Once children are old enough to start to talking to each other about what it's going to be like when they are teens, the first thing mentioned is likely to be acne. Forget all the other sources of angst. This is the one big fear to confront. And, because they all start talking about it young, they create a mythology about when it's first likely to appear, what causes it and how long it lasts. They start monitoring their faces. They speculate on how well they are likely to stand up to the comments. It becomes a dominant part of their lives. We can all wish it were not so. There's just so much cruelty out there. But, until there's a cultural revolution and we all decide to accept each other as people, the young will no doubt keep on torturing each other. Except it's no longer just a problem for the young. The latest figures suggest that about 15% of adult women are now asking for acne treatment. This may simply be more women asking their doctors for treatment rather than relying on cosmetic and beauty salons, or it may reflect a real rise in the "problem". Sadly, adults are as unforgiving as teens when it comes to appearance.

Why might acne carry over into adulthood? Well, it all comes down to lifestyle. Smoking or being exposed to secondhand smoke damages the skin. There's some evidence that eating too much fatty food and drinking excessive amounts of alcohol encourages acne. A recent clinical trial into the effect of different diets found a low-GI menu based on fresh fruit, vegetables, wholegrain foods and lean meat, reduced outbreaks of acne by half. If weight is a problem, take care to wash and shower properly after exercise. Excess sweat can encourage the growth of bacteria. Higher levels of stress also contribute. Clinical trials in universities have found acne increases as exams approach and the adrenal gland produces more androgens. Stress also undermines the autoimmune system making us more likely to develop infections. If you have digestive problems and your bladder is not working as well as it should, there can be a build up of toxins in the body and this causes acne. Then there are changes in your hormone levels. Both men and women have testosterone in their bodies. If the level rises, more oil is produced in the skin and causes acne.

The scientific evidence shows women are more at risk because their hormone levels change more dramatically during the menstrual cycle and pregnancy. Although taking some of the oral contraceptives can smooth out the testosterone levels and reduce the outbreaks of acne, this cannot work during pregnancy. Once you know there's a child on the way, rely on benzoyl peroxide to keep the skin clean. Do not take Accutane. Although this is the best of all drugs to clear up acne at all ages, it cannot be taken during pregnancy. Indeed, if you do decide to take this drug, you must use guaranteed contraceptive measures to ensure you cannot become pregnant. Accutane is the guaranteed cure, but you must follow your doctor's instructions to ensure safety.