As long-term acne sufferers know, acne treatments rarely work and do not work on everyone. The hoax of over the counter acne products, such as creams, cleansers, ointments, etc. and what they do not tell you, is they only clear the surface problem, if they don't irritate the skin so badly to actually make the problem worse.

Physicians tell you that their medications will not cure acne, but can help you control it. Another mask, just what we need! Physicians refer to acne as a "mysterious disease". Is there a cure - possibly, some seem to think so. During research for this article, I never really found anything substantial. However, it appears that our biological and hormonal makeup have a lot to do with whether we have acne problems and to what extent, if we do.

Most look at acne as merely a skin problem, but for those who have had acne over a period of years it is so much more. Self-esteem, insecurities and emotional problems may develop as well. The problem with acne medications remains with their claims to kill bacteria on the skin surface. However, bacteria is not the root cause of acne, it is a symptom of acne. Therefore, not one of these products or medications will cure the problem.

If this were indeed a disease, then wouldn't it make sense that the problem lies within the body, making its entrance through the pores of the skin, which in turn creates the bacterial result. Therefore, the real answer lies within a search for an internal cure.

Another form of lessening the effects of acne is to watch what we eat. While this may help some, others are still plagued and usually go back to their normal diet after only seeing slight improvement.

The sorry truth is that none of the products on the market or through our pharmaceutical industry actually offers the cure. We can spend hundreds or even thousands of dollars and still we have not cured the acne. Our best hopes are for less acne or if lucky, invisible acne.

The ironic part of acne products is to look at the ingredients found in them. Most over the counter products contain at least one of the following active ingredients.

Benzoyl peroxide - Claimed to be the most effective because it removes excess oil from the skin and dead cells from the pores. Benzoyl peroxide may cause excessive drying, minor swelling, scaling and/or redness, as well as sensitivity to UV exposure.

Salicylic acid - Used to prevent pores from clogging and may break down clogged pores that do not have an opening (whiteheads). This active ingredient may cause skin irritation.

Sulfur and resorcinol - This ingredient is used in conjunction with other active ingredients to help remove dead skin and excessive oil and may breakdown both whiteheads and blackheads. This may cause redness and peeling a few days after the first use.

Alcohol and acetone - Commonly found in astringents and cleansing washes. These active ingredients remove dirt and oil from the skin and may cause a burning or stinging sensation.

So what's the most effective way to control acne? Here are some suggestions from the Mayo Clinic staff.

If using over the counter products, start out with the lowest strength acne products, then increase strength as your skin adjusts to the product.

Never combine products that use different active ingredients, such as Benzoyl peroxide and salicylic acid. This combination can cause even more skin problems.

Do not use oily cosmetics, sunscreen, or shampoo. Look for products labeled "oil free" so as not to clog pores.

Wash acne problems areas twice a day. Over-washing and scrubbing can make the acne problem worse.

Cover the problem areas with just enough of the acne product, but do not over apply.

Use a moisturizer that is oil-free and water-based to help alleviate dry, peeling skin.

Picking and squeezing blemishes will cause infection and scarring - so don't do it.

Acne products take four to six weeks to see results. To date there is no proof of a quick fix.

See a dermatologist if acne problem does not improve.

Other suggestions to help with the underlying cause of acne are to improve eating habits and adding natural food supplements to your diet.

Michael Russell Your Independent guide to Acne