Acne in teen

[Teaching3bears]

What mild and topical things can be done to reduce acne for a teen boy?  He does not have oily skin and the acne is not in the t-zone but more on the sides of his face.  It is not deep but there it is not a mild case.  I put tea tree oil in his soap and have used witch hazel but that is not doing much.  His hair is not on his face and not greasy.

[katilac]

The minute the word 'acne' springs to mind, I take them to the dermatologist. I think you just waste more money and time trying otc stuff without expert advice. 

[saraha]

I second this. I wish we had gone to a dermatologist years earlier than we did for ds. We messed around with otc too long, then with pediatrician too long. finally got it cleared up, but by then he was almost done with college. I do really regret that even now

[marbel]

7 minutes ago, katilac said:

The minute the word 'acne' springs to mind, I take them to the dermatologist. I think you just waste more money and time trying otc stuff without expert advice. 

Agreed. We wasted so much time and $$ thinking we were avoiding the expense of the dermatologist. So wrong.

[RootAnn]

For those of you who went to a dermatologist, what did they do that worked?

[saraha]

I also want to add, the fact that it is not oily, not t zone, and is on his cheeks makes me want to suggest dr even more. You can start out at pediatrician and it won’t cost nearly as much and try some of the easier options first. Shaving is so hard when there is acne. I know it’s not what you asked for, so feel free to ignore, but I just wanted to put it out there.

[katilac]

1 minute ago, RootAnn said:

For those of you who went to a dermatologist, what did they do that worked?

Epiduo in some cases, Accutane in others. 

[saraha]

1 minute ago, RootAnn said:

For those of you who went to a dermatologist, what did they do that worked?

We ended up on the “nuclear option” acutane as we had tried LITERALLY everything else under the sun. But the first thing the dermatologist wanted to know was if we had tried the antibiotic option, which we had with pediatrician and had records.

[popmom]

I agree with seeing a dermatologist. I will say that I was not impressed with our last experience with a dermatologist. She prescribed Finecea Foam. There was no generic at the time, so it was expensive. It didn't help my daughter, and we have since figured out that hers is more hormone related.

I have another daughter who orders a retinoid from The Ordinary. It's called Granactive Retinoid 2% in Squalane. It's really helped her acne. She also uses their Niacinamide product. She does not have oily skin either. She hydrates with hyaluraonic acid because dry skin exacerbates acne. This is a good one.

BTW: the ingredient in Finecea is 15% Azelaic Acid. You can get it in slightly lower concentrations OTC if you want to try it--clearly it works for a lot of people. The Ordinary has it (10% concentration). All of their stuff is very reasonably priced, and it lasts a long time. I ordered the 30 ml bottle of the same retinoid my dd uses (less than $10) back in July, and I've only used a little more than half. https://theordinary.deciem.com/default?ccvis=1

ETA: If you do end up trying a retinoid--whether it's Retin-a or an the one I listed above, it's important to know that he'll go through a purge phase. The acne will get worse before it gets better. Also--this is SUPER IMPORTANT because many doctors will NOT tell you this--If you use Retin-A, you must let the skin dry completely before applying it. Like wait 30 minutes after washing face. Otherwise, it's horribly irritating. I know from personal experience. 😕 Once I was told to let my skin dry, I could tolerate it. This does not apply to the Granactive Retinoid I linked above. 

 

Edited September 27, 2020 by popmom

[Shellydon]

I would first try having him wash his face with a benzoyl peroxide based face wash in the morning and CeraVe foaming face wash at night.    Apply Differin at night.  Use strides salicylic face pads in the morning. You may have to start off with alternating Differin every other night if it is irritating his face. 

[popmom]

3 minutes ago, Shellydon said:

I would first try having him wash his face with a benzoyl peroxide based face wash in the morning and CeraVe foaming face wash at night.    Apply Differin at night.  Use strides salicylic face pads in the morning. You may have to start off with alternating Differin every other night if it is irritating his face. 

Do you think this would be okay for someone who does NOT have oily skin? We haven't had any luck with these products, and I think it's because my kids don't have oily skin. I'm curious what your thoughts are.

[Shellydon]

1 hour ago, popmom said:

Do you think this would be okay for someone who does NOT have oily skin? We haven't had any luck with these products, and I think it's because my kids don't have oily skin. I'm curious what your thoughts are.

Yes. Acne isn't actually caused by oily skin.  Differin is retnoid that turns the skin cells over faster. It takes 4-6 weeks to be effective. 

[MercyA]

We are seeing improvement with this regimen:

Night: cleanse with Acne.org cleanser. Rub face with ice cube and pat dry. (Sounds weird, but it worked for me as a teen and is working for DD12 now.) Apply 2.5% benzoyl peroxide gel over all problem areas.

Morning: cleanse with Acne.org cleanser. Pat dry. Apply Differin over all problem areas.

She does not have extremely oily skin.

[SanDiegoMom]

We just went to the doctor and she prescribed... something? That has an antibiotic in it.  I didn't really look too hard at it (bad mom) but it's working really well.  It was the first line product and if it didn't work she said to call and she would prescribe something stronger.  They just apply it to their face once a day (at night usually) and then in the morning they are still washing with a clearasil face wash. 

[gardenmom5]

Diet.  Benzoyl peroxide.  wash - wash - wash.  Keep hair clean (the oil from hair can make the skin near it break out.)

[catz]

For both my kids a benzoil peroxide scrub in the shower and a good multivitamin make a big difference.  I was ready to move on to a derm for them, but this worked well here.  

This is the current one both my teens use

https://www.amazon.com/Neutrogena-Stubborn-Acne-Cleanser-Peroxide/dp/B00S49XI6M/ref=sr_1_13?crid=1I2DXPYP7MJ70&dchild=1&keywords=neutrogena+face+wash&qid=1601228839&sprefix=neutrogena+%2Caps%2C188&sr=8-13

This is similar to proactive which made a huge difference for me when I was younger.  I had considered trying those products as well but with teens less steps are better.

[crazyforlatin]

20 hours ago, RootAnn said:

For those of you who went to a dermatologist, what did they do that worked?

We went to 2 dermatologists. I gave each suggestion enough time (including Epiduo) and in the end I decided to go on our own using adapalene .1% at night with 5.5% BP  in the morning. I looked through all the products and threw away anything with fragrance and alcohol.  I have Dd use Paula's Choice BHA 2% in the morning with niacinamide. 

So the last in person derm had her use dapsone/tazarotene which helped a bit, but I didn't see enough results to continue after 4 months.

At that point I subscribed to Curology after trying suggestions from the previous 2 derms. Their product didn't work very well. Partly was my fault because I didn't think tretinoin was right for Dd when they suggested it since we had tried my generic tube for 8 weeks (and if our current combo stops working I will go back to Curology for their tretinoin combo) They had Dd try a clindamycin azeliac acid combo. I should have realized that if clindamycin doesn't really work on her hairline folliculitis it can't work well on her forehead. 

If an in-person derm is too costly, I think Curology is the next best thing because you can work with them to find a different combo. A doctor does evaluate your skin based on what you tell her and based on close up pictures of your skin. I decided not to continue with them because at the same time I was already thinking of using adapalene after watching a Dr. Dray YouTube video. 

Sulfur spot treatment/mask has helped a lot as well in shortening the time for any pimples to come to a head or zapping it. But spot treatment really depends on the skin.

I switched her to silk pillowcases recently and I feel like it's helped a lot as well.

First shipment from Curology is free except for shipping. 

So Epiduo Forte is .3% adapalene and 2.5% BP, but last year, this didn't work for Dd. Yet splitting them into .1% adapalene ( I would go higher if I could find it over the counter) and 5.5% BP works. I do want to try Epiduo Forte should our current combo stop working, just to test it out again.

For face wash I have Dd do a double cleanse. The second cleanse is either an SA cleanser by Cerave or by Inky List. And I'm waiting for the Panoxyl BP wash 4% to be used maybe 2-3 times per week.

[Mommalongadingdong]

Okay I didn't see it already, but a clean towel and pillowcase would be my number one fix that you could do immediately and without cost.

 

[Teaching3bears]

Do any of these products have bad side effects?  

[EKS]

I went to a dermatologist for acne 30 years ago, and she gave me something called "erythromycin topical solution" which I put on my face twice a day.  After a month my skin was clear.  I used it for maybe a year and then stopped.  My skin has been clear ever since.

I know that the go to antibiotics now are oral, but I just wanted to share that topical antibiotics can work. 

[Tenaj]

Just had my 15 year old in for a regular physical and he was having a pretty  bad outbreak at the time.  We will not use Accutane due to a situation with one of my older kids so I was anxiously awaiting the ped's opinion (we had just been using over the counter stuff).    He put him on the low-dose antibiotics plus Clindamycin and Benzoyl Peroxide Gel in the morning and Adapalene at night.  He's been on this regiment for only 24 hours and the difference is amazing.  This afternoon he said, "Did you notice my face, Mom?".   I don't think the Accutane even worked this well.  I'm hoping it continues.  We go back for a dr. check in a month to reevaluate.

[crazyforlatin]

11 minutes ago, JanOH said:

Just had my 15 year old in for a regular physical and he was having a pretty  bad outbreak at the time.  We will not use Accutane due to a situation with one of my older kids so I was anxiously awaiting the ped's opinion (we had just been using over the counter stuff).    He put him on the low-dose antibiotics plus Clindamycin and Benzoyl Peroxide Gel in the morning and Adapalene at night.  He's been on this regiment for only 24 hours and the difference is amazing.  This afternoon he said, "Did you notice my face, Mom?".   I don't think the Accutane even worked this well.  I'm hoping it continues.  We go back for a dr. check in a month to reevaluate.

What's the percentage for the adapalene?

[Reefgazer]

A dermatologist, honestly.  With both my kids, the acne was only under control with a topical antibiotic and prescription face wash; OTC did nothing.

[hellen]

My teen boy developed acne on his forehead that wouldn't go away.  He tried many of the OTC products over the course of months and was vigilant about skin care, but nothing worked.  It turned out to be fungal acne that was cleared up with athlete foot cream within days.  I had never heard of fungal acne before so I just wanted to mention it just in case it can help others.  

[Beth S]

After years of dermatologist visits (& our resistance to trying Acutane), antibiotics, diet elimination trials, etc.  our teen had success with Acne.org products.
They have a specific regimen, with products.
Teen's other siblings (with minor acne) had success with Walmart's Equate Oil-free Daily Face Wash, and Zapzyt acne treatment.

[mlktwins]

Following!

One of my boys is having a really hard time all of a sudden - especially bad on his temples.  I would take him to a derm, but not risking it at the moment.  I think I am risking his well-check and scheduled shots in mid-October though so I will ask the ped about it.  I wonder if we could do a zoom with the derm?

[Tenaj]

15 hours ago, crazyforlatin said:

What's the percentage for the adapalene?

.1 percent

[crazyforlatin]

3 hours ago, mlktwins said:

Following!

One of my boys is having a really hard time all of a sudden - especially bad on his temples.  I would take him to a derm, but not risking it at the moment.  I think I am risking his well-check and scheduled shots in mid-October though so I will ask the ped about it.  I wonder if we could do a zoom with the derm?

Curology has the patient answer questions and upload photos. First shipment is free but you pay for shipping. You can work with a derm to revise the ingredients. I find them to have good customer service and advice. In fact even though Dd doesn't have a current prescription from them, I decided to give them a try.

Dd had the same problem, clogged pores on the temples and along the sides. There were fewer after using adapalene and BP but still I could see that there were new clogged pores, just clogging less frequently. I did try using new pillowcases every day, but it didn't happen every day, more like 3x per week. I switched to silk pillowcases last month and I've noticed that now it's so much better after the switch. I don't think it's from just the topical treatments bc we started those in June and silk cases around end of August.