Acne affects approximately 85 percent of all Americans. While acne is a common condition it is also among the most emotional to deal with – especially during the delicate teenage years when image, emotions, and self-worth are heightened.
Treating Acne in Teenagers
Acne is an inherited condition. Chances are if either parent suffered from severe acne as a teenager, then a child of theirs is more likely to suffer from the same condition. In these cases it’s important that even young children begin good skin care habits, starting at age 8 or 9 or at the onset of puberty (which may be earlier is some girls).
The onset of puberty triggers hormonal changes – these changes ultimately stimulate an increase in sebum (oil) production, which accelerates the development of acne. Girls also often suffer from cyclical acne – acne stimulated by a girl’s menstrual cycle. Estrogen is the main hormone released during the first half of a girl’s cycle and progesterone releases during the 2nd half during which time the skin and the follicles swell (which trap excess oils), increasing the likelihood of acne breakouts in the 10 days before menstruation.
That said, the importance of a simple daily cleansing routine cannot be overstated. Educating the child about how acne is formed and the importance of daily cleansing is the first line of defense. At first, parents might need to oversee the daily cleansing routine or even perform these tasks (especially for a young child) so correct cleansing techniques are learned. These include simple techniques for gently cleansing, light hydration and proper use of a broad spectrum SPF each day.
For pre-teens a simple, gentle cleansing routine that includes a light hydration at night and proper use of a broad spectrum SPF each day is all that is needed. As the child ages, gentle cleansers should be replaced by benzoyl peroxide washes, salicylic acid products, topical retinoids, bacteria-fighting hydrators, and oil-free SPF products.
Step 1 – Controlling Sebum (Oil)
This is quite possibly the most important step in preventing acne and maintaining clear skin. However, controlling oil is often over-done which leads to excessive drying of the skin. This, in turn, leads to more oil production – and so the cycle continues. More oil leads to more intense efforts to control the oil and so on.
Using a gentle astringent that also moisturizes the skin will avoid this over-production of sebum while conditioning the skin. Though it might seem counter-productive to moisturize oily skin – it’s important to know that acne-prone skin is deficient in essential fatty acids (EFAs). This absence of EFAs promotes the production of excess sebum. Using acne treatments that contain EFA-rich beneficial oils like borage seed oil, grape seed oil, and wheat germ oil will actually help reduce sebum production and prevent/control breakouts.
Step 2 – Preventing Blocked Pores
The pores become clogged and blocked when skin cells do not shed properly on their own, creating build up on the surface of the skin that results in trapped oil and bacteria in the pores. This can lead to the development of acne bacteria, called P. acnes bacteria – the precursor for inflamed acne.
Using products that aid in the removal and turnover of dead skin cells is essential for anyone with acne or acne-prone skin. Teenage skin requires gentle exfoliant products and clay masks to absorb oil to detoxify the skin and remove excess skin cells before they block the pores. Topical retinoids (products derived from Vitamin A) are also effective. While they help increase cell turnover, prescription-strength retinoids may not be appropriate for more sensitive teenage skin. Unless the acne condition is severe, pure retinol may be a better option for younger teenagers. Retinol is a gentle form of Vitamin A that is effective, but not irritating to sensitive skin. Daily use of a mild pure retinol, combined with gentle professional peels are an excellent approach for treating teenage acne.
Inflammation is both the cause and the result of acne. When pores become clogged and acne bacteria (P. acnes) increases, the skin ultimately becomes inflamed and irritated. Using anti-inflammatory topical product with ingredients that sooth irritated skin is important. Products that contain aloe vera, salicylic acid, licorice extract, boldine extract, resveratrol, and green tea (EGCG), are just some effective anti-inflammatory ingredients to look for.
UV exposure should be avoided . Exposing the skin to sunlight does not ‘dry’ the skin (a common misconception) – it will irritate and inflame the skin. Using a broad-spectrum SPF product for acne-prone skin is an essential part of a healthy skin care regimen for teenage skin.
Step 4 – Minimizing P. Acnes (Bacteria)
One of the most critical steps in managing teenage acne is controlling the P. acnes bacteria. Using topical antibacterial and antimicrobial products and (in severe cases) using oral or topical antibiotics is necessary. Topical oxygen-based products like benzoyl peroxide and hydrogen peroxide reduce bacteria’s ability to thrive. Products with 10% benzoyl peroxide are available over the counter (higher doses are available by prescription) and are a good choice for face washes and creams. Daily use of benzoyl peroxide products means that teenagers should avoid exposure to UV rays. That’s because benzoyl peroxide increases the skin’s sensitivity to sunlight which can be harmful to acneic skin. As mentioned before, daily use of a broad-spectrum sunscreen is important for everyone, particularly teenagers with acne prone skin.
Increasing the circulation and blood flow delivers oxygen to the skin, which in turn, decreases P. acnes while assisting in healing any damaged skin. Professional treatments that include a light massage also increases circulation to the skin, although those with severe acne should avoid these treatments to prevent cross-contamination.
Teenagers who have severe or chronic acne might need professional treatments to ensure results. Bear in mind that your skincare professional should treat teenage skin appropriately. Gentle products and low level alpha-hydroxy acid (AHA) and beta hydroxyl acid (BHA) blends and masks are best for teenage skin. There are many professional products that incorporate therapeutic levels of salicylic acid with calming, anti-inflammatory agents to make treatments effective and pleasant.
Professional acne treatments should be set two weeks apart. This is enough time between appointments to keep inflamed skin calm, but not too far apart to allow bacteria and clogged pores to increase. Your skincare professional should develop a trusting relationship with your teenager, call between treatments and help educate your teen on best practices for keeping skin clear.
May 2013: 77-78.