Since the sixth grade, I have rolled out of bed thinking the same thing: today is the day I am going to look in the mirror and it will all be gone. The inflamed mountains bursting with white blood cells will have receded into my face. But every day I see the same thing. As one zit begins to disappear, another one pops up to replace it.

Statistics from cureresearch.com estimates that 17 million Americans ages 12 to 24 will experience acne at some point in their life. For some, the days of experiencing acne ended in middle school while others will continue fighting acne late in life. This fact makes acne the most common type of skin disease.

For men and women, acne carries a social stigma similar to obesity. It can make you feel uncomfortable and impede your self-esteem.

Jessica Wicks, Bakersfield, Calif., senior, remembers when she was 13 and got her first zit. It made her face red as it stood out on her fair skin. At first she thought it was cool because she was becoming a teenager, but that image slowly faded as one zit grew into many. “I felt like I could never be the perfect girl in school. I always felt ugly and sometimes I would avoid the people whose opinion I cared about,” she says.

The Cause

My dermatologist kept telling me that I would grow out of my acne after I was done with puberty and that my acne was just a phase that takes time to clear up. But after puberty ended, my acne did not. I am now a college student that still deals with pimples. Dr. Heather Woolery-Lloyd, professor at Miller School of Medicine at the University of Miami, says that acne is a skin disease with no exact known cause or cure, and it’s unknown why some people have it worse than others. It does not matter the color or type of skin you have; anyone can get it at any time. For women, increased hormones around the menstrual cycle can cause acne to flare up. As for men, their acne tends to calm down as their hormones settle down. Overall, acne stems from genetics and hormones. Look at your parents, aunts and uncles; if they had acne, you will most likely have it, too. Wicks says that her dad suffered from it as he grew up, and even as an adult had some breakouts.

Acne is a condition of the sebaceous gland. Androgens, the male sex hormone that is produced when both men and women go through puberty, causes extra oil to form, making the gland sticky. However, other hormonal changes like changing birth control and things like stress, pressure around your hairline from wearing hats and washing your face too much can cause acne to form.

Bacteria feed on the extra oil underneath the skin waiting to make its appearance on the surface. Oil, bacteria and dead skin cells that should normally drain to the surface clog hair follicles, causing bacteria and pressure to form beneath the skin. As the bacteria continue to multiply, the pressure inside increases. The body sends white blood cells to fight off the bacteria, causing redness and white pus to form. In the end, a distinguished red inflamed zit forms.

Zits can form anywhere on the body where there are sebaceous glands that produce oil, and are given various titles: bacne, chestne, buttne and scalpne. Kathy Fields, M.D., dermatologist and co-creator of Proactiv, says that hair shares the same follicle as the sebaceous gland, causing the areas with hair to break out more.

Unfortunately, we are partly to blame for acne in these areas. Fields says that when students study, they have a habit of picking at their head or back. And the more you prod at the affected areas, the bigger the acne gets. Bottom line: touching your face, back, chest or scalp can aggravate acne and make it worse. And if you want to pick, Fields says it is okay to pop a pimple as long as it is a white head.

Treatments

I have taken almost every oral medication, used numerous topical creams and countless over-the-counter products. I have taken tetracycline, erythromycin and any other word ending in “cline” or “cin.” I have used Differin gel, Tazorac and BenzaClin. I have even tried Proactiv. The process was the same every time: extreme dry skin, clear skin for a week then back to more acne. Most of these medications will work for people with moderate to mild acne, but mine was severe.

Treating acne can be expensive, but the outcome is worth the money. Fields says that studies have shown that people with acne go on fewer dates because they become a victim of their skin. But with the advancements that dermatologists have made, preventing acne can be as easy as long as you stick to a routine.

Acnemagazine.com says that at one point, sun lamps were the only option for treating acne. People would sit under a lamp that emitted UVA and UVB rays for ten to thirty minutes. Fields says that small amounts of sun can help acne, but over time rays from the sun can increase the clogging of pores. Today, the sun lamps are rare. Instead, there are over-the-counter products that can prevent zits. Any product that contains 2.5 percent Benzoyl peroxide works the best when paired with an oil-free acne wash that contains salicylic acid.

For more severe acne, Fields says that taking antibiotics can help with inflammation but for the most part, antibiotics will not stop acne. She says over-the-counter products work just as well and if needed, a dermatologist can prescribe a topical gel that contains higher amounts of Benzoyl peroxide.

But be careful. Wicks says she has tried a variety of medications but had to quit the majority because of allergic reactions. She says that some of the antibiotics caused stomach pain and the prescriptions she could take didn’t work.

David Burchfield, Shawnee junior, had a similar experience while taking tetracycline. Although it cleared up his acne, he developed stomach ulcers from taking the medication.

He says he started getting acne when he was 12 and it never bothered him unless he had a crush on a girl. Then, sophomore year of high school he began taking tetracycline. “It worked pretty well until I had an upset stomach all the time and an acidic taste in my mouth,” he says.

He believes the reason he had a reaction was because the medicine had stringent guidelines on when to take it, like with a meal, and he didn’t always follow them.

For fast relief, Fields suggests using toothpaste, Preparation H or cortisone to shrink the inflammation and help with the redness. Ice and aspirin can also help with the swelling.

As a last resort I turned to Accutane. A drug that contains high levels of vitamin A. For four-months, the recommend amount of time to take Accutane, I suffered through dry crusty skin that coiled and flaked off my face. I had bloody noses that would last for about a half hour. Each month I had to have blood drawn to make sure that there were no complications with my liver since accutane can raise cholesterol levels and birth control was a must.

The side effects of Accutane are extreme: it can cause serious birth defects, and in rare occasions, depression. Dr. Woolery-Lloyd says that there have been case reports about depression and suicide, but these side effects are not common. And if people experience mood swings, they are advised to stop taking the medication. She says that it cures the patient’s acne 80 percent of the time and when it does, it can be life changing. Especially because it can prevent scarring, which is also a genetic side effect of acne.

So when you are shopping for skincare products, Fields says read the labels. Look for products that contain Benzoyl peroxide, sulfur and salicyclic acid. Dan Kern, creator of Acne.org, suggests using Purpose daily face wash, Neutrogena on the spot acne treatment and Cetaphil daily face moisturizer on a daily basis. At a total cost of $16.57, it’s a cheap price to pay for a clear complexion.

The Cure

Basically, there is no cure because the cause is still unknown. Everyone deals with it and it is normal. Wicks says that she will never grow to live with her acne and she believes that it won’t go away until her hormones balance out. It has drained her self-esteem and sometimes she takes up to three showers a day just to feel clean. And Burchfield says that for the most part his acne has cleared up. He washes his face and uses Differin gel when he remembers to. He says that people shouldn’t worry about zits so much, because if someone were going to judge you because of your skin, you wouldn’t want them around you anyway.

I have stopped taking antibiotics and I only use over-the-counter products. From all of the products I have taken, topical gels and crèmes work the best when used on a regular basis. I try not to touch my face or pick at my back and chest because when my face is clear, it is one less thing I have to worry about in the morning.

Dermatologists are still searching for the best treatment for acne. It is just a matter of finding the right product that works for you and using it daily within moderation because treating your acne too much can make it worse. “Treating acne is like treating tooth decay; you brush your teeth every day so you have to treat acne every day,” Fields says.