For some students, pimples started when you began puberty. For others, you are seeing it now for the first time as a young adult. Either way, it can affect your self-esteem. Don't despair. You are not alone.

In fact, many of you inherited it from your parents, especially if you have moderate to severe acne. Any case of acne is important to recognize and address as soon as possible in order to achieve and maintain healthy, non-blemished skin.

In order to understand the treatment of acne, you have to understand how it arises. At the start of puberty, a gland in the skin called a sebaceous gland increases the production of sebum, or oil. The purpose of this gland is to prevent our skin from drying out, but it can make too much oil during puberty because of hormonal changes.

With this overproduction comes filling of pores that can then become plugged. If the pore remains closed, it will present as a whitehead on the surface of your skin. If the pore is open, the material will become blackened because of exposure to the air. This is called a blackhead and has nothing to do with dirty skin, as some people may believe.

There are normal bacteria that exist on our skin called Propionibacterium acnes or P. acnes, which increase when there is an increase in sebum. With that increase there is inflammation at the site of the blocked pore, which will lead to reddened pimples, and with enough of a reaction, to a pustule (a pimple containing pus). If the inflammation is deep within the blocked pore, it can develop into a nodule or cyst, which is larger and can cause pain and scarring.

There is no proof that foods cause acne. However, if you know from personal experience that certain foods will aggravate your acne, you can modify your diet. Also, dirt does not directly cause acne, but washing your face or affected area will help keep your pores open, decrease oil and wash away dead skin cells to keep you looking healthy and to minimize your outbreaks.

Scrubbing your face is not wise because it will cause irritation and will only lead to more inflammation and acne. Squeezing or "popping" your pimples can cause you to push the infection deeper into the pore and make the area more inflamed. This can ultimately cause discoloration and scarring.

Tanning does not clear up acne. It can temporarily mask the acne but can lead to irritation and dry skin, resulting in more breakouts in the future. Finally, using more medication will not make your acne go away any sooner. In fact, applying too much medication can lead to excessive drying and redness that can cause more blemishes.

A clinician will assess what type of acne you have and its severity. Over-the-counter medications, such as antibacterial benzyl peroxide and salicylic acid, may be all that is needed for mild cases of acne that consist of whiteheads and blackheads or a few pimples. If that is not enough, there are several prescription medications used for treatment of acne. Retinoids are topical prescription medications that reverse the plugging of pores. An example is Retin-A, which comes in a cream, gel or ointment in various strengths.

Topical antibiotics can be prescribed and will help control P. acnes that can proliferate within the pimples. There are also combination topical medications of antibiotics and benzyl peroxide. Drying and peeling topical agents counteract the oiliness of the skin. Oral antibiotics may be added if topicals do not control outbreaks. And for women, oral contraceptives can help stabilize hormones that otherwise may lead to increased oil production and cause acne.

Sometimes a referral to a dermatologist or a skin specialist will be necessary for treatment. They may prescribe other medications like Accutane, an oral retinoid that is often effective for severe cystic acne. Specialists will provide close monitoring of people taking this medication because stringent guidelines must be followed.