By David Ward, MD
Acne is one of the most commonly discussed issues at teenage checkups. Recent studies indicate that 87% of teens have to deal with acne at some point. Here we’ll discuss basic causes and treatment of acne to try at home, and when to see your doctor.
Let’s first discuss the cause of acne. Our skin’s pores contain oil glands and dividing skin cells whose activity is ramped up by the hormonal changes with puberty. Acne arises when excess skin cells and oil build up and clog skin pores forming something called a “comedone.”
You’ve probably heard the common names for the two types of comedones – blackheads and whiteheads. The only difference is where the clogging happens: white = clogging near the surface of the skin; black = clogging deeper down in the pore. This buildup can then trap bacteria in the pores and cause the redness and irritation of the skin often seen in acne.
So, what can we do about it? The first step is to wash the face twice daily. This will help open up the pores by clearing away excess oil and skin cells. There are specific face washes for acne that you can use – look for ones containing 2% salicylic acid or benzoyl peroxide. A common myth is that cosmetics and makeup can cause acne – this is largely false. Look for cosmetic products that are oil free and/or “non-comedogenic” (these days, most are).
Benzoyl peroxide is the primary over the counter medication used to treat acne. Look for this as the active ingredient of the common acne medications at the store. It comes in many forms – face and body washes, cleansing pads, and creams/gels. Start with a 5% formulation, and if no improvement after 4-6 weeks, you can either try 10% or see your pediatrician to discuss further treatment options.
The most common side effect is dryness or a burning feeling of the skin on your face. Look for lotions that say “won’t clog pores” or “non-comedogenic” on the packaging to treat this side effect. Two other things are worth mentioning. Because it contains peroxide, benzoyl peroxide can bleach clothes or bedding if not completely absorbed. It can also increase your skin’s sensitivity to sunlight, so it’s best to use at night.
If your acne does not respond to the basic treatment described above, it is time to see your pediatrician. Several prescription medications are available to treat acne. Your pediatrician will need to see you to prescribe the proper treatment based on the type and severity of your acne. Remember to be patient, as every treatment available tends to take at least 4-6 weeks before improvement is seen.