| Acne appears around the onset of puberty and runs a variable course till adolescence is over. |
| Women maintain a revered and protected status in Kuna society and their reaching puberty is celebrated in a series of ancient rituals and feasts. |
| Children who come of age and have not gone through the puberty rite are liable to be forcibly seized to undergo the procedure. |
| The glands remain immature until puberty, and it is the secretion of sebum that is associated with pubertal acne. |
| The onset of acne is usually around puberty, but in a minority of cases it may also start in adulthood. |
| As puberty dawns for a young girl, the ritu kala home-ceremony is performed to acknowledge her first menses. |
