Got Acne? We’ve Got Solutions.

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Puberty is an exciting time when a young person leaves the world of childhood and develops into a young adult. Hormones cause lots of changes during this period, one of which is pimples or acne. Up to 95% of teens will have some form of acne during puberty and your pediatrician is a great first source for information and treatment about this condition.

What causes acne

Mason Gomberg, MD

Mason Gomberg, MD

Acne is a chronic inflammatory process of the skin due to the increased production of androgens (a male hormone produced by both sexes). Any of the following can contribute to acne: genetics, stress, pre-menstruation, occlusive (air-blocking) skin preparations and certain medications.

Medically, acne is caused by excessive skin cell sloughing, increased sebum (a type of oil beneath the skin), bacterial skin infection and inflammation. This will cause pimples called comedomes. If the acne worsens, the comedomes can lead to red lesions called papules, nodules or painful cysts. These lesions can be found on the face, arms, chest or back. Some kids are not too concerned about mild acne but if it becomes moderate or severe, it can lead to scarring and psychological problems, including social withdrawal and depression.

Good news: there are many wonderful treatments your pediatrician can recommend

In most cases, a pediatrician and a patient working together to conquer acne can get great results and avoid a referral to a dermatologist. Here are some important points to consider:

  • The old wives’ tale of certain foods causing acne has been debunked — fatty, greasy foods and chocolates do not cause acne.
  • The old advice of not squeezing the pimple still stands.
  • Some cosmetics can cause acne by occluding (blocking) the skin pores. Your child should use products that are labeled “non-comedogenic.”
  • Brief sun exposure can be helpful for acne but extended sunbathing can cause skin irritation that will worsen the condition.
  • If your child’s case is mild, start with OTC products, beginning with an acne cleanser/wash at least twice a day, then use a medicine containing 5% benzoyl peroxide at bedtime. If this does not work, change to a 10% concentration of this OTC medicine. As with all acne creams, dryness, burning and redness are the two most common side effects.
  • If OTC medicines do not do the trick, speak to your pediatrician — he/she has stronger creams such as retinoids. These have an anti-inflammatory effect, plus they remove excess skin cells to prevent them from causing pimples. Another type of cream combines benzoyl peroxide with a topical antibiotic. These two creams can be used as alternating therapy.
  • If the creams do not work, the next step is an oral antibiotic (erythromycin or tetracycline). This should be used along with the acne skin creams and is usually reserved for the more inflammatory acne conditions where a teen has larger and deeper pimples, cysts or nodules.
  • In girls, estrogens (female hormones) in the form of oral contraceptives can be used if other treatments have failed and if there seems to be a relationship between the acne and ovulation or her menstrual period.
  • If none of the above medicines work, there is still one very strong medication to be considered, called oral isotretinoin or Accutane. This medicine usually is prescribed by a dermatologist and since there can be many side effects, is reserved for the most severe cases .

Acne and puberty together can be tough but your pediatrician can help

For many (if not all) teens, puberty is an awkward stage due the many changes taking place in their bodies. Even though acne or pimples are often part of this transition period from a child to an adult, your pediatrician can help in alleviating this issue. Please come in and see us; together we’ll get through it!

By Mason Gomberg, MD, a pediatrician with Westchester Health Pediatrics.

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About the Author: ML Ball