Acne surprises young teens -- unpleasantly. Hormonal surges stimulate skin oil production, and the resulting acne frustrates kids and bruises their self-esteem.

In girls, the menstrual cycle often takes years to stabilize, and fluctuating estrogen and progesterone levels can make acne worse. Boys find that their acne worsens during large growth spurts. What can young teens do to help their skin stay clearer, and how can parents help?

"Get them in the habit of taking care of their skin early," suggests Brandith Irwin, M.D., a Seattle dermatologist and nationally recognized skin-care expert. "Don't wait until they're 16 and fighting acne and then try to change their habits."

Irwin says that the type of cleanser teens use on mild acne isn't as important as the drying product they apply, since cleansers generally stay on the skin less than 15 seconds. She recommends that when parents talk to teens about skin care, they also explain the importance of using sunscreen and minimizing tanning to prevent melanoma.

Physicians divide acne into four types, ranging from least to most severe: comedonal (blackheads and whiteheads), papular (red bumps), pustular (red bumps with puss), and cystic (deep, inflamed, pus-filled bumps, often painful). While milder acne often responds well to nonprescription medication, "if a child is psychologically suffering because of acne or is starting to show permanent scarring, that's the time to seek a dermatologist," Irwin cautions.

Naturopathic physician Kimberly Kelly, N.D., R.N., who practices in Kirkland and North Seattle, says that clearing acne can take as much as a year of combined skin care and dietary change. As a naturopath, Kelly sees a strong connection between what kids eat and how their skin responds.

"Teens get really busy and have access to a lot more sugar and fast foods," she says. "Saturated fats aggravate the acne. Parents can use their kid's concern about their skin as an opportunity to talk about nutrition. Don't focus on fat or calories, but on the quality of food the teen chooses.

Families who seek naturopathic care for acne will most likely find dietary advice and dietary supplements such as fish oil or flaxseed oil that provide essential fatty acids and boost skin health. Kelly recommends tea tree oil antibacterial soap as a topical first line of defense for average (not cystic) teen acne.

Both Irwin and Kelly recommend Proactiv Solution, a regime of topical products developed by two dermatologists, for non-cystic acne. The products contain benzoyl peroxide and salicylic acid, both of which are also used in a variety of other non-prescriptive topical products available at drugstores. Irwin also recommends microdermabrasion treatments performed by a well-trained aesthetician for treating teen acne and cites the Gene Juarez Salon chain as a good option for this service.

Of course, acne products sitting unused under the bathroom sink are ineffective. Getting young teens to buy into a skin-care regime is crucial. "Setting products up where they can see them -- and purchasing those products rather than asking them to pay for them -- is really important," Kelly advises.

If parents notice their teen's acne getting worse despite available products, Kelly suggests opening up a dialogue rather than asking pointed questions. "Ask how things are going in general, and give gentle prompts. Kids sometimes just forget to use the products," she says.

When young teens do require dermatological care, Irwin says that she and many other physicians now rarely prescribe antibiotics, opting instead for one of a dozen or so topical medications.

"Accutane may be an appropriate treatment for cystic acne even at this age," she advises, noting that girls of any age who are given Accutane will also be required to take birth control pills. Parents should know that although this drug is highly effective, its use in teens is controversial because of very serious side effects.

Paula Becker is a Seattle freelance writer and a mother of three.

Healthy skin habits

  • Wash hands before touching face.
  • Wash face gently twice daily. Do not scrub.
  • Girls who wear makeup should look for products labeled "oil-free" or "non-comedogenic."
  • Don't squeeze or pick at pimples. Instead, apply a drying product.
  • Always use sunscreen.


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