Dear Dr. Benabio,

OMG, my face is a disaster! My acne is worse than ever. PLZ help me!

Desperately,

Your Patient

Many of my patients email me; this is the most common email I am getting this week. Why is everyone’s acne flaring up all of a sudden? It’s because of this simple formula: [High School Stress + Hormones = Acne].

Acne results when your pores clog, trapping sebaceous oils and bacteria deep in the skin. When you’re under stress, your body releases cortisol, a hormone that helps you stay alive in life or death situations. High school, however stressful, is not usually life or death, but your body doesn’t know that, and it reacts as if it were.

Two side effects of increased cortisol are increased sebaceous oil production and increased inflammation in your skin. The result: big, red pimples in the middle of your face that make you now wish you were dead.

If you have painful, cystic acne bumps, then your dermatologist can inject the worst ones with steroids to reduce the inflammation and to flatten them out quickly — “Nurse! Give me a syringe with Kenalog. Stat!” (Who said I don’t do emergencies?) Steroid injections can, however, cause atrophy or dimpling in your skin, which can last for months — much longer than the original pimple.

• Spot treating acne is difficult at home. Tretinoin products such as Retin-A, Differin, or Tazorac do not work if applied to acne spots.
• You can pop a pimple; however, unless it has a white head, squeezing usually just makes a little pimple into a big pimple.
• Apply a spot acne treatment such as Neutrogena Rapid Clear Fight and Fade Gel. The mild acids in it help dissolve a pimple when applied directly.
• Use a spot cover-up or concealer that has salicylic acid in it. Yes, guys, it is OK for you to apply a dab of cover-up. Use your sister’s.
• If you have a little extra cash lying around (humor intended), then acne zappers like Zeno can help. They apply heat directly to the pimple killing the bacteria and hastening recovery. Or just use your iPhone, (I’m sure they will have an app for that soon, right?).

Remember that school is stressful, so eat well, sleep well (preferably not in calculus class), and exercise regularly. These will decrease your stress hormones and help keep you acne free.

Disclaimer: I did not receive any free products or reimbursement from any products mentioned in this post; these are my unbiased suggestions.

Photo: John Steven Fernandez