If you are looking for something to blame, blame the sebum. Acne is a curse to many and, as is the way when your life is made a misery, it always helps to have something to blame. In this case, you do not have to look far. Your body is set up to grow hair, not just on the scalp, but on most of the upper body. In women, this hair will be very fine and almost invisible. Men sprout hair more obviously. Each hair is rooted in a follicle and every follicle has glands that produce an oil called sebum. This oil helps to keep the skin waterproof and also gives the hair that lustre or sheen. This all works fine so long as your body produces the right amount, but if anything disturbs the natural cycle, an overproduction starts you down the slippery slope (sorry, pun intended). Too much oil creates a pool at the base of the follicle. You are shedding dead skin cells all the time. If some fall into the follicle, they stick in the pool and this slowly blocks it up. There are also colonies of bacteria on the surface of the skin and in the follicles. So long as there is a free movement of air, the growth is limited. But if some are lucky enough to trapped in a pleasingly warm environment with lots of dead skin cells and oil mixed together, they grow. This produces inflammation and off we go to acne. For the record, the pores in your skin are not involved. They are not guilty.

Why does your body suddenly start to produce too much sebum? This is where we come back to hormones as a chief suspect. No-one knows exactly what triggers it. There is some evidence that acne runs in families so heredity is one factor. Some medications can produce skin problems as a side effect. It may be that the presence of certain bacteria affect the sebaceous glands. Whatever the reason, once there is too much sebum, you get acne.

This leaves us with two issues which are clear. The first is a simple reassurance. There is no connection between cleanliness and acne. In fact, the reverse is true. If people scrub their faces too fiercely, this can make the acne worse. There are also no links with food. Changing your diet does not help cure the acne. The second reassurance is that there is an ultimately successful drug for the treatment of acne. It is called accutane. But because there are problems with its use, you should not try it first. You should come to it only after trying all the other products and medications on the market. The strong recommendation is that people should take accutane under the supervision of a dermatologist. This ensures that all the necessary precautions are put in place and maintained while taking the drug. That said, it is worth following all the rules because this drug almost always clears the problem.