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"My acne seems to pop up more often during the beginning of the school year and when exams start, when I'm more stressed out about my grades," explains Hall.
Dermatologist Diane Madfes says preliminary data shows a link between stress and acne in some people. In her own practice, she sees a 20 percent increase in teens and young adults when it's time to hit the books.
"When your stress levels go up, you get a little bit of an elevation of a hormone called cortisol," said Dr. Madfes. "And what that does is it turns on the sebaceous glands in your skin that triggers the acne."
Dermatologist Julie C. Harper says often patients need to know acne treatments take time.
"I would say it takes two months to see a 40 to 50 percent improvement in acne, and it really takes four months to see 80 to 90 percent improvement," said Dr. Harper.
And problems can occur if patients apply too much or too little of a treatment or scrub too hard.
Experts say teens and young adults often lose patience and stop their treatments. That can lead to scarring. Dr. Madfes says you need to make it part of your routine.
"If you put your acne medicines right next to your toothbrush, after you put your toothbrush down you can put on your acne medication," said Dr. Madfes.
Also, speak in detail with your dermatologist. There are a slew of new treatments on the market designed to be more gentle. Elizabeth now uses one. Every so often she forgets to apply, but overall she says her skin now makes the grade.
"It's a lot clearer. It's a lot smoother," said Hall.
Both doctors say there are effective over-the-counter medicines for early, mild acne. Look for ingredients like benzoyl peroxide and salicylic acid. Of course, each case is different. If you have questions, consult a dermatologist.
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According to Dr. Diane Madfes, spokesperson with the American Academy of Dermatology, preliminary data shows there is a connection between stress and acne.
She says that you do need to have a predisposition towards acne to have it exacerbated by stress.
Dr. Madfes says she would like to see more research done on stress and acne, although it is difficult to control the multiple factors that contribute to it, such as environment and genetics.
Dr. Madfes also says that when it's time to head back to school, she sees about a 20 percent increase in the number of teens and young adults in her office.
Dr. Julie C. Harper says she sees an increase of about 10-20 percent in her office.
According to both Dr. Harper and Dr. Madfes, older acne medications such as Retin-A and BenzaClin are still very effective. However, they contain high percentages of the active ingredient benzoyl peroxide. For many, this can cause peeling, redness and dry, itchy, skin within the first few weeks of use.
Dr. Harper says that when these medicines were the only option out there, some patients with bad acne would put up with the side effects. Both doctors have seen patients give up on their treatment plan rather than waiting for these symptoms to subside, or switching medications.
According to Dr. Madfes, some of the newer, gentler medications on the market include Pacnex, Atralin, Epiduo and Acanya. Dr. Madfes and Dr. Harper say these formulas combine benzoyl peroxide with other acne fighting ingredients, as well as a moisturizer to prevent dryness and irritation. They say these prescriptions are equally effective as the older ones available and patients are more apt to be compliant with them.
We also spoke to American Academy of Dermatology spokesperson Amy Derrick, who added, "I agree that the formulations (or vehicles) have improved significantly over the past several years. The active ingredient now can be delivered in a more patient-friendly vehicle. Patients do not like to have both acne and a rash from their acne medication."
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