“I would almost say acne is a universal problem for teens,” said Dr. David Knutson, a dermatologist and owner of Dermatology Clinic of Iowa in Cedar Rapids.
“Most people will get acne at some point in their life. There are inflammatory and hormone influences, and it can run in families, but you can’t always predict who will have it worse than the next person,” he said.
While acne typically tends to develop during puberty, Knutson said the timeline often varies for males and females.
“For boys, there’s a pretty uniform bell curve where it peaks in the teen years from ages 14 to 16,” Knutson said. “Occasionally, you’ll see young men in their 20s that may have issues as well.
“For women, we see acne earlier and longer. For young women, puberty is starting earlier than it used to. Those hormone changes affect the glands of the face. Women have a peak in puberty and sometimes another peak during childbearing years.”
The timeline and the severity of one’s acne depends on the individual. That’s why it can be hard to determine when to seek help beyond the over-the-counter products available at the pharmacy.
“Each person tolerates acne to varying degrees. The amount of acne that one person may consider very mild may seem very severe to another,” said Dr. Matthew Landherr, a dermatologist at Forefront Dermatology in Cedar Rapids. “I generally feel that if acne is bothersome to the point where it is affecting a person’s self-image or leading to anxiety or embarrassment, then it is worth seeking care.”
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Knutson agreed, suggesting checking with your primary care physician if you’re unsure if your teen would benefit from seeing a dermatologist.
“We have excellent primary care in our community,” Knutson said. “Acne is a super common condition. It’s a good place to start, and they will refer you on if you need specialized care.”
Both dermatologists agreed it makes sense to seek help if a teen begins to have scarring from acne.
“It is typically worth seeking treatment in an effort to prevent further scarring,” Landherr said. “Scarring is usually permanent — though it can be treated with cosmetic procedures — so prevention of scarring is paramount.”
HOW TO TREAT
Treatment options are plentiful.
“There are three primary classes of treatment — topical agents, things that are applied to the skin; oral medications; and other modalities such as laser or light-based therapies, chemical peels, dermabrasion, etc.,” Landherr said.
“Within the category of topical agents, there are myriad options. Oral medications most commonly include oral antibiotics, oral retinoids — primarily isotretinoin — and, for female patients, oral contraceptives and a medication called spironolactone.”
Options can be discussed with a doctor, but Knutson has some basic recommendations that he said fit most patients.
“For mild acne, find a good skin regimen that you can stick to and that you like,” he said. “I try to leave it open-ended because there are so many products out there, and many are good. But stay away from perfumed or fragrant cleansers.”
A good routine should be simple and gentle.
“Wash your face twice a day with lukewarm water and cleanser and then pat it dry,” Knutson said. “One common pitfall is that we tend to overdo things. It’s easy to be overly aggressive with too strong of a cream or medicine, which then dries out and irritates the skin.”
Knutson offers recommendations for steps to keep skin healthy.
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“The one bit of advice I will give is try to eat and drink as healthy as you can, and stay hydrated,” he said. “High glycemic foods promote inflammation, and that can impact your acne.”
Examples of high glycemic foods to avoid include sugar and sugary foods, white bread, potatoes and white rice. Low glycemic foods include whole grains and some fruits and vegetables.
Another piece of advice: Protect your skin from the sun.
“The most important recommendation for people of all ages, including children, is to perform adequate sun protection,” Landherr said. “This can be done by avoiding peak hours of sun exposure, seeking shade, wearing clothing to cover the skin, avoidance of tanning beds and wearing sunscreen.”
Sunscreens labeled as “mineral” or “physical blockers” are typically considered the safest for all age groups, Landherr added.
“These include zinc oxide and/or titanium dioxide as the active ingredients,” he said. “Sun protection has been shown to reduce the risk of skin cancers as well as reduce the signs of aging.”
The last recommendation is one you’ll hear from all doctors: Don’t smoke.
“Smoking plays a role in skin aging but is also associated with causing or worsening of several inflammatory skin conditions,” Landherr said.
Whatever type of acne or skin condition you’re facing, it’s important to remember that time is an essential ingredient in healing. “We all want instant gratification — but it’s best to ease into any products if you have sensitive skin,” Knutson said. “We want things better now, but it typically takes two to three months to see a 50 percent or greater improvement,” Knutson said. “That’s a tricky thing. If you want to see results, it takes time and patience.”