Acne affects at least 50 million Americans, 80 percent of all people between the ages of 18 and 30, and millions more who are both younger and older. Yet most of us self-medicate -- rushing off to the drugstore to purchase just about anything that p

Katie Rodan, M.D., is a clinical associate professor of dermatology at Stanford University School of Medicine Kathy Fields, M.D., is an assistant clinical professor of dermatology at the University of California San Francisco

Foreword	p. ix
Introduction	p. 1
Skin under siege	p. 12
Acne treatment	p. 38
Acne's psychological aftermath	p. 65
The healing power of proactive treatment	p. 86
The rodan and fields approach: how it works	p. 107
Babies and children--the preteen years	p. 144
Teenage girls	p. 152
Teenage boys	p. 174
Adult women	p. 193
Perimenopause, menopause, and your aging skin	p. 218
Adult men	p. 244
Acne in people of color	p. 257
Rosacea	p. 269
Acne on the body	p. 290
Not just acne: Acne imposters	p. 303
Taking care of your skin and body	p. 317
Makeup that works	p. 342
Glossary	p. 359
Index	p. 364
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Chapter One: skin under siege "My little nephew, who's only two, turned to me and said, 'Auntie, can I connect the dots on your face?' He didn't know what he was saying, but I was totally humiliated. I used to wake up crying because I'd feel a new lump on my face every morning."Amanda, age thirty-one No matter what your skin color or type, whether you're eight, eighteen, thirty-eight, or sixty-eight, you can get acne. You may have one pimple or a hundred, but the process is the same. Acne vulgaris is the most common and often the most debilitating skin disease that exists. Over 90 percent of all people on earth suffer from it at one point or another. So even if you didn't get it as a teenager, chances are extremely high that you'll experience it later in life. It's a rare human indeed who manages to get through life without a single zit!Before we explore acne in detail, let's learn a little bit about the organ it affects: the skin. all about skin Even when it is covered with acne, your skin is still a marvelous organ. It reflects who you are and how you feel, and it keeps you safe. It has an almost magical ability to repair itself, and we certainly almost always take it for granted. (Except, of course, when plagued by acne.) Constantly replenishing itself, the skin covers a whopping twenty square feet and constitutes 15 percent of our total body weight. In the three layers of one square inch of skin you'll find: 19 yards of blood vessels 65 hairs 78 yards of nerves 100 sebaceous glands 650 sweat glands 1,300 nerve endings 20,000 sensory cells 129,040 pores 9,500,000 cells Epidermis -- Top Layer The first living layer of the skin is the epidermis. This microscopically thin layer is seven to ten cells thick and in a young adult completely renews itself every twenty-eight days. Nearly 95 percent of the epidermis is composed of new cells called keratinocytes. The remaining 5 percent is made up of the cells that produce melanin, the substance that gives skin its color, and the all-important Langerhan cells, which work with the immune system to help fight infections.As keratinocyte cells age, they flatten out and eventually lose their nucleus, becoming horn cells. These horn cells create the stratum corneum, the outermost layer of skin. Even though the stratum corneum consists of dead, overlapping horn cells, like shingles on a roof, it serves a vital function as our first line of immunological defense between the outside world and our bodies.The renewal rate of the epidermis diminishes with age. As a result, the stratum corneum becomes thicker and the pores pack up with dead skin cells, which makes them look larger. Dermis -- Middle Layer Most of the skin's volume is found here. The dermis is composed of collagen and elastin fibers; nerve endings that sense temperature and pressure; blood vessels supplying nutrients to keep everything replenished and renewed; sweat glands, which function to cool you down, and erector pili muscles, which contract, causing you to shiver and making your hairs "stand up" (these functions keep you at a stable 98.6 degrees Fahrenheit); hair follicles; and those pesky oil glands, which produce the sebum that keeps skin soft, pliable, and waterproof. However pesky they are, you can't live without those oil glands (although when your acne is bad, you certainly wish you could!). Subcutaneous -- Bottom Layer Here lie lots of fat cells. These fat cells are good fat cells. Without them, you'd lack insulation and protection for your fragile organs. Also rooted in these fat cells are most of your hair follicles. The hair follicle and the attached sebaceous, or oil, gland share the space known as the