All My Children

In adolescence in both sexes the skin texture coarsens and the pores (hair follicles) enlarge, more so in boys. Adolescent skin becomes susceptible to acne—more in one individual, less in another. In acne the wax from the sebaceous (wax) glands, which are connected to the hair follicles (to keep the skin and hair oiled), collects in the follicles and hardens there. The top of each plug of wax, mixed with dirt, becomes a ‘blackhead’, which can be squeezed out with the fingernails, with some difficulty and pain. When the pores become plugged, it is easy for ordinary pus germs, which are usually on the skin anyway, to work down and cause infections under the plugs. These first show as red pimples, which later get white tops on them (`whiteheads’) as the white blood cells collect to try to destroy the germs.

In spite of the fact that acne is so very common and causes so mach mental anguish, very little that is useful is known about its cause or cure. It is not caused by sexual contact or by masturbation or by sexual thoughts, as some adolescents have guiltily imagined. You should consult a dermatologist if acne is troublesome.

Formerly a diet rich in sweets and chocolate was thought to be an important causative factor, but research has disproved that theory. The daily use of a soap containing hexachlorophene has been found helpful because it reduces the number of pus germs on the skin. Squeezing out the blackheads every month or so also helps. (Wash face and hands thoroughly with hexachlorophene soap first.) But don’t squeeze a red (infected) pimple, or a whitehead, because the pressure tends to spread the germs through the surrounding tissues, which only makes a larger pimple and one which is therefore more apt to leave a scar. If an unsightly white top has formed, you can soften it by applying a piece of wet absorbent cotton for five or ten minutes and then try to wipe it off. (Also put a drop of hexachlorophene solution on the cotton to help prevent the spread of germs over the surrounding skin when the white top opens.) It’s wise to try to keep your hands off your face if you have acne, because they spread the pus germs and rub them in.

Very helpful for improving the appearance of pimples is the use (by boys as well as girls) of a stick cosmetic which comes in various skin shades, in a case like a lipstick case. Pat the end of a finger on the tip of the cosmetic stick, then pat the finger on the pimple, aiming to get the heaviest concentration on the pimple itself, then shading off or blending the cosmetic into the surrounding skin. With practice you can make pimples almost unnoticeable, yet without giving an obviously made-up look. (Don’t apply the stick directly to the pimple—the cosmetic is then too heavy and noticeable.)

When acne is very severe and leaves scars, a plastic surgeon sometimes recommends sanding off the outside skin under anaesthesia, which leaves—temporarily at least —a thinner, less easily infected skin. In a great majority of people, acne ceases to be troublesome in adulthood.

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