Perhaps you belong to this class and, like others, burn the candle at both ends. You work hard all day and fre­quently are busy for long hours at night. Your ability to keep going is due as much to your enthusiasm for what you’re doing as to the strength in your body. One might say that you are tired but do not know it. The amount of energy you burn up through such intense activity and continuous excitement is a drain on your general level of health. Living under such a physical strain may well contribute to the cause of your acne.

Eating on the run without taking the time to sit down and have a well-balanced meal of a variety of foods is certain to make your diet low in building materials. Be­sides that you would not be getting the essentials which supply the fuel for all the energy you use up. Among other things you would not be getting your vitamins. You have probably heard about vitamins and their im­portance to growth and health. They are necessary in order for the body to get the full value out of the foods you eat. Acne is not actually due to a deficiency of vita­mins, yet it is not at all uncommon to see improvement in the appearance of the skin when large doses of certain vitamins are added to the diet.

Vitamins are not only essential to one’s general health, they are also important to the health of the skin. When they are absent from a diet, the skin is affected in vari­ous ways. Dryness and roughening of the skin occur when Vitamin A is deficient. Vitamin B really consists of a whole subgroup of vitamins within itself. But since they are all found in the same foods, they are lumped together and called Vitamin B Complex. When one or all are missing from the diet, many changes in the skin may appear, such as cracking and crusting at the corners of the mouth. The tongue can become smooth, red and tender. The exposed parts of the skin, such as the back of the hand, may become darkened and scaly or the face and scalp may become oily and reddened. A good quan­tity of Vitamin B Complex in one’s diet is especially important to the skin. When Vitamin C is not a daily part of the diet, the gums become soft. Brushing your teeth is enough to make them bleed. You will learn about the foods which you should eat to get these vita­mins when we discuss what you can do to help your com­plexion.

The expression “athlete’s acne” is used by dermatolo­gists because acne is sometimes very severe in young men who are extremely active in sports. Physical condition­ing and training is an accepted part of an athlete’s life. You assume that athletes are perfect physical specimens who would never have acne. However, a well-trained athlete is like a race horse in the sense that every effort has been made to bring to perfection all his special capa­bilities. In doing this, great stress is put on the body as a whole, causing excessive fatigue, and this may explain the frequency of acne in athletes. I have noticed the same thing in women who are professional dancers. Hours of rehearsal topped by performances are as stren­uous physically as any basketball or football game.

Besides the physical strain on your body which has just been mentioned you are under another type of strain or, to use another word, tension. The development taking place in your growing body has already been discussed. But so far, no mention has been made of another type of change which is occurring. This is the change in your at­titude towards yourself and those about you. These changes are the ones which affect your emotional life.

Acne starts during a period in your life which is filled with new experiences. High school is one of the first of these. The longer hours of classes and attention to your studies require more effort and concentration than any­thing you have known before. Early business ventures with a long day’s work and greater responsibility are quite different from any former experience. Besides these adjustments which must be made there are changes tak­ing place in your relationships with your parents. No longer can you be completely dependent on your par­ents. You have to make your own decisions and solve many of your own problems. Or perhaps you feel that your parents cannot get used to the idea that you are no longer a child. Another new aspect of your life is the feelings you have towards members of the opposite sex. This is a big change, indeed, about which revolve many emotional problems.

It may well be that the emotional stress and strain which result from these new needs for adjustment are partly to blame for the overactivity of your oil glands. This should not be so hard to understand since there are many examples in everyday life which illustrate how your emotions cause various skin reactions. Everyone knows that after a bad fright one may blanch, break out in a cold sweat or get “goose pimples.” Certainly you have seen blushing occur after an embarrassing incident. You may have noticed even that your face becomes very oily towards the end of a busy day at work or during a period of emotional excitement. These commonplace observations show beyond doubt that emotions do affect the skin and they suggest that emotions may be one of the forces at work in causing acne.

Very often those who have acne observe that during periods of tension they are worse. Perhaps emotional ex­citement increases the blood supply to the skin and oil glands, causing them to become overactive. Perhaps the hormone balance is affected, tipping it even more out of balance. So far, we do not know the exact explana­tion.

Some acne eruptions should be called “after vacation” acne because of the way they break out when the sum­mer is over. Just recently a young high school girl told me that her skin was fine all summer. She returned to school in September and in two weeks her acne reap­peared. Perhaps there is some other explanation for what happened, but it is likely that the tensions of school life were responsible.

Recently a group of doctors made an interesting study on some acne patients which seems to throw some light on the connection between acne and emotional tension. First they learned as much as possible about the patient’s childhood and background. Then they made the patient angry by saying something to him that the doctors knew used to make him angry as a child. Before and right after this the oil on the skin was measured. It was found that the amount of oil on the skin was always greater after than before the patient had been made angry. This experiment suggests what many have observed and thought, namely that at least one emotion, anger, makes the oil glands overactive.