Claudia Rodgers used to spend an inordinate amount of time peering at her face in the mirror, scrutinizing every pore carefully.

Shari Schwendener finds it hard to swallow the emotions that well up when she touches the slight indent in the skin next to her mouth.

Eric Sribnick recalls how people used to judge him as having poor personal hygiene.

All three have one thing in common: acne. Whether you call them zits, pimples, blemishes, blackheads, whiteheads or cysts, acne is hardly a laughing matter to them. Or to the estimated 20 million teens who, according to the American Academy of Dermatology, suffer from it.

Even though those statistics are easy to come by, statistics on adult acne sufferers are not. But those who treat them claim it is much higher than perceived.

“At least 50 percent of those I treat are over 30,” confirmed Dr. Jon Morgan, a dermatologist in private practice in Columbia, S.C. “Of that number, about 20 percent see their first breakouts after 20. It’s a misconception that it goes away after the teen years are over.”

For Rodgers, acne has been a constant companion for more than half of her life. “By the time I was 24, I realized it was never going away,” explained the 26-year-old public relations executive from Miami, Fla., adding that “money and pain,” as in the lack of money and fear of pain, were the main reasons she never went to a dermatologist. “I dealt with it at home, through some very unconventional methods. I tried different things, like toothpaste, Listerine and Vick’s VapoRub. Sometimes they would burn my skin, but they were much cheaper than the over-the-counter acne medicines.”

When looking for the right job, Rodgers evaluated the benefits package to make sure the company’s HMO covered dermatologist’s visits. After a combination of treatments including topical ointments, glycolic skin peels and antibiotic tetracycline treatments, her skin cleared up. While her breakouts are under control and she follows a regimen for caring for her skin, Rodgers was motivated to change other behaviors.

“My doctor taught me not to look in the mirror so much because the more I do, the more I want to pick, push or pull at my skin. So I don’t look as much. I’m not super-paranoid anymore.”

The over-scrutinizing and picking becomes part of the psyche of an acne sufferer, Morgan explained.

“Picking would appear to be the best thing to get rid of acne. It’s really a grooming instinct. But obviously it does not cure acne and in actuality may enhance scarring, too,” said the board-certified dermatologist and member of the AAD, which represents 13,000 dermatologists across the country.

“I felt that if I extracted it, if I could get it out, I would cleanse myself of it,” said Schwendener, a Boston-based dancer and 34-year-old mother of two, who had her worst acne flare-ups in her mid- to late-20s.

“There’s some self-hatred involved as well. I remember feeling so angry when I was doing it. Of course, now I’m dealing with the scars from it, both internally and externally.”