Nearly 100% of people are affected by acne at some point during their life. The most common time for an initial acne breakout is during your teenage years. The reason for this is that, while a teenager, your hormones are in constant fluctuation. This fluctuation, particularly of the androgen hormone, causes increased oil production on the skin. When more oil is produced on the skin, it can build up in the pores and attract acne-causing p. acnes bacteria. No matter how diligent teenagers are with cleansing their skin, this is a time in life when acne can show up for the first time.
Dr. McKeen: Acne can be a very frustrating condition for patients and has a wide range of psycho-social implications. It can cause patients to be self-conscious and withdrawn from friends, family and other activities. Acne is not something that happens because the patient is doing something “wrong” when caring for their skin, but a condition that many people experience. The great news is that we have a lot of excellent treatment options for acne. I recommend patients come in for evaluation as soon as they start experiencing acne in order to help control their condition, prevent scarring and improve the overall health of their skin.
In addition to hormonal changes experienced during your teenage years, there are other influencing factors that may cause acne. For example, increased levels of stress cause the release of a hormone called cortisol; cortisol signals the release of increased levels of androgen hormones, which in turn stimulate the production of excess oil on the skin. For this reason, it is not unusual for teenagers to tell us that they experience their worst acne flares just before midterms or a big event at school.
Additionally, there is a form of acne that may affect high school athletes, called acne mechanica. This condition is often seen on the foreheads and chins of teenagers who play football. Their helmet rubbing on this area causes friction and inflammation, which when combined with excess oil and sweat on the skin, leads to the development of acne.
Dr. McKeen: As a part of the treatment regimen for patients with acne mechanica, I commonly recommend cleansing the skin immediately after practices or games. There are over the counter facial wipes that can be thrown in your gym bag that serve as a quick and easy reminder for busy teens. Depending on the cause (helmets, chin straps, football pads, etc), there are different techniques that can be used to reduce friction and decrease acne production.
Many teenagers try over-the-counter treatments before visiting a dermatologist to get rid of their acne. Unfortunately, we often meet patients who begin to experience permanent scarring from acne during the time that they are trying out different over-the-counter acne treatments. Even for very mild teenage acne, your dermatologist can help to recommend an effective treatment that will actually be less expensive and easier to use than trying many over-the-counter formulations from the drug store aisle. Not all acne is the same, and your acne should be treated in the best and most specific way possible.
Looking down the aisle at the drugstore can be overwhelming when shopping for acne products. There are numerous different products out there and you may not know where to start. I commonly see frustrated patients that have spent hundreds of dollars in over the counter products that have not shown much help. Rather than wasting time, money and frustration, I recommend patients be seen early in the course of their acne for evaluation and treatment. Early intervention can help restore your skin health and prevent permanent scarring.
Teenage acne is treated in a variety of ways, depending on the type of acne and its severity. Prescription medications used to treat teenage acne include topical antibacterial creams (like clindamycin and benzoyl peroxide), topical retinoids (like Retin-A Micro® or Tazorac®), oral antibiotics specifically targets at the p. acnes bacteria, and isotretinoin for severe acne that does not clear from other acne treatments.
We find that our teenage patients tend to respond very well to in-office acne-fighting treatments.
Dr. McKeen: There are several different types of lesions that can be present with acne and each requires a targeted therapy. Just because a particular cream or pill worked for a friend or sibling, it may not be the right treatment for you. It is important to have a thorough examination of your acne and formulate a treatment plan that specifically targets the type of acne you are experiencing. Once we help you to find a medication regimen, patients can typically get back to their baseline and begin to feel great about their skin.
Depending on the type of acne being treated, a series of chemical peels, medical facials, or laser treatments for acne may be recommended. For inflammatory acne (often referred to as ‘pimples’), a combination of Isolaz acne laser treatments and photodynamic therapy is effective for decreasing excess oil production on the skin, killing the acne-causing bacteria, and cleaning out clogged pores. Particularly for teenage skin, which tends to be a bit oilier than adult skin, we recommend combining these in-office acne laser treatments with at-home prescription medications.