Your Health and Safety is our Priority. Learn more about our COVID-19 Safety Protocols
While there have been big advances in the way we treat teenage acne in the past few years, there is no single approach that works for every patient. For the best results, dermatologists need to match the treatment to the teen. There’s more to finding the best treatment than just examining the patient’s pimples: If you want to see results, you need to consider a teen’s active lifestyle. Despite the fact that today’s therapies can effectively treat the problem, patient compliance is often as important as the therapies themselves.
Acne often causes serious social, emotional, and psychological problems, and its symptoms can vary dramatically with age, heredity, habits, and beliefs. Lots of teens have misconceptions about the causes of acne and unrealistic treatment expectations. They often have trouble incorporating the treatment into their daily lives or sticking with it long-term after they start to see results. Dermatologists and patients need to discuss the patient’s lifestyle, family history, and habits—as well as his or her expectations—and then decide together which medicines are best.
Although acne is hardly something new—the ancient Greeks and Egyptians were battling pimples, and practically every teenager today has them—the exact cause of acne remains unknown. It is caused by several related factors, including the rise in male sex hormones that occurs in all adolescents, which sends the sebaceous (oil) glands into overdrive. Another important factor is heredity: Most pimply teens have one (or two) parents with their own history of acne. There are also several other factors that are typical for most teens: Psychological stress, cosmetics (too much or inappropriate makeup), physical pressure from a sports helmet or uniform, exposure to oil in the air (think of the fry vats at most fast-food places), and overly zealous scrubbing. Additionally, there is new evidence that suggests processed foods with a high glycemic index may promote breakouts. Dairy foods have also been implicated as a cause of acne but further research is needed to confirm these preliminary studies concerning food.
Dermatologists most often recommend topical medications for teens with acne. The most common nonprescription options are benzoyl peroxide, mild acids like salicylic acid, and sulfur-based products. Prescription-strength topical medications include topical antibiotics, sulfur-based products and retinoids (derivatives of Vitamin A) such as tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac). All of these medicines are available as gels, lotions, creams, soaps, liquids, and pads. They require compliance, meaning the teen needs to be consistent in using them. Dermatologists should always ask teenagers, if I prescribe a topical medicine, would you use it? Half the time, the answer is no. Sometimes, especially among the young male population, there is a stigma associated with cream use. Liquid soaps are sometimes a better topical choice, because the soaps can be used in the shower, where there is already an activity (the shower) in progress.
Additionally, many a teen has heard their dermatologist tell them that sometimes things get worse before they get better. That may be because the medications speed up the life cycle of all the pimples, including the little baby pimples that would have taken a lot longer to come to a head without medicine. Also, topical acne medicines can easily be over-used, especially by teenagers who follow the “more-is-better” mantra, because they are often desperate to get an instant clear complexion. Most acne medications need to be used in small amounts so this approach can cause side effects like dryness, irritation, burning, or redness. This will force patients to stop using the medications before they’ve had a chance to work. Some medications may interact with the sun. The dermatologist needs to talk with the patient about ways to minimize and manage the side effects.
Stronger options include prescription oral medications: antibiotics, isotretinoin (Sotret, Claravis, Amnesteem, formerly sold as Accutane), and hormonal therapy (birth control pills and spironolactone). These pills could interact with medication or birth control pills, so care must be taken. As with any pill, these drugs need to be taken as prescribed, meaning a teen who’s less-than-perfect at sticking to a schedule may not do very well on them. However, many teenagers prefer pills to creams, since there is a perception that they are easier to use. Frequently, the teen who won’t use topical medications will be extremely compliant with oral medicines.
In addition, dermatologists can use in-office procedures such as laser (for example, Acleara) or light therapy, acne surgery and corticosteroid injections for large or painful pimples and to permanently fix the acne scarring. These procedures don’t require compliance (with the exception of making it to the appointments), and as a result are usually a good option for teen patients.
In many cases, adolescent acne goes hand-in-hand with psychological issues. Research shows that psychological stress can definitely exacerbate acne, and numerous other studies have shown that having acne can create or worsen depression and social anxiety. Whichever way you look at it, being depressed or anxious can significantly affect your compliance with a treatment plan. It might be better to bite the bullet and pull out the ‘big guns’ to treat acne in these patients. The stronger medicines can lead to more dramatic results, which create big improvements in the patient’s emotional well-being and complexion.
While acne is highly distressing at any age, it can be treated. If you or your child are suffering from acne, contact us today to schedule a consultation and discuss treatment options. At Advanced Dermatology, PC, our board-certified dermatologists are experts at treating acne and other concerns of the skin, hair and nails. Our conveniently located offices welcome patients from Queens (Bayside, Flushing), Long Island – Nassau/Suffolk (Roslyn Heights, West Islip, Commack, East Setauket), New York City (Upper West Side, Upper East Side), Brooklyn (Park Slope) Westchester County (Ossining, Briarcliff Manor), Bergen County, NJ, Union County, NJ, and all surrounding areas.