Melanie Kingsley, a dermatologist at Indiana University Health, explains when and how a professional can help.
Pimples aren’t just a superficial problem—they can take a physical and emotional toll on your child. Melanie Kingsley, a dermatologist at Indiana University Health, explains when and how a professional can help.
If your child doesn’t have acne, she can count herself among the lucky few: 85 percent of teenagers will battle pimples at some point. “Acne is a basic biological reality of puberty,” Dr. Kingsley says. Not only is your child developing sweat and sebum glands at this stage, the hormonal changes she’s undergoing change the microbacterial content of her skin. “Genetics, environment, and a diet high in sugar and refined carbs also play a role, so acne is actually a very complex problem,” adds William Wooden, MD, a plastic surgeon at Indiana University Health.
For some teens and preteens with mild acne, over-the-counter products containing benzoyl peroxide or salicylic acid may suffice. But if you don’t see any improvement within the first month or two of use, you should consider taking your child to a dermatologist. Why? “It’s important for patients and their families to get ahead of this problem,” Dr. Wooden says. “We have such a progressive array of products we can use to treat acne that there’s no reason for your child to suffer.”
In some cases, you may want to skip over-the-counter products altogether and head straight to a dermatologist. If your child has severe acne with cysts or abscesses, Dr. Kingsley recommends prompt treatment due to the risk of infections and scarring. Girls who are experiencing stubborn acne along with other symptoms such as weight gain and excessive facial hair should also see a dermatologist since these may be signs of polycystic ovary syndrome, a hormonal problem that can lead to serious health issues. Boys who develop acne and other signs of puberty before age 9 should also see a doctor, since this may indicate a problem with the pituitary or adrenal glands. “In these cases, a dermatologist will recommend a metabolic workup,” she says.
As a first line of treatment for mild acne, your doctor will likely recommend a topical retinoid, prescription-strength benzoyl peroxide, or a combination of the two; moderate cases may require the addition of a topical or oral antibiotic. Girls who have moderate acne can opt to take certain birth control pills that control acne, but due to their side effects, Dr. Kingsley says this option is best for girls who are already considering using contraception.
For very stubborn cases of moderate to severe acne that don’t respond to any of these treatments, your dermatologist may recommend the drug Accutane or a laser treatment. “Accutane is a very effective treatment but it does come with serious side effects,” says Dr. Kingsley. Some patients have become depressed while on the drug, and it also causes severe neural tube defects in babies born to mothers who took Accutane while pregnant.
Rest assured, however, that your doctor will always use the most conservative treatment possible. “The goal is always to get the maximum benefit with the least amount of drugs possible, and then only add drugs as you need them,” she says.
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