Although acne is "merely" a superficial skin disease, it's possible that it causes teenagers more misery than all other diseases combined. Developing sometimes when kids are as young as 11, and lasting into early adulthood, chronic skin problems wear on on the fragile self-esteem and mood common among adolescents. And if a serious case of acne develops, the consequences could include scars -- and feelings of being unattractive -- that last a lifetime.
Two years ago, we wrote about how parents can help their children deal with skin conditions. Since then, new perspectives and approaches have come to our attention, and we'd like to share them with you.
First, a little background. Acne results mainly from several factors: sex hormones (particularly testosterone) that rise with puberty, foods that affect those hormones, bacteria swarming in pores, and cleanliness of the skin.
Because the causes of acne vary from child to child, different kids respond to different treatments, so you may need to experiment with various methods. Ask your pediatrician for advice, and perhaps get a referral to a dermatologist. Meanwhile, consider the suggestions below.
A Word of Caution
The evidence is mounting that some conventional acne treatments have significant downsides. Most topical acne treatment -- applied directly to the skin -- is safe, both over the counter remedies and prescription medications. But oral medications have genuine risks; in the short-term they can seem like miracle cures, but they often have hidden consequences that last for decades or more.
The most common oral treatment for acne is prescription antibiotics. These are usually given for a minimum of 4- 6 weeks, and frequently much longer. (For instance, Jan took oral antibiotics continuously for about ten years, from 13 to 23.) In addition to creating antibiotic-resistant bacteria, antibiotics also kill beneficial bacteria in the intestines. This can lead to long-lasting bowel problems, particular if antibiotics are given over a lengthy period. While taking acidopholus bacteria in one form or another can compensate somewhat for the harmful effects of antibiotics, that's usually inadequate to rebalance the intestines completely. Further, severe acne is often treated with Acutane, whose known potential side effects include depression and birth defects.
The other common oral treatment for acne is birth control pills for girls. Apart from any consideration that such a practice might promote sexual activity in some cases, a reasonable person would have concerns about artificially regulating a girl's hormonal cycles at a vulnerable and young age.
Healthy, Clean Skin
Clear skin begins with clean skin. In addition to the benefits for personal hygiene, a daily shower is an opportunity for a daily shampoo, which will help keep skin clean. As to washing the face itself, there are many acne soaps available with different characteristics, and you should experiment to find the ones that work best for your child's individual complexion.
Next, over-the-counter topical treatments are usually helpful. Benzyl-peroxide is a key ingredient found in many creams. Ironically, the lower concentration of 2.5% could be more effective than the more concentrated level (10%) found in most creams. 2.5% concentrations are found in Proactive products and in BP (which is less expensive and can be ordered at Acne.org). 10% concentrations are found in Clearasil and most over-the-counter creams.
A problem with benzyl-peroxide is that it is drying, necessitating a moisturizer. Also, since it contains peroxide, it will bleach any fabrics it touches, from bathroom towels to shirt collars, so be careful.
Topically, a fabulous natural supplement is vitamin B-3 (niacinamide) in a 4% or 5% lotion. You can get this is by prescription, but it's also available as an over-the-counter product called Acnicure Lotion, found at AcneMiracle. This product is not drying, and our kids like it a lot. It can be combined with other topical products, too.
If you consult a dermatologist, he or she may prescribe prescription topical antibiotics, such as clindamycin or vitamin A creams. These topical preparations work fine, with few risks.