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HOW COME? Why pimples plague teenagers

Why do we get pimples? asks reader Lizzy GruberPimples can be the bane of teenagehood for a reason: Almost 80 percent of us get them during middle- and high-school years. Which makes acne, however unwanted, perfectly normal.

Hormones called androgens are the trigger. Both boy's and girl's bodies begin churning out androgens as they approach ages ending in "-teen." Besides the hormones' other maturing effects, androgens also have effects on the skin's sebaceous glands. Located at the root of hair follicles, these glands produce oily "sebum," the stuff face-blotting sheets were made to mop up.

Hair follicles cover the face, back, and chest, even if the hairs are too fine to see, or have fallen out. So pimples can crop up in any or all of those spots. (Thankfully, you'll never find a pimple on your follicle-free palms of your hands, or soles of your feet.)

So what's the sebum/pimple connection? Sebum seeps out onto skin, making it oilier. But the waxy stuff also gets trapped in pores, along with dead skin cells and other debris. As a pore plug gets bigger, it pushes up into a visible bump -- a "whitehead." A plug exposed to air and light oxidizes and darkens, leaving a "blackhead."

And then there are those angry red pimples. The tendency to get pimples is inherited from our parents. But don't blame Mom and Dad. The ultimate culprit is bacteria. Bacteria living in skin pores turn blackheads and whiteheads into inflamed pimples -- the kind you're desperate to get rid of before school-picture day.

How does it work? Bacteria chow down on sebum, dead skin cells and other tasty gunk, slowly multiplying in their cozy (oily) hideout. The result is inflammation, from redness and swelling to a pus-filled sac -- a pimple.

According to researchers, a single bacterium seems to cause most pimples: Propionibacterium acnes. And while P. acnes is right at home in skin pores, the bacterium may lurk inside other body cells, too. Researchers say that P. acnes can grow on the surface of implanted medical devices like joint replacements. The acne bacteria also may be responsible for some eye and chest infections.

As for zits, keeping skin clean helps, as may drugstore lotions designed to unclog pores. Dermatologists also advise avoiding too much sun, which ramps up sebum production -- making breakouts more likely.

Some research shows a link between diet and acne. One study found that pimples receded when young men ate more protein and fewer carbs. And several studies showed that Omega-3 fatty acids, found in fish like salmon or in supplements, improved acne -- probably because Omega-3s reduce inflammation.

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