For the majority of people, acne comes, stays for a month or so, and then passes peacefully away. There’s some looks and comments to put up with but, for the most part, the whole experience is painless. But for those of you who are unlucky, the comments and behavior toward you are cruel. This is more likely when a mild outbreak refuses to clear up, or the outbreak is more severe. Then those whose mouths are bigger than their brains will suggest you have hygiene problems or start treating you as if you have leprosy or some serious contagious disease. This can cause emotional scarring. No matter how you prepare yourself when you leave home every morning, there’s a sense of dread you can never shake off as you approach school or work. It passes beyond self-consciousness. It becomes a fear of being seen in public. Left untreated, this can become social anxiety disorder or, in the worst cases, agoraphobia. In theory, schools and colleges are supposed to have policies in place to deal with bullying. Workplaces are supposed to have codes to deal with harassment. But the reality is that pieces of paper cannot stop a group of fellow students or colleagues from making your life a misery. Because your emotional health is at risk, this is not a time to be slow in coming forward. You need to get protection and support. Failure to confront the problem now simply stores up the problem for you in the future. When it comes to physical scars, only a small number of people have levels of inflammation or skin irritation sufficiently severe to leave blemishes as the acne heals. No one is sure why some people scar and others do not. It seems to be something to do with the way the collagen in your skin reacts, causing a change in the texture or coloring of the skin around the site of the inflammation. This can show as small pits or holes in the skin. These are not usually deep and have smooth edges, but one variety is called “ice pick” where the hole is deeper, has steeper sides, and has more defined edges. Or there can be slightly raised, thicker scar tissue on the chest or back. These scars are more common on those with darker skin so if you are African American or Asian, you should have early treatment to reduce the risk. Physical scars can be a permanent mark, but you can have them removed by dermabrasion – a procedure that removes the top layers of skin. This can be painful for ice pick scars and a local anesthetic is used. If deep abrasion is required, there can be risks of even further damage to the skin, so take proper medical advice before consenting to the treatment. This should emphasize the importance of early treatment to prevent the acne from growing severe. If the other treatments fail, Accutane will restore unblemished skin. But do remember the risks. Do not use Accutane for more than three months in any one session. If you can have children, take every possible precaution to prevent pregnancy.

The changes in levels of hormone in the human body can play a decisive role in whether and when acne appears. As children go through puberty and sexual maturity dawns, the range and balance of hormones slowly change over to the adult requirements. In the male biology, the transition usually results in a stable balance of hormones as an adult. The female adult biology, however, is not stable. There is a slow shift in the hormone balance through the menstrual cycle and a major change during pregnancy. In many ways, the monthly cycle emphasizes the fundamental unfairness of biology. Not only do women have to put up with cramp and pain, their appearance can also be blighted by the appearance of acne. As to pregnancy, there is little that can be done to relieve the problem of acne other than lifestyle changes. The most powerful drug is not available to any women during pregnancy because of the high risk of fetal abnormalities. Patience sees the acne disappear naturally after birth.

For the monthly acne, there are a number of natural steps you can take to reduce the seriousness of the problem. First, you need to consider diet. A high-fibre content is the ideal with plenty of fruit and vegetables. The aim is to ensure regular bowel movements. A proportion of the hormones excreted into the blood stream are diverted into the gut. Regular motions eliminate them before they can be recycled back into the body. Drinking plenty of water is also helpful to flush toxins and waste out your digestive system. Ensuring you have the right find of fat influences the hormone levels. Omega 3 fatty acids are the best, found in fish like salmon and halibut, tofu, various nuts, seeds and so on.

Diet must be supported by getting enough good quality sleep and reducing the stress in your life. It’s important to sleep six to eight hours every night, preferably going to bed before midnight to ensure the sleep restores the body to health. There is long-standing research to show sleep improves the body’s immune system so you should stay free of the usual coughs and colds. More generally, stress management strikes the right balance between the hormones: estrogens and cortisol. Adding regular exercise helps the mind relax, encourages deeper sleep and improves bowel regularity. Taking all together gives you a better quality of life and reduces the risk of acne.

If these lifestyle changes prove insufficient, then you have to decide whether your appearance is important enough to justify using accutane. This drug is a more-or-less guaranteed cure, but to use it safely requires you to ensure you cannot conceive. This means taking every reasonable precaution against pregnancy. Ironically, some of the oral contraceptives also help control acne. If you buy accutane in addition, the treatment is usually sufficient the first time round. If there are blemishes left at the end of the first three-month course, a second three months always clears the skin. This can produce a positive year for you. The lifestyle changes will boost your general health. You will feel fitter and stronger. If, at the end of six months, the acne remains a problem, the use of accutane will complete your transformation into a beautiful person inside and out.