1. Play it cool but take action
Acne can profoundly impact self-esteem at any age, especially during the vulnerable teenage years. If your teen tells you that his acne doesn't bother him, be aware that he may be simply putting on a brave face. I've seen this countless times with young acne sufferers in my office. For instance, during a recent consultation, 16-year-old Jeff's* mother informed me that he seemed unconcerned about his acne even though it was severe, and that it had taken a lot of persuasion to get him to come and see me.
However, during a later visit when Jeff was alone without his mother, he confessed to sleepless nights over his skin and told me that he avoided going out whenever possible because he was embarrassed about his acne. If you suspect that your teen's acne is affecting his quality of life by impairing social or academic activities, try opening the conversation in a low-key, non-judgmental way, and ask whether he'd be interested in consulting a dermatologist.
2. Lose the blame
Explain to your teen - and ask your dermatologist to explain too - that the acne is not her fault. Acne is not due to dirty skin, poor skin care habits or even, in most cases, what you eat. It's not an infection, but a skin inflammation caused by an overgrowth of bacteria that live normally on everyone's skin. Some sufferers may have inherited a predisposition to acne, which is worsened by hormonal changes during adolescence and by stress. Acne is a treatable skin disease. I believe it's vital to start effective treatment for acne while it's still in an early stage, to prevent the development of permanent scarring, which can lead to a lifetime of low self-esteem.
3. Keep it Simple
Early morning school bus pick-ups, evenings of homework, sleep-away camps and burgeoning social activities make simple, easily portable skincare regimes a must for teenage acne sufferers. Perhaps that's why many of them fall into the trap of purchasing Proactiv, a mail order acne system that contains the same ingredients as the over-the-counter acne remedies in your local drugstore, but is far more expensive and often irritating to the skin.
For a step-by-step acne treatment system that really works, ask your dermatologist about the Tretin-X kit, which combines prescription strength tretinoin cream with an antioxidant cleanser and moisturizer. The Tretin-X kit is not only much more effective than Proactiv and other over-the-counter treatments, it's better value too: The cleanser and moisturizer are free when you fill your prescription. For more severe acne, your dermatologist may add the Minocin PAC, which contains prescription antibiotic minocycline capsules along with complimentary cleansing wipes, facial serum and a skin calming masque that contains antioxidants and natural algae extracts.
If you wish to try over-the-counter acne products first, Neutrogena has a line that, while not endorsed by the likes of Lindsay Lohan and Jessica Simpson, is reasonably priced although it may be too drying for some skins. A major advantage of prescription acne treatment is that it can be individualized for oily, dry or sensitive skins.
4. Remove the triggers
Is your teen applying something to his face that is triggering or worsening his acne? Sunscreens, should be non-comedogenic, hypoallergenic and provide broad spectrum sun protection; good choices from your dermatologist include DermaTopix and SkinMedica sunscreens, and ColoreScience Sunforgettable, a brush-on chemical-free mineral sunscreen that is recommended by the Skin Cancer Foundation. Neutrogena and Aveeno facial sunscreens are available from your drugstore.
Sports helmets and other headgear can also promote acne, by trapping perspiration and blocking pores in the areas of skin that they cover. If your teen is shaving, it's better to wet-shave than to use an electric razor, and to shave only in the direction of hair growth, even though this gives a less close shave than moving the razor in different directions. Ask your dermatologist about a medicated shave cream such as Topix Glycolix Shave Cream. Make-up (see "Cover the Wounds" below) should also be noncomedogenic and hypoallergenic. Stress is often a trigger for acne; de-stressing with plenty of sleep, a healthy diet, regular exercise and relaxation often works wonders.
5. ** Cover the wounds**
For many acne sufferers, it's empowering to be able to cover up the acne and to go about your daily activities without being defined or judged by your skin. I recommend ColoreScience mineral make-up to my female patients and even to some of my male ones; it's light enough to provide good, long-lasting skin coverage that is virtually unnoticeable. ColoreScience is a medical-grade mineral make-up, available from doctors' offices, that is compatible with prescription acne therapy and may even improve acne in some cases due to the anti-inflammatory effect of its ingredients. It definitely improves social lives and self-esteem for patients like 15-year-old Megan, whose quick cover-up with ColoreScience enabled her to attend and fully enjoy a school dance this spring, instead of staying home alone as she did last year.
And there's another advantage: when pimples are camouflaged there is less temptation to pick at them, which increases the rate of healing and decreases the risk of scarring. If you opt for a drugstore make-up, steer clear of those that are misleadingly labeled "mineral" even though they contain oils, preservatives and other undesirable ingredients. Instead, look for a water-based, non-comedogenic foundation such as Neutrogena.
6. Add procedures
Ask your dermatologist about new in-office procedures for acne, such as DermaSweep MD, a multi-step crystal-free microdermabrasion system that painlessly exfoliates, extracts whiteheads and blackheads and then infuses your skin with acne-fighting salicylic and glycolic acid. I find that DermaSweep MD treatment is much more effective for acne and scarring than traditional microdermabrasion. It also has the advantage of being aluminum-free.
Acne lasers such as the Palomar Lux V target and kill the bacteria whose overgrowth causes acne. Another option is the Vitalize chemical peel, an effective combination of fruit acids that improves acne and scarring. Facials are not just for girls any more; both teenage boys and girls can benefit from steaming and extractions performed in a medical setting by a licensed aesthetician. If your teen has already developed significant scarring, you may consider treatment with new fractional lasers such as the Fraxel Repair or Palomar Lux 1540, which stimulate collagen formation in the skin, to dramatically improve scars with little or no down time.
*Patients' names have been changed to protect their privacy