Many teens and young adults suffer from different forms and severities of acne. Unfortunately, the “old school” philosophy of treating acne with topical and oral antibiotics and even Accutane is not always the best or even necessary for the child. Kids are too often diagnosed with “acne” and are prescribed some form of antibiotic or Accutane when simply addressing skin health and cleanliness may be all that is necessary to significantly improve their acne.
Here is what we will address in the consult. We will take a full medical and lifestyle history of the child. This goes beyond the medical part of the history by addressing skin health and daily routine. How does the patient clean his/her skin? Does the patient have any undiagnosed allergies or abnormal hormone levels that can be treated? What are the patient’s daily activities that may cause the skin to be dirty (touching the skin, studying with hands touching the lower face, picking the skin, sports activities)? Most of the time, the patient can be successfully treated with better medical grade skincare, twice daily skin cleansing, minimal time between “sweat producing” activities (sports and exercise) and skin cleansing, sunblock, and careful attention to everything that might touch the skin (clothes, shampoos, fabric softeners and detergents, sports equipment like helmet straps, and the patient’s own fingers and hands). My approach is education on skin cleanliness, habits and medical grade skincare. Antibiotics and/or Accutane (which can have significant short and especially long term side effects) are almost never necessary.
One great example in my practice is a cosmetic patient of mine who brought in her 16 year old son. He had significant acne and had seen multiple dermatologists in the past few years. He had been prescribed many topical and oral antibiotics and even had Accutane suggested. He had not seen significant improvement with any of the drugs and luckily he did not take Accutane. I spent some time with him asking him detailed questions about everything that he did during the day. He was a very healthy and athletic kid who got up early in the morning and showered. He would go all day (school, sports activities, etc.) and not wash his face before bed. He also would keep sweat drenched clothes on for hours and he never cleaned his sports equipment (especially his helmet chin strap). I educated him about these things and told him to shower more often, especially after each type of exercise and to clean his equipment. I also encouraged him to try to not touch his face during the day and not lean on his hand to study. We put him on Seiler Skin’s recommended acne treatment plan without any type of antibiotic. He came in for his first two week follow-up and his mom was in tears about how much his skin improved. He just needed to be educated about cleaning his skin and using better medical grade skincare and sunblock!