Dear Doctor,

My daughter is 15 years old but she has a pimple problem that is killing her self-esteem. I have tried soaps and lotions recommended by friends but nothing seems to work. On the contrary, it looks like it is getting worse. She is a pretty girl but many times, she gets teased about the pimples on her face. How can I help her? Is there something you can recommend?

Fiona

Dear Fiona,

Pimples are a common teenage problem. The sebaceous glands, which produce sebum, exist inside the pores of our skin. The outer layers of our skin are being shed continuously. Sometimes, dead skin cells are left behind and get stuck together by the sticky sebum, causing a blockage in the pore. This leads to swollen reddish lesions which become filled with pus.

The development of pimples is primarily connected to oil production, dead skin cells, clogged pores and bacteria. Yeast infection can also cause pimples to develop.

Sebaceous glands, which are located at the base of hair follicles, can become overactive due to changes in the balance of hormones, which is why pimples are most commonly associated with puberty, and why breakouts occur around the time of menses. Though not frequent, they can occur around middle years as well.

Propionibacterium acnes, a bacterium, generally exist harmlessly on the skin; however, when the conditions are right, it can reproduce more rapidly and become a problem. The bacterium feeds off the sebum and produces a substance that causes an immune response, leading to skin inflammation and spots.

Fatty food has long been said to cause pimples. However, this has not been scientifically backed up in recent studies. Mental stress has also been implicated in causing pimples and aggravating them in those who are susceptible.

The most likely parts of the body to be affected by pimples are the face, back, chest and shoulders due to the proliferation of sebaceous glands in these areas of skin.

As such, pimples are quiet harmless. They may come and go or persist in more or less numbers, depending on the skin type of a person. They are not contagious as well. Only risk is, if somebody scratches it, finger nails can present infection. Popping it can lead to a permanent scar.

As such, no active treatment is needed. Leading health experts have already expressed their concern over use of antibiotic tablets and creams in treatment of pimples, where it helps only in a small way but is contributing to antibiotic resistance. Retinoids and benzoyl peroxide creams are useful in treating pimples.

Keeping the face clean and dry helps in minimising the risk of pimples. Hormone therapy is useful for those in whom it is persistent or problematic like big and extensive pimples. Dermabrasion is yet another option in those with a persistent problem. Here the superficial skin is scraped off, with the view that new skin regenerating would be okay.

Counsel your child; she has nothing to worry about. As for her schoolmates teasing her, it is adolescent behaviour, ignorance on their part and is best ignored.