Carmen Rasmusen was in tears over her problem with acne.

As a finalist on American Idol, Carmen Rasmusen faced some difficult challenges and heartbreaking moments. But not all of them occurred on stage.  Some of her toughest experiences happened when she woke up and looked in the mirror.

"It seemed like every day we were taping I would wake up with like four zits on my face," says Rasmusen. "It's one thing to get zits at school but I was basically performing in front of millions of people. I remember waking up one morning and just crying because it's hard to do your best when you fell like everyone is staring at your zits."

Rasmusen felt so bad that later she was eager to help launch a new campaign to help teenagers learn about acne and how to get rid of it.

"I hated having zits so I thought this would be a great help to teenagers to show them that acne is normal and everyone gets it," says Rasmusen, who is 18 now. "I want to explain to teens that going to a dermatologist is not scary and there's a way to cure zits."

To help teens find acne solutions, Rasmusen taped a webcast with a dermatologist to help answer questions. "There's also really great information at LosetheZits.com," adds Rasmusen, who is compensated by the campaign's sponsor, Galderma Laboratories, a pharmaceutical company that manufactures an acne remedy. 

Acne is quite simple.

It results when the skin produces more oil than necessary. This typically occurs in adolescents as their bodies begin producing more hormones called androgens which stimulate the production of oil in the sebaceous glands. This excess oil then builds up in the pores - tube-like structures leading from the oil glands to the surface of the skin. As dead skin cells and oil clog or completely plug the pore, the earliest change in the evolution of acne takes place - blackheads and whiteheads. If the pore is open and oxygen can get to the oil, then it turns black creating a blackhead. If the pore is covered over, it is called a whitehead.

"The other contributing factor to acne is that bacteria which normally grow on the surface of the skin begin to proliferate and grow very rapidly," explains John Wolf, professor of medicine and chairman of the department of dermatology at Baylor College of Medicine in Houston Texas. "These bacteria break the oil down converting it to fatty acid which damages the skin and produces the red bumps and pimples."

Stressing out

Acne is the most common skin disease in the world. And while it is estimated that nearly every adolescent experiences acne at some point, the more important consideration according to Wolf is "when they get it and how severe the acne is."

One important revelation from a new national Lose the Zits survey indicates that acne has a profound negative effect on a teen's self esteem.

About 25% of teens with acne reported that it makes them:

• Feel paranoid that others are looking at their acne (29%)
• Feel self-conscious about their skin (27%)
• Feel unattractive regardless of what they wear of how they look (23%)
• Feel shy or timid in social situations (21%)

And more than one in six teens experience either depression (16%) or preoccupation/obsession (17%) because of their acne.

"When I got zits I felt badly around the other Idols," Rasmusen admits. "If you're not comfortable with yourself and not happy with yourself then you're not going to act happy and you're going to have lower self esteem."

But Rasmusen wants teens to remember that the stress of the teen years and getting zits is normal. "Everyone gets zits and gets stressed," she adds.

It is also important to dispel some of the myths about what causes acne.

"I like to describe acne as an 'inside job' because all the components necessary for acne to occur exist right in the body," Wolf says. These components include androgens, oil glands, skin debris, bacteria and your genetics.

"Foods really don't have much to do with getting acne - it's really hormones and your genetics," Rasmusen notes. "If your parents had bad acne, then more than likely you will have acne.  Different people have different levels of oil production."

Acne is not caused by pizza or chocolate binges.  Neither is it caused by dirt. Even those with extremely clean skin can suffer from acne. 

But stress does have an adverse effect on acne.

"Stress plays a very important role in acne because stress can cause increased production of hormones which in turn stimulate the production of oil," Wolf reports. "Females can also experience acne during their menstrual cycle and again this is due to the hormones stimulating more oil production."

"I think the stress I was under performing on the show definitely contributed to the acne I was already prone to having," Rasmusen says. "It just made them come out even more.  It was hard being under that much stress and I tried everything to get rid of my zits - every single over the counter medication and nothing worked."

"I even tried toothpaste on my zits," Rasmusen admits. "And that was just terrible.  It just smelled funny."

Relief that works

So how do you get rid of acne?

"I was in tears at one point and I called my mom and said there has to be something I can do about this," Rasmusen recalls. "So she called a dermatologist and I got a prescription and within two weeks they were all gone."

"We generally start patients out with topical retinoids that are applied once a day to unplug the pores," Wolf states. "Topical retinoids not only clear the acne but by going in and correcting the underlying defect in the pore they can help prevent acne from reoccurring."

Antibacterial agents also help.

The most common topically applied antibacterial agent is benzoyl peroxide and is available in many over-the-counter products. While teens can learn about benzoyl peroxide and start using themselves, they need a prescription for topical retinoids.

Topically applied antibiotics are often used to kill skin bacteria. The two most commonly used ones are clindamycin and erythromycin.  And recently three new products combining both topical retnoids and benzoyl peroxide have become available.

"Now it's possible to use something on your skin that provides two types of bacteria killing activity," Wolf says. "Studies have shown that the combination of the two agents is better at killing the bacteria."

Wolf notes that oral antibiotics like minocycline and doxycycline are also commonly used to treat acne.  For severe scarring acne, Accutane® (isotretinoin, a retinoid) can be prescribed but must be rigorously monitored once a month by the prescribing doctor due to side effects. Additionally, Accutane causes birth defects and must not be used in pregnant patients, or those who may become pregnant during treatment.

However severe a person's acne is, Rasmusen wants people to get help like she did.

"I got rid of all my zits and that's amazing," Rasmusen says. "The most important thing is that everyone gets acne and to see your dermatologist. Don't stress about zits. We all get them and we can all get rid of them too."

Click here to go to Carmen's webcast and info for teen girls.

Click here to go to Carmen's webcast and info for teen boys.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 8/29/2003  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 8/29/2003  -  Donnica Moore, M.D.