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From A to Zit: Why Acne Happens and How to Prevent It

It always seems to happen at the worst time: Just as you're getting ready for a first date or an important performance, a big pimple appears in the middle of your face. It's huge, it's painful and it's so embarrassing. Should you lock yourself in your room until it heals?

Don't go into hiding! Dance Spirit spoke to dermatologists to get the scoop on all your most pressing acne questions—why it happens, how to prevent it and how to get rid of it.


The Cause

Why do I have acne?

The reason some teens have acne and others don't is mostly luck of the draw, with family history being a big contributing factor. Most likely, your pimples are also related to changing hormone levels during puberty. “Acne is so common in the teen population that it's almost physiologically normal," says Dr. Bethanee J. Schlosser, dermatologist and director of the Women's Skin Health Program for Northwestern Medicine in Chicago. In fact, 70 to 95 percent of teens have some level of acne.

Does sweating all day in class lead to zits?

Sweat itself won't cause acne. The real culprits are the dirt and dust that stick to your moist skin. “Dancers need to shower after every workout," Schlosser says. “If you don't have access to a shower, use an over-the-counter pad that contains salicylic acid."

Can wearing tight dance clothes make body acne worse?

Yes. “When tight-fitting clothing puts pressure on skin that's prone to acne, oil and dead skin get stuck more easily," says dermatologist Dr. Daniela Kroshinsky of Massachusetts General Hospital in Boston.

(Photo courtesy Thinkstock)

Will eating junk food make my skin worse?

Not exactly. If you break out after eating junk food, it's most likely due to the reason you're eating junk food in the first place. Stress hormones can increase certain acne-causing pro-inflammatory molecules within the body—“and stressful times are when you'll tend to binge on junk," Schlosser says.

However, foods full of sugar or highly processed carbohydrates may exacerbate skin problems. Dairy intake, specifically skim milk, has been shown to lead to a greater risk of breakouts as well. Schlosser recommends almond milk or fortified orange juice as a calcium alternative for teenagers experiencing issues with acne.

The Fix

(Photo courtesy Thinkstock)

A pimple is coming! What can I do to stop it in its tracks?

“Nothing is going to work overnight," says Schlosser, who adds that a pimple actually begins forming up to three months before it causes a bump. “To ward it off, you need an ongoing maintenance regimen." This includes washing your face daily—preferably with an acne treatment wash—and then addressing flare-ups with a spot treatment.

What are the best products to use?

Most over-the-counter acne treatments contain one of two main ingredients: salicylic acid and benzoyl peroxide. Salicylic acid, often found in acne-reducing face washes, cleans out the pores, so it's best for blackheads. Benzoyl peroxide, on the other hand, is key for treating your red, inflamed pimples.

“Those two treatments used in combination can help keep mild acne at bay, but it's important to use them judiciously, because both have the potential to cause irritation and drying of the skin if overused," Kroshinsky says.

When should I see a doctor about my acne?

If you have fewer than 10 bumps over your face, chest and back, with no evidence of scarring, Schlosser recommends trying an over-the-counter medication first. If you've used that for two months with no improvement, have trouble tolerating the medication or your acne worsens, ask a pediatrician or dermatologist about other treatments, including prescription medication.

What Exactly Are Pimples?

Zits happen when excess oil and dead skin cause a blockage in a pore. “As the pore fills with debris, it stretches to capacity, which allows bacteria to grow and creates inflammation," explains Dr. Daniela Kroshinsky, a dermatologist with Massachusetts General Hospital. “Once those contents spill into the deeper layers of the skin, the body's immune system tries to push them out from the skin." Here's a breakdown of the different types of pimples you may experience.

Comedones: Clogged pores that form tiny bumps, commonly referred to as blackheads or (when skin grows over the top) whiteheads. Regular use of a salicylic acid–based wash can help prevent and heal comedones.

Papules: The red bumps everyone hates to see pop up—but loves to pop. They form under the skin and are often tender. Papules may require benzoyl peroxide or prescription treatment to heal without scarring.

Cysts: Cystic pimples often show up in clusters. They're large, inflamed and can lead to scarring. Common bouts of cystic acne are a good reason to see a dermatologist for treatment.

Nodules: Large, solid raised bumps that form deep within the skin. Nodular acne may require a cortisone shot from your doctor in order to heal quickly.

To Pop or Not to Pop?

According to dermatologist Dr. Bethanee J. Schlosser of Northwestern Medicine in Chicago, popping a zit is a big no-no. “Any manipulation of acne lesions can potentially cause scars—not just the red or brown spot left over after the lesion goes away, but an actual dip in the skin that looks like someone poked you with a toothpick," she says. “That's not a process that can be undone by any medication."

Schlosser's general rule is that once you see a pimple start to form pus, you can carefully swab it with a cotton Q-tip, but you should never pick, squeeze or dig. If there's no pus and your spot treatment isn't working fast enough, try a warm compress, which will decrease some of the inflammation and potentially bring the pimple to a head.

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