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| Main > School Age > Common Problems
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Acne
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| Acne is a common problem that affects most teenagers at one time or another. It is caused by oil clogging the pores in your skin. The buildup of more oil and bacteria can then cause your skin to become red and inflamed. It commonly begins during puberty, because this is a time when many hormones increase and it is these hormones that cause your skin to produce more oil.
Acne is not caused by the foods that you eat (such as chocolate, soft drinks or greasy foods) or by dirt (blackheads are caused by a pigment, not dirt), and you can't catch it from someone else. It can be made worse by pinching pimples, harsh scrubbing which irritates the skin, certain cosmetics which can further block oil ducts, and emotional stress.
Acne usually improves by the time you are twenty –twenty five years old, but can be brought under control sooner with the proper measures.
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Avoiding Acne
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- Wash (but don't scrub) your skin twice a day with a mild soap. Avoid harsh cleansers or scrubs, as they can irritate your skin.
- Don't pop or pinch pimples.
- Use noncomedogenic cosmetics and moisturizers and don't put oily or greasy substances on your face or hair.
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Treating Acne
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| The medications used to treat acne include benzoyl peroxide, antibiotics, retinoid creams and combinations of these products.
Benzoyl Peroxide 2.5% 5% 10%
This is the most effective acne medicine available OTC (such as PersaGel or Clearasel) and helps to kill bacteria, unplug oil ducts and heal pimples. You should start with a low strength once a day and work up to 10% twice a day. Apply it to all areas where pimples occur, and not just on your current pimples.
If you do not see improvement in 4-6 weeks using OTC meds, then you should see your Pediatrician about using the following prescription medicines:
Benzamycin Topical Gel
This is a combination of 5% Benzoyl Peroxide and Erythromycin (an antibiotic) and it must be kept in the refrigerator and may bleach clothing. Apply a thin layer of it to affected areas after washing once or twice a day. Use it in the morning only if you are also using Retin A at night.
Benzaclin Topical Gel
This is a combination of 5% Benzoyl Peroxide and Clindamycin (an antibiotic) and doesn't need to be kept in the refrigerator. Apply a thin layer of it to affected areas after washing once or twice a day. Use it in the morning only if you are also using Retin A at night.
Retin A 0.025% 0.05% 0.1% cream
This cream helps unplug oil ducts and should be applied to the affected areas at least 20-30 minutes after washing (applying to wet skin may cause irritation). Use a small amount (one pea-sized dose is enough for your entire face) every third night, and if tolerated, increase to every other night and then every night.
If your skin can't tolerate Retin A cream, there is a Retin A-Microsphere gel that is less irritating, or we can try some of the newer medicines, including Azelex, Tazorac or Differen gel.
Oral antibiotics such as Minocin are sometimes used if topical therapy doesn't clear up your acne. They are used twice a day until your acne has cleared up (usually 1-3 months), and then are slowly weaned off.
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Skin Irritation
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It is not uncommon for the skin to become red, dry and irritated when beginning to use acne medicines. This usually improves with time, but here are some suggestions to minimize irritation:
- Use moisturizers if your skin is becoming dry.
- If starting more than one new medicine, consider starting with just one and then waiting two or three weeks before beginning the other one.
- You can also begin a new medicine by applying it every third night, and then gradually increasing it to every other night and then every night.
- Another alternative is washing the medicine off after about five minutes. Each night, you can then leave it on for longer periods of time before washing it off.
- In general liquid and solution forms of medications are less irritating than creams and gels, so you can try using a different form of the medication if you can't tolerate it well.
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Seeing a Dermatologist
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| While most primary care physicians can treat mild and moderate acne, you should consider seeing a specialist if you have severe cystic acne that may lead to scarring, if you are not improving with your current regimen, if you have very sensitive skin and can't tolerate topical medicines, or if your doctor is not comfortable treating acne. A Dermatologist may be able to use different combinations of the above medicines or may put you on Accutane, an oral retinoic acid that you take daily for three to four months. |
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Important Reminders
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- Be patient. It can take 3-6 weeks to see improvement and your acne may get worse before it starts getting better.
- Use your medicines every day. If your skin is getting too irritated, red or dry, then start using them every other day. It takes time for your skin to adapt to your new medicines.
- Don't overdo it! Scrubbing your skin or using too much of these medicines can irritate and dry out your skin and won't make your pimples go away any quicker.
- Protect your skin from the sun. These medicines will make your skin more sensitive to the effects of the sun.
- Call your physician if you haven't improved in 4-6 weeks with your current regimen.
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