Dealing with Teen Acne
Who doesn't remember getting a pimple or two before their class photos or a big date? If you don't, you are one of the few people who didn't get acne during their teen years. Arm yourself with knowledge about acne so you can help your teen with this common and frustrating condition.
What Is Acne?
Zits, pimples, blackheads, whiteheads – these are all referring to what we generally call acne. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the birth of a pimple occurs inside a hair follicle that is connected to a sebaceous (oil) gland. These follicles are lined with skin cells called keratinocytes. The oil and cells mix together in the follicle to form a plug. A kind of bacteria called Propionibacterium acnes (P. acnes) can sometimes grow out of control in this plug, causing inflammation. This mixture of oil, cells, bacteria and inflammation lead to what we think of as acne.
What Causes Acne?
There are many things that may cause acne, or may make it worse:
- Changes in hormone levels. This can happen because of puberty, menstrual periods, pregnancy, birth control pills, or stress.
- Oily beauty products. Cosmetics, lotions, or hair products that are oily or greasy may contribute to acne problems.
- Medications, such as testosterone, estrogen, steroids, phenytoin and other drugs.
- Sweating, humidity, or air pollution.
- Irritation to the skin, like scrubbing too hard or squeezing pimples can make acne worse. Rubbing of the skin from sports helmets, backpacks, jewelry or tight clothing can be a problem, too.
What Doesn’t Cause Acne?
No, chocolate does not necessarily cause pimples. Greasy foods probably don't either - unless you are rubbing them on the skin!
The American Osteopathic College of Dermatology does think our modern American diet could contribute to acne. Their research shows that there are remote jungle tribes that do not experience acne. Their diets do not contain beef, dairy, wheat and refined sugars – things that many of us eat every day. Some of these foods might contribute to acne by influencing our hormone levels, but the jury is still out.
A healthy, balanced diet full of fruits and vegetables is still the recommendation for all of us – but the occasional chocolate or French fry is probably OK and most likely not the cause of acne.
How to Treat Acne?
Some basic hygiene and a few other strategies can help to prevent some acne.
- If a hair product, skin cream, or kind of makeup seems to make things worse, switch to a new product and see if the acne improves.
- If it appears that the skin is irritated from scrubbing, picking or rubbing, reduce the irritation and look for any changes in the acne.
- Wash your face with a mild cleanser such as Cetaphil. This can be done once or twice a day, but avoid excessive skin washing as this irritates the skin. Be sure to wash any makeup off at night.
- Shampoo oily hair daily and keep the hair off of the skin. The oil from the hair can make acne worse.
The American Academy of Pediatrics (AAP) recommends benzoyl peroxide as the first-line treatment for acne. Benzoyl peroxide is available without a prescription and comes in lotions, creams, gels, face washes and many other forms. It also comes in different strengths such as 2.5%, 5% and 10%, so look at the package carefully when buying a product.
Tips on using benzoyl peroxide from the AAP:
- Start off slowly. Use a 5% lotion only once a day. If after a week the skin isn’t red or peeling, try using it twice a day.
- Apply a thin layer of the lotion over the entire affected area. Avoid the skin around the eyes.
- If the acne doesn't improve after four to six weeks, try a 10% lotion or gel. Use it once a day for a week, then try twice a day if the skin isn’t irritated.
There are other products that contain other medications such as salicylic acid, resorcinol and sulfur that might improve acne. Like with all over-the-counter medications, if there are any questions or concerns about their use, contact your primary care provider.
The Big Guns: Prescription Medication for Acne
Prevention hasn’t worked, over-the-counter treatments haven’t work – so what’s next? Contact your family physician, pediatrician or local dermatologist. He or she can prescribe various medications for the acne if necessary.
The AAP lists a few of these prescription medications for acne:
- Retinoids, such as Retin A, Differin and Tazorac. These medications come in cream or gel form and can unplug oil ducts. Stay out of the sun when using these treatments and let your doctor know if the skin peels or turns red while using them.
- Antibiotics. Your doctor may prescribe pills to take by mouth or antibiotic creams, lotions or gels.
- Isotretinoin, such as Accutane and other brands. This medication is available in pill form and is very powerful. Women who take this medication need to be very careful to avoid pregnancy. Isotretinoin can cause severe or fatal birth defects in an unborn child, so the use of the medication must be supervised by a health care professional who is knowledgeable about its use. A woman who is prescribed Isotretinoin is often required to be on effective and reliable birth control to prevent such birth defects.
Over-the-counter medications and prescription meds come with their own issues and side effects. Research and discuss your concerns with your pediatrician, dermatologist or pharmacist.
There are many effective ways to deal with acne. As always, consult your primary care provider with any questions or concerns about this or any other health issue.
For more information on acne at any age: About.com's Guide to Acne
Sources: Acne. American Osteopathic College of Dermatology. July 7, 2008. http://www.acod.org/skin/dermatologic_diseases/acne.html Ance. National Institute of Arthritis and Musculoskeletal and Skin Diseases. July 7, 2008. http://www.niams.nih.gov/health_info/acne/ Medical Encyclopedia: Acne. Medline Plus. July 7, 2008. http://www.nlm.nih.gov/medlineplus/print/ency/article/000873.htm Teen Q&A: Acne. American Academy of Pediatrics. July 7, 2008. http://www.aap.org/publiced/br_teen_acne.htm
Acne. American Osteopathic College of Dermatology. July 7, 2008. http://www.acod.org/skin/dermatologic_diseases/acne.html
Ance. National Institute of Arthritis and Musculoskeletal and Skin Diseases. July 7, 2008. http://www.niams.nih.gov/health_info/acne/
Medical Encyclopedia: Acne. Medline Plus. July 7, 2008. http://www.nlm.nih.gov/medlineplus/print/ency/article/000873.htm
Teen Q&A: Acne. American Academy of Pediatrics. July 7, 2008. http://www.aap.org/publiced/br_teen_acne.htm