When It’s Time to See a Doctor About Your Teen’s Acne

OTC medicines won’t help cystic acne, but they might help other kinds

Pimples are par for the course during teenage years, thanks to hormonal changes that increase the skin’s oil production during puberty. That oil mixes with dead skin cells on the body and clogs pores, trapping bacteria inside. Then, pop! There comes a pimple.

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While some teens escape with only mild blemishes that are relatively inconsequential, others experience acne so severe that it leaves them with physical — and sometimes even emotional — scars.

Acne can start as early as age 9 or 10 and last all the way through adulthood. It often starts as clogged pores (called comedones) on the forehead or along the T-zone that become inflamed and appear as small bumps.

To keep the damage to a minimum, you’ll want to address your teen’s acne as early as possible, says Vickie Baker, MD, a family medicine doctor who specializes in dermatology. But that doesn’t necessarily mean running to the doctor for a prescription the moment a few zits appear.

Treating acne over-the-counter

If your teen has large, red pimples that look like cysts or cause pain, over-the-counter treatments aren’t going to help, Dr. Baker says. The best course of action is to see a doctor.

For other types of blemishes. Dr. Baker recommends starting with one of these acne treatments available without a prescription:

A face wash that contains an acne-fighting medication. This could be either benzoyl peroxide or salicylic acid.

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Salicylic acid is good for more sensitive skin, Dr. Baker says, and tends to be effective at exfoliating blocked pores. Teens with sensitive skin could also start with a lower percentage of benzoyl peroxide, which kills bacteria and removes excess oil from the pores.

The best face wash for oily acne skin would be a higher percentage benzoyl peroxide formula, between 5 and 10%.

A gel that went over-the-counter in 2016. Adapalene is a topical gel that’s applied once a day to unblock pores and control inflammation.

To give these treatments the best opportunity to work, your teen needs to use them regularly for about three months.

“A lot of teens don’t understand that you have to be regimented about it, just like brushing your teeth every night,” Dr. Baker says. “You have to wash your face in the morning and at night, because when you wash it you’re treating it with medicine that’s going to help your acne.”

If the blemishes don’t seem to be under control after three months, it’s time to make an appointment.

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Many pediatricians are comfortable treating acne, Dr. Baker says, so that’s likely the best place to start. He or she can refer your teen to a dermatologist, if necessary.

Doctor’s orders

What pediatricians or dermatologists recommend for acne depends on the individual patient as well as what his or her insurance will cover.

As a general rule, Dr. Baker says, a doctor will prescribe something to control the bacteria and inflammation, such as benzoyl peroxide or a topical antibiotic called clindamycin, as well as something to unblock pores, such as adapalene or tretinoin.

Each teen reacts differently to his or her acne: While some will feel self-conscious, others might hardly even notice it. Either way, it’s important to take it seriously and work with a pediatrician or dermatologist to find a treatment that helps clear the skin, prevent scarring and avoid emotional distress.

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