32. Treating Acne in Teenagers

The most important piece of advice I can offer parents who have teenagers with acne is get the acne treated before it progresses and becomes severe.

For mild acne, parents can purchase over-the-counter benzoyl peroxide products and Differin. Differin is a mild, topical Retin A that became available without a prescription in 2016. All topical Retin A treatments cause irritation and peeling, so they should be applied sparingly and in conjunction with a moisturizer before bed. If the skin becomes too irritated while using Retin A, the medication may be applied every other day.

Teenagers with moderate acne should see their pediatrician to discuss starting topical prescription antibiotics like Duac and Benzaclin; these contain a combination of benzoyl peroxide and clindamycin. Oral tetracyclines, such as Doxycycline and Minocycline, are also useful for treating moderate to severe acne, especially if the acne is located on the back. Topical and oral antibiotics are usually combined with some type of Retin A to achieve optimal results. Doxycycline should be taken with a big glass of water to ensure that the pill does not become lodged in the esophagus, where it can cause a painful esophagitis.

For children with severe cystic or nodular acne, a dermatologist should be consulted as soon as possible. Early treatment with Accutane (oral Retin A) can help prevent lifelong scarring. Accutane is truly a wonder drug that clears severe acne in a timely fashion. Due to potential side effects, including liver inflammation, Accutane is usually not prescribed by general pediatricians. However, the risk of developing liver problems is low and shouldn’t be a major deterrent to starting the medication. Because Accutane is associated with birth defects, teenage girls taking the medication are often placed on birth control pills simultaneously. This is a useful combination, because OCP’s help to minimize acne through hormonal regulation.