Teenage acne is caused by a combination of factors: oily skin, genetics, stress, bacteria, and hormones.
A proper skin care regime, along with over-the-counter and prescription medications, can clear up acne affected skin and prevent future breakouts.
Acne treatments may take 6-8 weeks to be effective.
Has your child recently started to suffer anxiety because of adolescent acne blemishes? You’re probably not the only one who has noticed. For teenagers, there’s perhaps nothing more socially awkward — or a more major blow to the self-esteem — than an enormous pimple in the middle of their forehead.
What causes teen acne?
When a child enters adolescence, rising hormone levels stimulate an increase in oil production of the sebaceous glands on the head, neck, chest and back.
About 8 in 10 tweens and teens have acne; several factors influence its development:
- Oily skin
What is an appropriate skin care routine for a typical teenager?
My advice is to wash the face once or twice daily with a lathering soap to remove bacteria, dead skin cells, and excess oil.
Keep hair clean by shampooing daily. Greasy hair contacting the face or neck can increase acne.
And don’t excessively touch the face. Constant poking and prodding may occlude (plug up) follicles more easily, leading to more pimples.
What over-the-counter products do you recommend?
First, discuss with your teen how important it is to stick with a skin care treatment for at least 6-8 weeks to see if it is effective. Often, kids don’t use acne products long enough to see if they are actually working. Acne will not clear up overnight; it takes time.
For daily face washing, a simple soap like Dove for Sensitive Skin, or Cetaphil Foaming Face Wash, are good choices if the skin dries out easily.
For oily skin, or if the acne is considerable, try an over-the-counter (OTC) acne cleanser containing salicylic acid or benzoyl peroxide. Caution: benzoyl peroxide may bleach dark towels and clothing, and about 4% of users become allergic to it. If a rash develops, discontinue use and contact your doctor.
If a teenager has more than just a few pimples, try Differin Gel (adapalene). This is an over-the-counter retinoid, similar to the prescription product Retin-A. After washing and drying the face, apply a pea-sized amount, once daily.
To help or prevent dryness, use a light, non-comedogenic (won’t plug pores) moisturizer like Cetaphil or Cerave Lotion, once daily.
If acne has not improved after using Differin Gel for 6 weeks, add to the routine a topical gel or lotion that contains 5-10% benzoyl peroxide or 2% salicylic acid.
After acne clears, continue using products to prevent new breakouts.
What help can a dermatologist offer?
If a teenager tries the above recommended OTC products and is not improving after a trial of at least 2 months; usually has a dozen or more active pimples at the same time; or is developing deep, hard, cystic or nodular acne lesions (which can lead to scarring), it may be time to visit a dermatologist or family doctor.
Prescription treatments may include topical medications and oral antibiotics, which treat related bacteria, as well as offering anti-inflammatory benefits.
With proper and early treatment, it is usually possible to get acne under control and prevent scarring.
A dermatologist can also help mediate some of the acne-related tension that can occur between parents and teens and remind the teen that maintaining good habits for clear skin, and proper use of acne-fighting products, is their responsibility.
What do you advise teens know about picking or popping their pimples?
If you do decide to pop a pimple, only pop one that has a white head.
Only attempt to pop it once. Picking at or popping a pimple more than once will create a deeper scab and increase the possibility of scarring.
First, wash the area (and your hands) with soap and water. Then, use a pin or needle — cleaned with alcohol — to gently prick the surface of the pimple. Remove contents by pushing two cotton swabs together, rather than using fingernails.
Never attempt to squeeze a deep pimple, as you might cause additional inflammation and longer healing time.
What are some common misconceptions about acne and its treatment?
Diet. There are no scientific studies that prove a relationship between diet and acne. However, some research has suggested that a high glycemic diet, or consuming a lot of highly processed foods, may have some correlation with acne flares. If a teen drinks a lot of milk, organic milk is recommended since it does not have any added, artificial hormones. In general, for healthy skin, eat a sensible, well-balanced diet.
Birth control pills. There is some misunderstanding about how helpful birth control pills may be for teenage girls with acne. The higher estrogen pills may help for mild cases, but these also have additional side effects. If a patient needs to go on birth control for medical purposes other than acne control, ask about those which may be more favorable to clearing acne.
Accutane. Patients with serious acne may benefit from treatment with this medication. The generic form is called isotretinoin; the brand name is no longer made. One controversy about this drug is that it has been claimed to cause teen depression. However, the association has not been scientifically proven. Moreover, effective acne treatment improves mood and self-esteem. Ask your child’s dermatologist if this medication is an option, and be sure to tell the dermatologist and other providers about any new depressive symptoms in your child if he or she is taking isotretinoin. The American Academy of Dermatology recommends in detail this medication for treatment of severe acne and moderate acne that resists treatment or is producing scars or psychosocial distress.
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PacMed dermatologist Barbara Fox sees patients in the greater Seattle area.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.