel will keep bacteria levels low, and a light moisturizer can convince your glands that your face is sufficiently hydrated.
 Polis recommends washing with warm water, “because really hot water pulls all the oil out of the skin. Your sebaceous glands go into overdrive then, and you end up with oily skin a short time after cleaning your face.”
Keeping your face clean and out of the sun’s harmful rays is key, according to Polis. A tan can mask your acne by making your skin as red as your zits, she says, but the benefits are temporary. Sun bathing actually aggravates blemished skin by hardening the outer layers, which blocks oil drainage and causes bumps under the skin. Since sunlight ages the skin and can cause skin cancer, avoiding sunburn and sunlamps altogether is your best bet.
“If you absolutely have to have a suntanned look,” Polis says, “get yourself a non-oily, non-communogenic self-tanner and slather that on. But don’t go cook yourself. I promise you, you’ll regret it later.”
Another promise Polis makes is that acne can be kept at bay. “Several thousand years from now, man will have evolved to the point where acne won’t occur at all,” she says. “But in the meantime, a couple of weeks with the right bar of soap ought to take care of your little bumps very nicely.”
Clearing Up Acne Myths
- Acne is not caused by poor hygiene or bad living. Ninety percent of acne cases are the result of normal hormone secretion. Genetics plays a big part, too.
- Drinking lots of water won’t help clear up your complexion. While it benefits nearly every other function of the body, drinking water doesn’t moisturize the skin on your face. You’ll need a topical moisturizer for that.
- Those scary facials—during which a giantess squeezes stuff out of your pores until you cry—aren’t good for you. Extractions are rarely necessary, and you can flush out your pores with cleansers that won’t cause you to bleed or cry.
- Once and for all, chocolate does not cause zits. In a recent study in which scientists actually counted the pimples of a control group forced to eat Hershey bars at every meal, the subjects didn’t have more zits than those in another group who were deprived of chocolate.
- Acne isn’t caused by what you eat, but it may be caused by how you eat it. That pile of greasy McDonald’s fries is only hazardous to your complexion if you don’t wash your hands after you gobble it up. Otherwise, the grease from your fingers might end up on your face, where it reacts like a Big Mac for bacteria to feed on.
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