Prof Dr. Dwarika P Shrestha

I am a teenager, aged 14. I have heard that many physical changes occur in this period, and even I have a complaint with my skin. I have very sensitive skin, pimples are very regular, blackheads are very usual. I want to get rid of all these. My skin is oily, so I used a cleansing face wash but unfortunately, it has caused allergy and now my skin feels rough and dry. I have no idea what can I do, I have tried almost everything possible.

— Anonymous

As you said the body undergoes a lot of changes during the teenage or adolescent period, which is the transition phase between childhood and adult. One of the changes is the production of male sex hormones or androgens. Androgens stimulate sebaceous glands, which produces more sebum.

It is important that you have basic knowledge about acne or pimples and their prevention.

White and blackheads are the first lesions that you see in youngsters with acne. They form due to blockage of the pilo-sebaceous (hair follicle) opening. If they are few, it may be sufficient that you keep your face dry. Then red papules and pustules come. In the severe form known as acne conglobata there are nodules and cysts.

Oiliness of the face is the major factor which predisposes to pimples. The only way to control oiliness is to wash and avoid oily applications.

Here are simple rules to keep your face dry and prevent from acne.

• Wash your face with normal soap in the morning and evening. You should apply soap mainly on the T-zone, that is forehead, nose and naso-labial folds. Do not apply excessive soap. Using various and excessive facewash may cause dryness as in your case. If your skin is very dry and rough, you can use a moisturising lotion for a few days.

• Do not use oily creams on the face, and oil on the hair.

• Use less or no cosmetics.

• Do not squeeze. Squeezing is very harmful. Usually it makes the pimples red and big. Repeated squeezing almost always leave scars. It is very important to control this habit.

• Take a simple and normal diet. The role of diet in acne (pimples) is contradictory but is always beneficial to take a diet with low sugar and fat. I would suggest a normal Nepali diet with an added fruit and a green vegetable everyday.

• Stress can aggravate acne.

Treatment consists of oral drugs such as antibiotics (azithromycin, doxycycline) and vitamin A derivatives (isotretinoin), along with creams and gels (clarithromycin, clindamycin, tretinoin).

If you fail to prevent or treat, then acne leaves scars. There are different types of scars. Usually they are deep and pointed. The scars may be few or numerous as to disfigure the face.

Acne scars improve with time due to the natural healing process.