Acne is the most common skin disorder in the world. Blemishes, bumps, papules, pustules, spots, whiteheads, zits, goobers, the plague, or whatever you call it, almost everyone is liable to get it. In the United States and Canada, acne affects 45 to 55 million individuals at some point in their lives, the vast majority of whom are teenagers.

In fact, nearly 80 percent of all young people will face at least an occasional breakout of acne. Acne imposes itself on young men and young women about equally, but young men are likelier to have more severe forms of acne. The events that take place in the sebaceous glands and hair follicles trigger acne.

The exact cause is unknown; however, regardless of a person’s age, acne is a condition of clogged hair follicles and the reaction of sebaceous glands, glands that are attached to hair follicles and produce an oily substance called sebum. Mix in some dead skin cells that become “sticky” and block the pores, add a bit of bacteria, and you have the makings of a breakout.

Doctors believe that these events, and acne itself, result from several related factors, including your hormones (which are responsible for increasing oil production) and heredity (the tendency to develop acne is often inherited from parents and other relatives).

Less commonly, acne can occur as a reaction to certain drugs and chemicals, and other physical factors may exacerbate the problem. I cover all of these issues, including the myths and misinformation concerning the causes of acne, but I’ll put one myth to bed right now that will come as good news.

Pizza, French fries, and other greasy foods don’t cause acne or make it worse. You’re welcome. (I’m a doctor, so I’m compelled to remind you that though these foods won’t affect your acne, they aren’t the building blocks of a healthy diet.)

But before you snidely bring this mistaken notion to your mom’s attention, another one of her common statements is right on the money: “Quit playing with your face.” Picking does make zits worse!

Whiteheads, Blackheads, and Zits

In most cases, acne starts between the ages of 10 and 13 and usually lasts for 5 to 10 years. The appearance of teenage acne (acne vulgaris is the technical term that I throw around here) is largely the result of your body’s increased production of hormones.

The good news is that those embarrassing blemishes usually go away and are often gone for good by the time you reach your early 20s. However, the not-so-good news is that for some unlucky folks, acne vulgaris can persist into their late 20s or 30s or even beyond. But back to the good news: There are many steps you can take to zap the zits and improve the appearance of your skin.

Although acne is typically thought of as a condition of youth, an ever-growing number of women (less often men) get acne for the first time as adults. Acne is no longer just a teenage affliction. There’s definitely been a rise in the number of adult women in their 20s and 30s with acne — even those who never had a pimple before!

Teenage and adult-onset acne have somewhat different characteristics. For one thing, the appearance is different: Adults have fewer blackheads and whiteheads; for another, adult acne tends to be more often located on the lower part of a woman’s face.

Also, the appearance of female adult-onset acne is often closely linked to a woman’s menstrual cycle as well as increased sensitivity to hormones such as those brought about by pregnancy, starting or stopping birth control pills, and other hormonal abnormalities. If you’re really unlucky, you have adult-onset acne and have also brought along some acne vulgaris from your teenage years.

Acne-Treating Program

If you have acne in the 21st century, you’re fortunate. Why? Because there are so many great ways to treat it and there are many more to come. But there are no quick cures for acne; in fact, there aren’t really any cures.

The goal of treatment is to manage your acne, help control it, prevent it from scarring, and help you look your best. The truth is that acne tends to heal itself over time, but the right therapy can make your skin look better.

Acne treatment methods

Until the last couple of decades, there was very little anyone could do to treat acne. But we’ve now come a long way from the “dark ages” of arsenic and puppy blood. Now we have excellent methods to treat acne and the future looks even brighter. There are:

• Over-the-counter topical (applied to the skin) products that contain such tried-and-true medicines as benzoyl peroxide.

• Topical antibiotics and retinoids.

• Oral antibiotics.

• Hormones and anti-androgens for females.

• Oral retinoids, like Accutane.

• Chemical peels, special lasers, and lights.

Some people also claim that various alternative and complementary approaches have helped improve their acne.

Deciding whether to treat acne yourself

If you’re just starting to get breakouts or you have really mild acne with a few blemishes here and there, the over-the-counter (OTC), do-it-yourself route that may be just the ticket for you. Look in the mirror. If you see a few blackheads and whiteheads or a few pimples, you can probably find ways to treat them on your own.

You can find many acne products waiting for you at your local drugstores and cosmetic counters. You can do many things to improve the appearance of your skin without a prescription if you’re a teenager just starting to get acne. Shelves are also stocked with products specifically geared toward adult women.

You can also follow some of my skin-care tips and further ideas to help you that I bring up, like the face-washing advice, the tips for healthy skin, or the list of things you should never do to your skin.

Although going to a doctor generally costs more than buying a cream at your local drugstore, you’ll likely save money in the long run and get better results than you’ll get by running through the gamut of OTC acne products.

Relying on the acne experts

For some folks, acne can be more serious. In fact, by their midteens, more than 40 percent of adolescents have acne severe enough to require some treatment by a physician or a dermatologist who is an authority when it comes to acne.

And adult women who are having problems getting their acne to respond to treatment often need to make an appointment with a doctor. But no matter who you are, you should definitely have your acne evaluated by a knowledgeable healthcare provider if:

• Your acne didn’t respond to home remedies, diets, herbal medications, facials, special soaps, or nonprescription OTC treatments.

• Your skin can’t tolerate the OTC preparations.

• Your acne is widespread and it involves your chest and back.

• Your acne is beginning to scar or has already scarred.

• Your acne has become more severe.

• You are a female who develops facial hair or has irregular periods.

• You’re not a “do-it-yourselfer” and you want the pros to handle your acne.

• You have dark skin, and patches that are darker than your normal skin appear after your acne lesions clear.

In addition, you may need help dealing with acne scars, both the physical and emotional:

• Preventing and repairing scars: Even very mild or occasional breakouts have the potential to leave permanent scars. There are now exciting innovations in dermatologic surgery using lights, lasers, and chemical peels to help improve the appearance of the skin before and after acne has left its marks.

• Healing the inner scars: The emotional effects of acne haven’t always been fully appreciated, but many studies have demonstrated its damaging psychological impact. Nowadays there is a much greater interest in preventing and healing the inner scars of acne.

Avoiding quickie, quacky acne cures

Because your acne appears on your face and everyone can see it, you may feel desperate to make it go away. But because it’s not life threatening, you may feel reluctant or embarrassed to go to your healthcare provider about it. Certain people prey on that knowledge.

They want to sell you expensive over-the-counter acne “cures” that don’t do you any good, or get you to order them after watching testimonial-filled infomercials. The people giving those acne “testimonials” on TV are almost always professional actors reading a script.

And even those stories that are “real” generally mean nothing. You can always find one or two success stories while ignoring 99.9 percent of failures. Even if it’s on TV, on the radio, the Internet, or in magazines, that doesn’t mean it’s necessarily true. The world of acne fighting is filled with snake oils and false promises.

There are promises that guarantee “five day cures” for your acne, and there are the real slow pokes that state, “try this all timetested home treatment for acne and have clearer blemish-free skin within 30 days of use.” You can find many similar “cures” if you search the Internet.

Also, check out QuackWatch.com, a nonprofit organization whose purpose is to combat health-related frauds, myths, fads, and fallacies pertaining to health-related issues. Its primary focus is on quackery-related information.

There are several skin conditions that appear to be acne, but that aren’t acne at all. Rosacea and keratosis pilaris closely resemble acne, as does another acne look-alike, pseudofolliculitis barbae — also known as razor bumps. These conditions, among others, are pretenders that sometimes even fool doctors into thinking they’re actually acne. There are many ways to control these acne impostors.