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Some people are born with perfect, zit–free skin. Most of us, however, are not. More than 17 million people suffer from some form of acne — blackheads, whiteheads, pimples, and cysts. As a teenager, you're hardest hit — a fact that experts blame on hormones. Other than your age, causes of acne include your family's history of acne, stress, certain medicines (including lithium), and some birth control pills. This is a little confusing because some birth control pills are actually used to treat mild cases of acne.
Acne is caused by a combination of bacteria on the skin and clogged pores. Pores get clogged when the sebaceous glands produce more oil than usual. These oil–producing glands are located on your face, back, and neck. That's why acne occurs on the face, back, neck, and shoulders.
During your teenage years, hormone levels increase the production of sebum, waxy stuff that comes out through your pores to lubricate the hair and skin. When too much sebum is produced, it combines with dead skin cells to block the pores partly or all the way. Partly blocked pores are called blackheads (or open comedone). Fully blocked pores are called whiteheads (or closed comedone). By the way, blackheads are not caused by poor cleansing habits or dirt trapped in the skin.
He says that acne is, essentially, a disorder of the pilosebaceous unit. ‘What this means is that the human body, through evolution, is covered with millions and millions of hairs. These hairs come out of a follicle. Over time, these hairs have become miniaturized. Some are so small you can’t see them, but you certainly can see the follicles in the skin where the hairs protrude. These are commonly referred to as pores.
At the bottom of the pore, there is an oil gland called a sebaceous gland. The pore itself is like a tube, and the hair comes out of it. Sebaceous glands are found in high concentrations on the face, chest, shoulders, and back. These are the most common areas where acne can occur.’ Over time, he explains, the cells that line the follicular tubes where the hairs come out don’t behave properly.
When the sebum and other clogged materials are exposed to the air, they turn black (a process called oxidation). Bacteria can grow in the blocked pores and produce an inflammation, otherwise known as a zit. If there are pimples, blackheads, and whiteheads, but no deep cysts, it's called superficial acne or acne vulgaris. If the pimples project down into the skin, and there are cysts filled with pus, it's called deeper acne. You usually need to see a health professional for help with any type of acne because it can leave scars if not treated properly.
The following medications are all useful for treating acne on a variety of skin types and colors. If you have darker skin, be especially careful about what you use on it. Some acne treatments such as Retin–A (for preventing blackheads and fighting more serious cases of acne) and 10% benzoyl peroxide gel (for getting rid of pimples) may irritate your skin and cause it to darken. If you're not sure, ask a dermatologist before using anything new on your face.

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