PAMF Health Blog

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What Teens Can Do About Acne

Posted on Jun 24, 2014


Acne: it’s caused stress before many a first date and sent teens scurrying to the drug store for the latest miracle potion. If your teen has acne, he or she is not alone.

“Approximately 85 percent of all teens have acne at some point,” says Amy E. Gilliam, M.D., a pediatric dermatologist at the Palo Alto Medical Foundation. “Although there is no magic bullet or quick fix for teen acne, there are several effective treatment options that – with patience – can help clear up this skin condition.”

What Causes Acne?

Acne is caused by a teen’s hormones becoming active during puberty, causing an overproduction of sebum (a sticky substance) that clogs up pores and traps bacteria allowing whiteheads, blackheads, pustules and cysts to form. The pimples are usually found on a teen’s face, chest, back and shoulders.

First Solutions

The first step to treating acne is to unplug the pores. You can start with over-the-counter products that contain benzoyl peroxide or salicyclic acid and are sold as soaps, washes, lotions, gels and creams. These products can be reasonably effective at improving mild acne, but can take three to four weeks to start working.

“The most effective products are also the ones that cause the most skin irritation, which presents as red, flaky skin,” says Dr. Gilliam. “There is often a fine balance between using a product that works but doesn’t cause too much irritation. Using an “oil free” or “non-comedogenic” moisturizer diligently once to twice daily is an important step to counteract the irritation.”

Next Steps

If your teen’s acne worsens or doesn’t improve, a pediatrician or dermatologist can prescribe topical treatments. The active ingredients in these creams are often combination solutions containing benzoyl peroxide, retinoids (Vitamin A) and antibiotics.

Other treatments for moderate to severe acne include antibiotic pills that suppress the inflammation associated with the deeper pimples.. These treatments are taken daily for many months to “suppress” the acne and then they are gradually tapered off. Antibiotics are often used in combination with topical prescription treatments.

Girls may also be prescribed an oral contraceptive pill that can help balance hormones and improve acne.

“It’s important to have realistic expectations and understand that as you start these treatments, the acne may worsen for the first two to three weeks,” says Dr. Gilliam. “Typically you’ll see the skin improve within four to six weeks with these acne treatments.”

For Severe and Persistent Acne

If your teen’s acne is particularly severe or producing scarring, isotretinoin (a Vitamin A derivative) can be prescribed. This medication is taken daily for six months under close doctor supervision.  It takes about four to eight weeks to show an effect, but it is usually very effective once the six month course is completed.

“Isotetinoin is recommended only when all other treatments have failed and the acne is causing scarring that can be disfiguring,” says Dr. Gilliam. “This medication is very effective but can have some serious potential side effects including the risk of birth defects, very dry skin and eyes, headaches, muscle aches,  mood swings and possibly depression. Regular blood tests and monthly visits with the M.D. are required during treatment.”

Acne Myths

“There’s no medical proof that certain foods such as chocolate or fried dishes cause acne. It’s really due to the hormones,” says Dr. Gilliam. “But keep in mind that sticking to a healthy diet is best for your body and your skin.”

As for stress, that can worsen any skin condition, she says.

What about natural remedies – do they work? “Although there are all sorts of home remedies that promise to cure acne naturally, there’s no scientific evidence that any of these work,” explains Dr. Gilliam.

Instead, follow her tips for clear skin.

Acne Do’s and Don’ts

1)      Be patient and persistent. Stick closely to the regimen prescribed by your doctor and don’t give up.

2)      Don’t over-treat. Using more of a product won’t help your acne improve sooner. A pea-sized amount of acne medication is sufficient for the entire face.

3)      Moisturize well. Acne products can dry out and irritate the skin. Use a moisturizer that contains SPF 30 and pick a product that includes the words “non-comedogenic” (won’t clog pores) or “oil-free” in the description.

4)      Be kind to your skin. Use a gentle soap (bar or liquid) and don’t scrub. Avoid loofahs, pore strips or “buff puffs” that can irritate, and don’t wash too often. Twice a day with a mild soap is sufficient.

5)      Don’t squeeze or pick at acne. This just causes more irritation and inflammation and can cause scarring.


 Amy E. Gilliam, M.D., is a pediatric dermatologist at the Palo Alto Medical Foundation.

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