I didn’t have pimples very often as a teen but when I did get them, they were huge. Naturally, on the day we were having school photos one year, right in the middle of my forehead a pimple appeared that was so big I felt like a unicorn. Really, I am not just being dramatic here! It was a study in humiliation. So I get it when girls are deeply upset about having pimples.

And, of course, so do the companies who make acne treatments, who play on teen girls’ (and boys’) deepest fears in order to move their products. You know the ads: Girl has a date coming up and a pimple appears. The end is nigh; social ruin and a life of compulsive Farmville playing beckons, with only a houseful of cats for company. But wait! Magic tube of ointment makes the zit vanish in two seconds. Cut to girl confidently smiling at the adoring hunky boy.

Ever noticed that the girl is always impossibly thin and gorgeous — in a computer-enhanced, international-model kind of way — and has the most perfect complexion you’ve ever seen, except for one barely noticeable bump? Think how it looks to a teen who actually does have pimples: if the girl on the pimple-cream ad has perfect skin and is anxious out of her mind, just how anxious should she be? Awesome, now teen girls can feel not only the crushing anxiety of having pimples, but also play the compare-and-despair game with a TV fantasy girl who doesn’t even represent what a real girl looks like!

I love this example of the genre — partly because it’s so painfully obvious it’s dubbed from an American ad, but also because I’d really like to see the school where this young lady is able to waltz in and interrupt a class in order to deliver a note to a boy:

Marketers also use the scientific approach, using fancy words (that usually sound made-up to me) and promises that their product will help girls “control” their breakouts. It’s an interesting word, isn’t it? As a teen you feel like you have so little control, so how appealing this must be.

Another highly successful tack they take is the celebrity endorsement. Proactiv costs more than many products on pharmacy shelves, even though it shares the same active ingredient as the majority of over-the-counter acne treatments, benzoyl peroxide. How do you get people to pay more for the same ingredient? Have stars that teen girls adore — such as Katy Perry, Justin Bieber and Avril Lavigne — give testimonials for it. (By the way, Jennifer Love Hewitt, whom you may remember from a past blog post as a champion of the fine art of vajazzling, refers to Proactiv as her “ultimate companion”. Okay, Jennifer.)

I worry that by manipulating girls’ fears of social doom because of pimples, advertisers are encouraging them to use too many harsh chemicals, which strip their skin raw and then cause more problems — which, of course, they then need more products to fix.

I asked Dr Alicia Teska, a cosmetic physician in Melbourne, if girls can harm their skin by misusing over-the-counter acne products, to which she replied, “YES!! YES!! And YES again!! People think that if a little bit of something makes a big difference to their skin, then using a hell of a lot more of it will be a good thing for their skin, and it’s actually the reverse. If they overuse medicated products, they will not only strip the outer dead layer of their skin down too much and therefore make it far more susceptible to sun damage, they can create incredible irritation and sensitivity in their skin.” This can lead to the development or worsening of eczema.

If you have a girl in your life right now with pimples, it’s important to tell her that she’s beautiful on the inside and outside, no matter what. It’s equally important to listen to her concerns and help her find out the best way to treat acne, rather than just fall for advertisers’ promises of instantly amazing skin. Acne really is an issue that needs to be addressed — for instance, a woman I know actually wagged school a couple times as a teen because she felt so ashamed of her skin. So I asked Dr Teska for some practical advice on what girls who have pimples can do.

Home treatments

“You don’t need to spend a lot of money on skin care,” says Dr Teska. “Cleanse regularly with a combination of mild soap-free cleansers once daily, and AHA or BHA cleansers (or a daily gentle AHA/BHA scrub) once daily to encourage increased turnover of keratin and dead skin cells, as these will easily block pores.” (AHA and BHA are types of acids.) “If black- or white-heads have already formed, a night-time treatment with an AHA/BHA gel or topical Vitamin A product (preferably low-strength retinoic acid, not retinol) will be necessary.

“The key is not to rely on only one approach. One needs to attack acne from multiple angles to get a fast response.” Dr Teska suggests balancing acid-based products with non-acid-based ones, such as Australia’s ASAP and the French brand Avène.

GPs, cosmetic physicians and dermatologists

Dr Teska suggests that girls with any type of acne, even mild cases, should go and see an expert for advice. “If your GP has an interest in skin, your GP might be a suitable point of reference.” She says that GPs tend to prescribe long-term antibiotics or the oral contraceptive pill, or may refer patients to dermatologists for the drug Roaccutane. If you are wary of jumping straight to medication, you may want to get an opinion from a cosmetic physician, because while they can prescribe antibiotics and the pill, they also give non-drug-based skin treatments that GPs do not provide.

Does makeup make pimples worse?

A lot of girls want to hide their pimples with foundation or concealer, but wearing makeup to school is a thorny issue in many households, not to mention the old advice that it makes acne worse. “The last thing any teen girl wants to hear is that they can’t wear makeup to school anymore,” says Dr Teska. “I always say to the girls I see, ‘If you feel the need to wear the makeup to cover your acne, then that’s okay for the short term.'” Once a girl is on a treatment program and seeing improvement, she encourages them to gradually wear less makeup. “Obviously the sort of makeup they’re wearing is important . . . Anything that’s oil based is going to dramatically aggravate the acne.” Dr Teska suggests girls use only oil-free formulations.

To squeeze or not to squeeze?

I asked Dr Teska about the truth behind the advice that squeezing pimples causes scars. And yes, your mother was right. When you squeeze a pimple, “you’re introducing infection and trauma . . . and can cause permanent scarring.”

Don’t wait

Dr Teska’s final words of advice are: “Whatever you do, please ensure that even mild acne problems are treated rapidly. This is a critical time of your teenager’s identity development, and issues such as mild or moderate acne may seem trivial to parents, but to a teenager they can have enormous consequences.”