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You've got plans, new clothes. It's gonna be a great weekend. At least it was until you noticed a big zit.

Acne affects just about everyone. It's the most widespread skin condition in the world. More than 85 percent of 12- to 24-year-olds have some type of acne.

Acne isn't some kind of cosmic retribution for bad behavior or eating too much junk food. It occurs when dead skin cells mix with the body's natural oils and plug the pores. The severity of an outbreak is affected by hormones and genetics.

What's a person to do? You're not totally to blame for your blemishes. However, eating a balanced diet, gently washing your face twice a day, regular exercise, a good night's rest and avoiding stress can help reduce the occurrence and severity of outbreaks.

"They're like little infections. It's not going to clear up right away," says Washington Twp. dermatologist Dr. Samia Borchers, who was recognized in 2001 as the outstanding dermatologist of the year by the Ohio Dermatological Association. Dr. Borchers says there's only one sure cure for acne and that's Accutane.

Accutane

Accutane is the strongest oral medication available. It's the gold standard for people with severe cases. It's also very expensive and highly regulated.

According to Dr. Borchers, Accutane is strictly regulated by the government, due to the possibility of birth defects and suicidal depression. For these reasons, Accutane is only prescribed for patients who exhibit scarring from acne and have shown little or no benefit from standard treatments. There are other side effects, such as dry lips, eyes and skin.

"It dries you out. I needed nose spray, eye drops, moisturizer and lip gloss," Magsig Middle School mathematics teacher Jill Parker said.

The monthly costs associated with Accutane include the required blood work and, for females, pregnancy tests. That's in addition to the $500 to $600 for generics.

"It's worth every penny," Parker said.

Parker, who comes from a long line of acne sufferers, was part of a Clearasil test back in the 1960s. Parker figures she was in the placebo group because it didn't help her acne. The only thing that did work for her was Accutane.

Topicals

BenzaClin is another prescription medication. It's not recommended for patients who have a history of enteritis or colitis. The medication has a shelf life of two months.

Proactiv, like BenzaClin, contains a bleaching agent.

"Only use white towels when using Proactiv," Beavercreek interior designer Jenny Ackerman said. "It shows on all the towels you use. I got it on my clothes several times, and you smell like bleach all day."

According to the Proactiv Web site (www.proactive.com), side effects are usually mild, such as dryness and irritation. Potential users are directed to seek advice from their physicians.

Ackerman's dissatisfaction with Proactiv led her to switch to Nourifusion Multivitamin Skin Care System, a product she obtained from her Herbalife representative.

The Herbalife Web Site provides no details on side effects. Ackerman said her Herbalife representative can be contacted at www.jjGetResults

Shop.com.

Over-the-counter acne ointments are relatively inexpensive but helpful only for mild to moderate acne. Dabbing ointment on today's zit won't help to reduce future acne because the acne you see today began developing two to three weeks ago. So a daily regime is required to reduce the chances for and severity of future outbreaks.

Light treatments

Two of the newer treatments employ light. Dr. Borchers said the results she's seen aren't particularly good and that the treatments are controversial. Light therapy targets the bacteria that cause the inflammation associated with acne. Treatments require multiple sessions during the course of a month and provide a temporary reduction in the appearance of acne.

The American Academy of Dermatology cautions patients to be sure to have a qualified physician conduct potentially hazardous procedures to reduce the risks for error. These procedures can be costly and may not be covered by insurance.

Centerville dermatologist Karl Kellawan uses the Omnilux Blue light- therapy treatment.

"If a teenager comes in and wants to be cleared up last week, I'll use the Omnilux. It helps to clear up the acne in about three weeks," Dr. Kellawan says. "I use traditional treatments like lotions to maintain, because long-term usage of the Omnilux is prohibitively expensive."

Jiva Med Spa, (937) 306-1555, in Beavercreek includes the Aramis laser in its arsenal of treatments to fight acne.

Tanning beds and direct exposure to sunlight may initially improve acne, but continuous exposure may plug pores and lead to more pimples. Too much exposure may result in skin cancer. The medical community believes that the risks of sun exposure outweigh any benefits.

Take the acne test

1. True or false? Be patient. You'll outgrow it.

2. True or false? Freshen up. It's only caused by dirt.

3. True or false? There can be such a thing as too much soap and water.

4. True or false? Ah, nuts! You have to give up chocolate.

5. True or false? Don't cover up. Makeup makes it worse.

Answers:

1. False. Acne can happen at any age. While more than 85 percent of all people 12 to 24 get acne, it can also affect people of any age, especially women, because their hormones fluctuate. Genetics is another factor that contributes to the onset and severity of acne.

2. False. Acne is not caused simply by poor hygiene. Acne is due to the buildup of dead skin and natural oils produced by our bodies. When these clog the skin's pores, bacteria go to work. The result is acne.

3. True. Too much soap or use of alcohol-based cleansers makes the skin dry. Dry skin results in excess dead skin and stimulates the production of extra oil, which can lead to an increase in acne.

4. False. Scientists have been unable to find any substantial connection between what you eat and acne.

5. False. The use of makeup designed not to clog pores — oil-free and hypoallergenic — shouldn't contribute to the problem and can be beneficial if its use helps to raise self-esteem.

Contact this writer at ferris-olson@woh.rr.com.