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FAQ: What can I do about my teen's acne?

Posted by Dr. Claire McCarthy  May 8, 2013 09:38 AM

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Acne: it's part of life for most teens. And maybe because it's so much a part of life, it's easy sometimes for parents to minimize or ignore it. After all, it's going to get better, right?

It's true that it usually does get better. But living with it is no fun. To have pimples at a time in your life when what matters most to you is what people think about you...yikes. Also--some parents don't think about this--when acne is severe, it can leave scars.

Luckily, there are some effective treatments for acne. In fact, the American Academy of Pediatrics just published recommendations. Here's what they say:

First, the lowdown on washing: acne is not a hygiene problem. Too much scrubbing, especially with harsh products, can actually make acne worse! Use a mild, soap-free cleanser. You can try toners, which may help reduce oiliness, but stop if they irritate the skin.

Most cases of acne will respond really well to some combination of:
  • Benzoyl peroxide. This comes in strengths from 2.5 percent to 10 percent, without a prescription (stronger isn't necessarily better--sometimes stronger can irritate the skin and make things worse) and should be the first thing you try.
  • Retinoid cream or gel (tretinoin, adapalene or tazarotene). These are only available by prescription. The best way to use them is to spread a pea-sized amount over the area with pimples, rather than trying to get it on each pimple.
  • Antibiotics. While antibiotics can sometimes be helpful when put on the skin (especially if combined with benzoyl peroxide or a retinoid), they are most helpful when taken by mouth. This, too, requires a prescription. 
For more severe cases, your doctor might consider:
  • oral contraceptives (for girls). There are a few types that can help make acne better. Oral contraceptives can have risks and side effects, so you should discuss this carefully with your doctor.
  • Isotretinoin. This is a retinoid in a pill form, and it can make a big difference. However, teens who take it need to be monitored closely for side effects and need regular blood tests. It can cause birth defects if taken while pregnant, so girls who are taking it need regular pregnancy tests. There is also a possible risk of depression, so parents need to watch their teens closely for this (but given how depressed severe acne can make a teen, this risk may not seem so bad).
The bottom line: acne doesn't have to be a necessary evil of adolescence. There's lots that you can do. Talk to your doctor.

Is there something you'd like me to write about? Leave me a message on my Facebook page--and "like" the page for links to all my MD Mama blogs as well as my blogs on Thriving and Huffington Post.
This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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