Drop dead gorgeous 25-year-old Thomas, our last month's cover model, woke up one morning to discover a scattering of zits on his cheeks and forehead. "Oh God," he exclaimed, and dashed to a specialist in acne, and poured out his tale of woe. "I need to get rid of these messy pimples pronto or I'll lose a whole heap of modeling assignments. Just make it snappy! Money is no object!"

Nancy Walters stepped into her teens with cheerful anticipation. But, yikes, on her 13th birthday she discovered a pink spot on her rose petal skin, which multiplied into a gaggle of relatives. She desperately poked and prodded, only to leave unsightly scars in their wake. Advice flowed. Dab this lotion, drink this potion. Try homeopathic masks, beautician's ozone therapy. After six long years of on-and-off results - in which period her face was pitted with scars and her self esteem down in the pits - Nancy decided enough was enough, and went off to a dermatologist.


Acne, commonly known as pimples, is not exclusively a young person's problem, but an estimated 90% of youngsters below 25 are affected by it to some degree, at some time or the other.

"Teenage acne is caused by the accelerated production of the hormone testosterone, that stimulates the secretion of an oily substance called sebum in the skin," says an expert. When sebum gets trapped in the hair follicles, it clogs the pores and produces blackheads, whiteheads, pustules, bumps and their ilk, usually on the face, but sometimes also on the shoulders, back, chest and bottom. The condition is aggravated by excessive sweating; gooey make up; cradling the chin with unwashed hands and greasy hair products. In women, irregular periods, PMS and Poly Cystic Ovarian Disease (PCOD) are also culprits.

If the clogged pore bursts, Propionobacterium radiates to the surrounding tissue. White blood cells gather to battle the infection and, wham, an angry blister-like eruption is formed on the protesting skin. "So a pimple is actually the result of your own body's angry reaction to the invaders," reveals Dr Abel Mark, Dermatologist, adding that after the dangerous teens, "acne may yet again get activated by stress and emotional upsets; certain medications such as steroids, anti TB drugs, antipsychotic as well as pollution" and follow you into adulthood.

Now while acne is a normal part of the growing process and disappears in 80% cases by the time you hit 25, there's no doubt it can result in emotional distress, and can cause a happy youngster to become shy, self conscious, anti social, depressed. That is why, to avoid mental and physical scars, it makes sense to nip zits in the bud before ugly little heads are reared to 50. Here, Dr Abel Mark, Dermatologist lists all the ways by which you can prevent an outbreak.


Add these healthy bites to your diet to enhance your skin's appearance.

Fish: Fatty fish like tuna and sardine help maintain moisture in your skin, especially in dry climates.

Dark leafy greens: These vegetables are a healthy source of vitamin C, which helps with collagen production.

Whole grains: Their zinc is not only a great boon to collagen production, but it also has anti-inflammatory properties.

Nuts: are loaded with vitamins B6 and E to promote skin elasticity.

Citrus fruits: They're full off vitamin C, plus the folic acid in oranges, grapefruit and tangerines helps skin retain moisture


- Wash your face with a gentle cleanser to prevent oil build up. Rinse well with lukewarm water. Pat rather than rub dry. Easy does it: 'Too much scrubbing, esp. on active acne, can over stimulate the oil glands and make a greasy skin oilier," warns Abel.

- A weekly steam treatment can help loosen oil clogged in pores.

- Eat a balanced diet, which should include two bowls of veggies, 3 to 4 fruits, and two to three cups of skimmed milk/curd - than whatever else your heart desires. Wash it all down with 8 to 10 glasses of water. Supplements - iron, antioxidants, Vitamin C - may be necessary if you diet doesn't meet your nutritional needs, adds Dr Abel, Dermatologist.

- Exercise regularly to balance hormones and rev up circulation.

- And wash up soon after to prevent sweat and bacteria build up in the pores.

- Water based moisturizers containing alpha hydroxyl acids evens out the complexion and provides a healthy glow to the skin.

- Sunscreens should be water based, too, ideally one that contains zinc oxide and titanium dioxide.

- Steer clear of heavily perfumed cosmetics. Use beauty aids made only by reputed manufacturers.

- Tone oily skin with alcohol based products. Guys too!

- Avoid clogging creams and cosmetics. And cleanse well at bedtime.

- Face packs of Fuller’s Earth with rose water and 4 to 5 drops of lemon remove excess oil.

- Never squeeze or pick at a pimple. "You will be pushing bacteria into the deeper layers of the skin and exacerbating the damage," says Abel. "Worse, you'll end up with a scar."

- Beware of following advice from know-it-alls.

- Get dandruff treated with shampoo containing ketoconazole or zinc sulfide and avoid keeping oil on hair for more than an hour.

- Aluminum chloride hexhydrate in antiperspirants also has an antibacterial effect. Use it to prevent acne pustules under the arms.


- Myth: Acne is a part of growing up and need not be treated.

- Fact: Catching the problem early will 1 forestall a worst case scenario down the line.

- Myth: Eating oily, deep fried and 1 spicy food aggravates acne.

- Fact: The oil in food is not the same as the oil on your skin.

- Myth: Chocolates, sweets and cheese make your skin breakout.

- Fact: The evidence doesn't bear this out.

- Myth: Medicated soaps will dry your skin and clear acne.

- Fact: They may over stimulate oil production on your skin.

- Myth: Masturbation increases acne.

- Fact: Testosterone is responsible for male acne.


Depending on the degree of your acne, says Abel, you can try the following strategies, progressing to prescription medication for more severe cases.

- Cleanse with a foaming face wash containing salicylic acid two or three times a day.

- Use OTC Benzoyl Peroxide. Start with 2.5% and apply sparingly at night. Increase to 4% after a month.

- Antibiotic gels - Clindamycin, Nadiploxacin, and erythromycin - can be used during the day or alternated at nights with benzoyl peroxide - but only on pustules and red bumps.

- Azelaic acid (Aziderm) may be used nightly or alternated with antibiotic gels or benzoyl peroxide.

- Nose strips work on blackheads. Use every 5 to 10 days.

Avoid OTC acne products which do not have the ingredients mentioned in them.
For moderate to severe cases you need a dermatologist's intervention, who may prescribe

- Topical Vitamin A acids or tretinoin starting with a low strength (0.250%) and gradually increasing to 0.5% concentrations. Scrupulous use of sunscreen is essential as these drugs have a peeling effect.

- Oral antibiotics such as Minocycline, Erythromycin or Doxycycline for 2 to 3 months.

- Azithromycin on a pulse or intermittent therapy.

- Oral contraceptives or anti androgens for women after a blood hormone test and sonography to check for PCOD.


- Oral isotretinoin may be advised after ruling out high cholesterol and liver abnormalities. "Side effects are hair loss, extreme dryness of the mucous membranes, exacerbation of existing depression," reveals Abel. You can't get pregnant during treatment and for 6 months post treatment, so contraception is a must in this period.

- Peels of Alpha hydroxyl acid like glycolic acid, and betahydroxy acids in various concentrations and combinations, have a bacterial effect. They also enhance collagen regeneration causing reepitheliazation of scars, thus concealing them. Warns Abel, "Although many salons offer these peels nowadays, in inexpert hands, they may lead to blotching, hyper pigmentation and burning, and these effects can only be rectified with laser treatment or surgery."

- Blackhead extraction and drainage of pus "which again need expert handling or you'll end up with a worse case of acne or permanent scars."

- Vacuum evacuation of pus, which "under careless hands can loosen the skin," says Abel.

- Laser and light therapy: Blue light and Pulsed dye lasers kill the lethal bacteria. Without a qualified doctor, these treatments can result in blistering and scarring.

After the acne has been completely banished, the scars may be tackled with Microdermabrasion with aluminum oxide crystals; dermabrasion with high speed diamond buffing drills over several sittings; or lasers such as Erbium, YAG and Fraxel that resurface badly pitted skin.

Nancy Walters, whose persistent red pustules oozed venom, was put on a topical preparation of iso tretinoin gel at night with a course of oral antibiotics, together with loads of fruit and veggies and water, "because Nancy ate junk food and nothing but junk food," says Abel. "Five sittings of microdermabrasion cleared the scars. Within two months the results were dramatic."

Sanjay, who has normal testosterone levels, is a non-smoker, lifts weights and eats healthy to keep his abs fighting fit. Says Abel: "I put him on a short course of Clindamycin in the day and Benzoyl Peroxide at nights. Together with Pulse intermittent Azithromycin and two sittings of blue-light, the aggressive treatment cleaned his face like a dream. One and a half years later he's still raking in the compliments - and assignments - for his smooth and glowing skin."

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