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Clear Approaches to Skin Care Health & Wellness Volume 1 Number 1 Acne Treatment That Works The Truth About Visualize...for Top Performance Tips for Fab Abs Teens vs. Parents Survey Results The Raw Food Craze Clear Dear Friend Approaches to Skin Care Health & Wellness If you re like so many other teens and young adults who are troubled by acne this issue of CLEAR magazine is intended just for you. In these pages you ll find An article that sheds light on how to win the battle against acne A Q&A section answering common questions about acne A Lifestyle section on other concerns to teens fitness fad diets visualizing and more As a dermatologist who had acne as a teen and young adult I can relate to how it feels to have acne. I wrote the article The Truth About Acne with you in mind to help put you on the road to eliminating acne. Growing up with acne I was always self-conscious about my appearance and tried everything under the sun to try to hide or get rid of my acne. Finally I saw my local dermatologist and got some real help My selfconfidence improved right along with my acne. It was all in a day s work for my dermatologist but it made a huge difference in my life. Now thanks to my own experience as a teen today I am a dermatologist who frequently treats acne. I m always surprised to see how little my patients really know about acne. Many expect me to tell them to wash their face five times a day and avoid chocolate at all cost. Not so I make it clear from the first visit that they are not doing anything to cause their acne. There are however things that do make acne go away. Some require a prescription others do not. None require elimination diets or 30-minute facials. Our goal here is to help you sort fact from fiction and understand why you have acne and how to make it go away. I hope you find this issue of CLEAR helpful and will pass this information along to family and friends. Acne myths have been passed on long enough. It s time for the truth about acne. Warmest regards Julie C. Harper MD Editor-in-Chief 2 Clear Clear Approaches to Skin Care Health & Wellness 4 Volume 1 Number 1 Editor-in-Chief Julie C. Harper MD Editor Annette Lenzi Martin Creative Director David Zwierz Account Executive Howard Good Publisher Frank Rybinski Provided as a service by Stiefel Laboratories Copyright 2012 FMR Communications 1 Office Park West Pennington-Washington Crossing Road Pennington NJ 08534. All rights reserved. The publisher reserves the copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the publisher. The opinions expressed in the articles are those of the authors and are not to be construed as the opinions or recommendations of the advertiser or publisher. Contents 8 Lifestyle 8 10 4 The Truth About Acne Treatment That Works The truth is there are many misconceptions about acne. What really causes it What doesn t How can you conquer it This article reveals the facts and dispels the fiction. Visualize Your Way to Success A Closer Look at the Raw Food Craze What s the Deal on Creatine Or Herbal Weight Loss Products Fab Abs What Works What Doesn t Teens and Parents On Different Wavelengths The Ultimate and Unusual in Summer Jobs Buying Athletic Shoes Follow This Advice 10 Questions and Answers A dermatologist answers the most common questions teens and young adults ask about their acne. Clear 3 The Truth About by Julie C. Harper MD Treatment That Works Acne So you ve got acne. You ve tried everything but it still won t go away. What should you do Believe it or not some of the advice you re getting may be just old wives tales. Today dermatologists know what works and what doesn t in acne treatment. Here s the lowdown on effective ways to win the battle against acne. 4 Clear Acne is a very common problem and you don t have to be a dermatologist to easily make the diagnosis. But treating acne is another story. You might be surprised to learn that there are many myths regarding the causes and the treatment of acne. Magazines and TV are full of ads for acne medicine and well-meaning friends and family are full of advice on skin cleansing diets and home remedies. It s little wonder that many acne suffers are desperate for a cure and willing to follow this advice. But after changing diets trying various home remedies and spending big sums of money on overthe-counter treatments without success the acne sufferer finally arrives in the dermatologist s office and learns the truth about acne. immune system responds to the bacteria by causing inflammation around the involved pore. Inflammation the fourth factor in acne is characterized by redness tenderness and swelling. Redness tenderness and swelling around the pore is commonly referred to as a zit and represents a more mature inflamed acne pimple. What Doesn t Cause Acne Chocolate doesn t cause acne Neither do carbonated beverages or greasy foods. Rather acne is largely a hormonal condition and runs in families. Most environmental factors don t influence the development of acne at all. Of course keeping the face clean is important. But scrubbing the face or washing too often can actually make acne worse. Sweating particularly under a hat or helmet can aggravate acne. Therefore the skin should be gently cleansed as quickly as possible after sweating. What about cosmetics Most cosmetic products are safe to use on people with acne but some of the oilier makeups can cause problems. Some drugs can cause or worsen acne. The most common are steroids taken by young men to build muscle. Because these steroid drugs have many negative effects aside from acne they should be avoided. What Causes Acne Oily skin clogged pores bacteria and inflammation all work together to cause acne. There are four key players involved in the development of acne. Oily skin clogged pores bacteria and inflammation all work together to cause acne. Oil plays a critical role in acne. Acne develops during puberty when hormone levels begin to rise. These hormones circulate in the blood and attach to the oil glands in the skin causing them to produce oil or sebum that makes the skin feel greasy. The oil gland (called the sebaceous gland) is located in the skin that attaches to the hair pore (follicle). Oil is released from the gland and travels through the pore to get to the skin surface. The greatest number of oil glands is located on the face upper chest and upper back the same areas where acne arises. Just as oil is necessary in acne development so is the clogging of the hair pore. In fact when studying acne under the microscope the earliest pimple shows only plugging of the hair pore without any bacteria or inflammation. This early pimple called a microcomedo is invisible to the naked eye. All pimples start as a microcomedo. Scientists theorize that oil and hormones trigger the hair pore plugging but the exact cause is unknown. A third key player in acne is bacteria. Although not present in the earliest stages of acne bacteria are almost always present later on. The particular type of bacteria found in acne known as Propionibacterium acnes grows best in the plugged hair pore where it feeds on the oil. The bacteria itself is not a problem. The problem is that the body s Finally stress can certainly cause acne to flare. And in young women acne can worsen around the menstrual period. Everyday Care for Skin with Acne Less is probably more when caring for acne-prone skin. Here are some skincare tips to follow if you have acne Use a gentle non-abrasive cleanser. Wash with your fingertips rather than a rough washcloth. Use lukewarm water instead of hot water. Don t pick or pop pimples. This results in a longer healing time and increases the risk of scarring. Clear 5 Acne It s Not What You Eat You want to eat a well-balanced diet for good health of course. But contrary to conventional wisdom foods don t contribute to acne. That means acne has no relationship to bacteria present in acne pimples. Salicylic acid alphahydroxy acids and retinols target the plugging of the follicle but they have only a weak effect. Over-the-counter remedies are a reasonable place to start when mild acne develops. But if acne persists after trying one of these medications it s time to make an appointment with your dermatologist. Prescription Acne Treatments Chocolate Carbonated beverages Pizza French fries Other greasy foods Prescription medications are formulated to target and reverse the changes excess oil clogged pores bacteria and inflammation that lead to the development of a pimple. Remember that all acne starts microscopically as a microcomedo. Eventually large red tender zits can develop and if left untreated permanent scarring may result. Prescription medications include Topical retinoids. Some of the most effective acne medications prescribed are the retinoids. Retinoids unplug the hair pores and over time decrease the number of microcomedones. They are also anti-inflammatory. Retinoids can either be applied topically (adapalene tazarotene tretinoin) or may be taken by mouth (isotretinoin). The oral retinoid also dramatically reduces oil production. Obviously the retinoids target multiple causes of acne and are a good addition to any acne treatment plan. The most common side effects of topical retinoids are facial dryness redness and peeling. These side effects may be avoided by washing with a mild cleanser and letting the skin dry for 20 to 30 minutes before applying a pea-sized amount of the medication. Because these medications work on microscopic acne it is important that they be spread evenly over the entire acne-prone area and not limited to areas with active acne. Oral retinoids are extremely effective in treating acne but a long list of potential side effects limits their use to patients with very severe acne. Topical antibiotics. Antibiotics are a mainstay of acne treatment. They have been used with much success for many years and continue to be an important part of effective acne treatment for many acne sufferers. Benzoyl peroxides are highly effective in reducing the number of bacteria in acne. They also have a weak unplugging effect in the hair pore. An advantage of benzoyl peroxide is that it can be used effectively long-term without bacteria A toner or astringent is not needed and may actually irritate the skin. Many of these products contain alcohol which can cause overdrying of the skin. Rubbing alcohol should not be used on the skin. Masks and exfoliators should be avoided in acne-prone skin. If you need a moisturizer look for a product that is noncomedogenic (won t cause microcomedo formation). Noncomedogenic sunscreen is also available. Remember wearing sunscreen is an important part of a comprehensive skin care regimen. Over-the-Counter Acne Treatments Most over-the-counter acne treatments various washes creams gels and pads are designed to treat acne by killing the bacteria. The ingredients found in these products may include benzoyl peroxide salicylic acid alpha-hydroxy acids or retinols. Benzoyl peroxide works by decreasing the 6 Clear becoming resistant to the medication which is a common problem with other antibiotics. Other topical antibiotics (clindamycin erythromycin) work well in acne but their success is limited by the development of bacterial resistance. However when these antibiotics are combined with a topical benzoyl peroxide they remain effective long-term without the development of resistance. The latest combination product DuacTM Topical Gel (1% clindamycin 5% benzoyl peroxide) is unique from others on the market because you only have to use it once a day for effective therapy. Unlike older combinations it also does not require refrigeration and is available in a convenient readyto-dispense tube. Oral antibiotics. Oral antibiotics (tetracycline doxycycline minocyclifne) are often prescribed to treat acne. These medications also decrease the number of bacteria present in acne and are anti-inflammatory. As with the topical antibiotics bacteria can develop resistance to these antibiotics and the antibiotics may lose their effectiveness. Combining a topical benzoyl peroxide medication with an oral antibiotic will decrease the development of bacterial resistance. What s Best for You Talk to your dermatologist about which treatments will be most effective for you. Often a combination of several of medications offers the most improvement in the shortest amount of time. Whatever treatment approach is determined for you you ll need to keep in mind that treating acne takes time. Expect only 40% improvement after two months of treatment. It may take nearly six months of treatment to clear the acne. At that point it will be important to continue a maintenance therapy to prevent acne from recurring. The good news is that teenagers today can benefit tremendously from the medical advances in acne treatment. The author Julie C. Harper MD is a practicing dermatologist and Assistant Professor of Dermatology at the University of Alabama-Birmingham. Clear Lifestyle Whether you re in class in training or in competition you can boost your chances of scoring big through visualization techniques. Visualization thinking and seeing yourself perform successfully is a proven technique among top achievers. Here are some tips Visualize from your mind s eye how you want to perform. Use as many senses and intelligences as possible (see touch hear smell taste feelings muscle use). Visualize often (especially when you get up after practice and always before you fall asleep). Visualize all the various situations you will be facing. Visualize doing an excellent job performing the skills most difficult for you. Repeat each image in your mind as many times as possible. Visualize Your Way to Success A Closer Look at the The latest food fad the raw food craze claims that cooking kills nutrients and makes food decay in your stomach. But is that fact or fiction The truth is cooking isn t bad for foods. In fact cooking makes veggies easier to digest. And unlike what raw food gurus say heating foods doesn t destroy protein or fiber. What s more although some vitamins such as vitamin C and B benefit from minimal cooking other nutrients such as cancer-fighting lyocopene actually need heat to be released. Raw Food Craze What s the Deal on Creatine Or Herbal Weight Loss Products Creatine a substance that provides energy for muscles is used by some pro athletes but is it safe for teenagers to take Experts from the Mayo Clinic say its effects in teens are unknown and studies are needed to see if it s safe for this age group. Researchers do know that creatine alone without rigorous training won t increase muscle size and it won t help you become an athletic superstar. As for herbal weight loss supplements the verdict is clear None are effective long-term and some have ingredients that cause dangerous side effects. For example ephedra (also called ma huang) can wreak havoc causing dizziness jitters insomnia and heart problems. Some users have even had strokes heart attacks and seizures and in fact some athletes who have taken ephedra to boost performance have died from its use. Ephedra is so bad for health that Illinois recently became the first state to ban its sale. Other herbs found in diet aids can also be harmful or even deadly in large doses. Among these are chickweed ginseng kelp and bee pollen. 8 Clear Fab Abs What Works What Doesn t When it comes to getting great abs forget sit-ups They work more hip flexors than abdominal muscles and besides they can be hard on your back. Instead stick with crunches (lifting your shoulders a few inches off the floor). Another tip You don t need to do a zillion crunches to get strong abs. You wouldn t do 200 curls for your biceps and the same is true for abs. In fact if you can do 100 crunches you need to slow down and concentrate on form. Keep it slow and controlled. Contract your abs before you lift your body. And don t cheat by pulling on your head Teens and Parents On Different Wavelengths Talking with teens was the focus of a YMCA survey which revealed both good news and not-so-good news. On the up side the survey found that most teens (78%) turn to their parents in times of need and that boys are more likely to do so than girls (84% vs. 72%). But teens and parent differ on what they consider important. Teens are three times more likely than parents to say that not having enough time together is their biggest concern (21%). In fact family quality time tied with education for first place on the teens list of concerns. But with parents outside threats such as drugs and alcohol was their top concern while family quality time came in fourth. When families do spend time together the communication is not getting through completely. For example parents think they talk frequently (64% of the time) to their teens about values and beliefs but teens say they only hear it 41% of the time According to the survey 62% of parents say they definitely share the same basic values as their teens but only 46% of teens say this is true. The Ultimate and Unusual in According to a recent survey by Tombstone Pizza of 1 500 teens across the country nearly 90% of teens said they planned to get a summer job. Not surprisingly their preferences differed according to gender. The top job among boys was being a tester for new video games being developed while teen girls listed personal shopper at a major clothing store. For those not fortunate enough to land the ultimate in summer jobs other options are out there. Aside from the usual (mowing lawns babysitting working at a fast-food restaurant or a supermarket washing cars) consider these more unique opportunities dog walking or vacation pet care running errands for busy people teaching older people to use computers or the Internet creating Web sites house painting or baked goods (baking and selling them at local craft or farmers markets). Summer Jobs Buying Athletic Shoes Follow This Advice The next time you re buying athletic shoes consider these tips from shoe experts Shop late in the day (because your feet swell during the day). Measure your foot while standing not sitting. If one foot is larger than the other (which is very common) buy for your larger foot. Allow a thumbnail s width between the shoe and your big toe. Clear 9 Clear Questions Some common questions about acne are answered below by Clear s editor-in-chief Dr. Julie C. Harper Q How should I care for my acne-prone skin A Treat acne-prone skin very gently. Avoid harsh abrasive cleansers and drying toners or astringents. Wash with your fingertips using a gentle cleanser and lukewarm water. A noncomedogenic (won t clog pores) moisturizer can be used if needed. And don t forget to apply sunscreen as a vital part of any comprehensive skin care regimen. Q What am I doing to make my acne worse Q I have tried everything (for three weeks) and nothing is working. Now what should I do A The answer might surprise you. Overwashing or scrubbing the face and involved skin may actually make acne worse. Greasy cosmetics or hair care products may also worsen acne. Look for products that are noncomedogenic which means the product won t clog pores. Otherwise acne is hormonally driven and is a hereditary condition. Some other facts that may surprise you Chocolate and greasy foods don t cause acne and drinking more water will help your kidneys way more than it will ever help your acne. A Three weeks is not long enough for any acne treatment to have a significant impact. Wait and stick with it. After two months of treatment you can expect about a 40% improvement. It will take nearly six months to see the results you want. Hang in there Q I am having an allergic reaction to my topical medicines. My face is red dry and peeling. What should I do Q Should I get a tan to make my acne go away A Some people believe their acne improves when they are in the sun. Others believe their acne worsens. What we do know is this Getting a suntan is a definite risk for developing skin cancer and skin cancer can be deadly and deforming. You can turn to good safe treatments for acne that don t have this link to skin cancer so why risk your future by getting a suntan today Having clear skin right now is not worth the danger of losing a nose an ear or your life later on to skin cancer. Use sunscreen A Allergic reactions certainly can occur with topical acne preparations but it is far more common to see simple skin irritation. If you don t have itching weeping or swelling in the area where you ve applied the medication then review the proper use of the medication. Make sure you are cleansing with a mild cleanser. Avoid products with alpha-hydroxy acids and salicylic acids if the face is irritated. Let your face dry for 20 to 30 minutes after washing before applying the medication. Use only a small amount of medication and use a noncomedogenic moisturizer immediately afterwards if needed. Also consider using the medication every other day until the redness goes away. Let your doctor know if the problems persist after making these changes. 10 Clear