The question: My 14-year-old son has started to get acne, and he is freaking out. It's not bad, but he is very insecure about it and has burned through every product at the drugstore. What else can we do to help him control his acne?
The answer: There is no need for teenagers to be freaking out about acne.
Acne treatments have evolved over the years so that virtually all acne can be successfully treated and controlled. The consequences of not treating acne can be significant. Even mild acne can lead to embarrassment, anxiety and decreased self-esteem, while more severe acne can lead to permanent discolouration and scarring.
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Teens prone to acne should be encouraged to develop a daily skincare routine. Here are some basic strategies that can be easily included as a part of your adolescent's daily routine:
- 1. Gently wash your face twice a day (morning and night) and after exercise. There is no need to scrub; use your fingers and hands to massage your face with an alcohol-free soap. Facecloths and sponges can be abrasive and damaging to sensitive skin. Rinse with room temperature water and gently pat your skin dry with a clean towel.
- 2. Shampoo daily. This is important if your acne is problematic on your forehead or neck where your hair touches your skin.
- 3. Avoid make-up. Or at least be aware that make-up can exacerbate the problem and that you may need to try different brands to find the one that is best tolerated.
- 4. Don’t touch your face! Picking, popping, squeezing and even rubbing your acne can make it worse.
- 5. Be patient. It may take as long as a month to see real improvement with prescription acne treatments and things may get worse before they get better.
It sounds like what your son may need is professional help. Make an appointment with your family doctor or pediatrician if your teen has acne that has failed a trial of drugstore (or infomercial) therapy, if acne is severe, or if your child is anxious or self-conscious about their acne.
(Speaking of infomercials, I frequently get asked about the product Proactiv, and my experience to date has been mixed. Some of my patients with mild acne have found this product to be very helpful, while others, especially those with more severe disease, have been disappointed.)
Interestingly, I have often found that families are reluctant to seek medical advice for this condition. It's almost as if they feel that acne isn't a serious enough problem to justify a doctor's visit. Unfortunately, this misconception often leads to children with a potentially serious condition not receiving the treatment they need.
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Medical treatment of acne starts with prescription creams. Expect creams to contain benzoyl peroxide, antibiotics, tretinoin (a form of vitamin A) or some combination of these ingredients.
Anticipate prescription creams to cause some mild redness and drying of the skin. Don't hesitate to ask your doctor for a milder preparation, or try applying the creams every other day if this becomes problematic.
Again, be patient! Moderately severe acne or acne that involves large areas of skin (like the back) often needs treatment with antibiotics that are taken by mouth for a period of weeks or months. This can also be a helpful option for kids who don't like to apply creams.
More severe acne, especially acne that might potentially lead to scarring, should be managed by a dermatologist. Isotretinoin (commonly known as Accutane) is a potent but very effective treatment that is used when all else fails, but requires close supervision by an experienced physician.
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Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.
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