Pimples, technically known as acne vulgaris, are nothing more than plugged-up skin pores. As shown in the diagram below, whether they are white heads or black heads, big or small, they are all just different stages of the same problem – blocked skin pores. Acne often begins during puberty as a result of the release of various sex hormones. Pores become blocked with oil (sebum), which then seals the pores. More solid skin debris (keratin) is produced and plugs the openings of the pores. Acne is often worse on the face, shoulders, back and chest because that is where these changes in skin and oil production usually occur the most.

Blocked hair follicle pore builds up skin oil and becomes infected.

Once the outlet for an oil gland is blocked, the sebum builds up beneath the surface of the skin and causes a "white head." If the sebum is exposed to air but still stuck in the pore, it darkens into a "black head." Infection from bacteria or irritation causes swelling, redness, and pus. These infected cysts are the worst form of acne and can spread infection and cause permanent scarring.

Anything affecting the amount of skin oil, dead skin cells, dirt and other debris, or infectious bacteria on your skin will affect your acne in that area. Of course, the best way to prevent big, red, painful pimples is to stop squeezing and picking at them! This often just bursts them deep inside, enlarging and spreading the pimple.

Squeezing an infected pimple or cyst causes infection to burst out both above and below the skin, spreading the infection and causing scars.

The goal of acne prevention is simply keeping your pores open. You'll have to follow several steps every day for the best results:

• Wash your face at least twice a day, especially after sports or other activities that make you sweat or get your face dirty. Don't use a harsh detergent or very drying, abrasive soap.

• For best results, cleanse your face gently with a soft washcloth and mild facial soap. The goal is to gently remove oil, dirt and bacteria from the pores; scrubbing off a few layers of skin won't help and just causes more damage. Don’t try to exfoliate skin that is troubled by acne. Don’t wash acne-prone areas with rough sponges or loofas.

• Use water-based cosmetics only. Read make-up labels. Oil-based products (containing lanolin, mineral oil, or cocoa butter) plug up pores and worsen acne. After you finish removing make-up, be sure to wash your face as described above.

• Avoid athletic gear with headbands or chin straps. They may cause or worsen your acne just by skin contact.

• Avoid environments with lots of dirt or oil in the air (machine shops, commercial kitchens). They will also coat exposed skin and plug your pores.

Although some individuals may suffer "breakouts" of acne following certain foods, it's a myth that chocolate, caffeine or greasy foods commonly cause acne.

An important note to remember about tanning: it may temporarily improve your complexion, but it probably does so by damaging your skin and follicles. Premature aging and wrinkles can be visible in your 20's. So don't tan for the temporary improvement of acne. You will probably regret it in the future.

If you turn the above suggestions into consistent everyday habits, your acne may improve. If you don't get good results, over the counter topical medicine is the next step.

Over the counter treatment is aimed at breaking down the solid debris blocking the pores and removing it. Following the suggestions below will help you achieve that goal.

• A twice-daily regimen of gentle cleansing with a soft wash cloth and unscented, gentle soap will remove oil from your skin surface and pores, as well as some microscopic solid material and bacteria.

• After your skin has dried, apply a keratolytic medicine. It will help break down dead skin cells that remain behind and keep them out of the pores, readying them for removal the next time you wash your face.

• You may apply water-based cosmetics after this routine in the morning. At night, remove cosmetics with a gentle water-soluble make-up remover before washing your face, then apply the medication again.

Remember, consistency is very important in treating acne. You'll need to make the above routine a habit! Self-treating your acne with over the counter medicines can improve your complexion, but it won't cure it. If you are not satisfied with the results of over the counter treatment, the next step is to see a doctor.

We must note that the active ingredient benzoyl peroxide is no longer a Category I agent. It remains highly effective and available in both prescription and OTC forms. However, the FDA has not seen evidence to conclusively prove its long-term safety. Since there is no firm evidence that it is unsafe, it remains available and widely used by physicians and the public.

• Zenmed Derma Cleanse System is a proven formula that can help clear acne as well as prevent future breakouts from occurring. It is an all-natural treatment with powerful skin clearing botanicals that can show results in just a few days.