It is important for parents to know the facts, falsehoods about acne
ERIN ANDERSEN / Lincoln Journal Star | Posted: Thursday, April 17, 2008 7:00 pm
For teens, acne is a miserable rite of passage.
The good news is, acne treatment has come a long way since we were teens. Medical professionals know far more about acne’s causes and progression than ever before.
Today, the American Academy of Dermatology assures us: “Virtually every case of acne can be resolved.”
But treatment is not always simple — or quick. Often it takes months.
Even then, treatment does not offer a cure — which is exactly what teens and young adults want by the time they come to see Dr. Ann Lott at Lincoln’s Cosmetic Dermatology & Laser Center.
“Acne is a controllable problem, but we really have no cure, just have treatments to make it controllable,” she explained.
Often it falls to parents to get teens help.
That is why it is important for parents to know the facts — and falsehoods — about acne and its treatments.
First the facts
Nearly everyone gets acne at some point in their adolescence, according to the American Academy of Dermatology (AAD).
Typically it starts between the ages of 10 and 13 and lasts about five to 10 years.
However, acne can strike anytime pores clog — whether you’re 14 or 40.
The majority of people can control acne successfully with over-the-counter cleansers and solutions.
But about 40 percent of teens require medical treatment for their severe acne, the AAD said.
Severe acne can lead to permanent scarring — both emotionally and physically, said Dr. Richard Antaya, director of pediatric dermatology at Yale School of Medicine and a spokesman for OXY Acne Solutions.
What exactly is acne?
Acne develops when skin cells slough off and plug pores, allowing bacteria, dirt and other inflammatory substances to build up beneath the skin’s surface.
“Most causes of acne are basically hormonal influences inside the body that lead to the production of excess oil (sebum) and toxins from normal bacteria in the pores, which then combine with dead, shedding skin cells to clog pores on the skin’s surface, creating the eruptions that we see as pimples, redness, etc.,” Antaya said in a press release.
Acne can appear in many variations, from the more common blackheads, whiteheads and pustules to the painful and potentially disfiguring cysts and nodules that grow deeper into the skin.
Lott, who has been a dermatologist for 29 years, became a skin doctor because she suffered acne as a teen.
She grew up hearing many of the same things we now tell our teens about acne — that it is caused by eating greasy junk food and chocolate and poor hygiene.
None of which is true.
Acne is brought on by a “perfect storm” of physical changes that occur in adolescence, said Antaya — changes inside the hair follicles, increased sebum (oil) production, hormonal changes and the presence of bacteria.
And acne can be hereditary. If you had severe acne as a teen, odds are your child will, too, Lott said. Which gives your kids just one more thing to blame on you.
How to handle it
If you’re the parent of a teen — especially a teen who has suffered an untimely and unsightly pimple attack, you know the trauma and drama.
They refuse to leave their room.
They vow to wear a bag on their head.
They cry. Sob. Scream. Lash out.
Today there are lots of options available to acne sufferers, from gels and solutions, to pills, electronic zit zappers and laser treatments.
The biggest hurdle is getting teens to agree to try them, Lott said.
“Getting them to want treatment is 90 percent of the battle, she said.
Parents of teens who refuse help need to decide whether it is a battle worth fighting, Lott said.
Teens who aren’t willing to comply with long-term treatment regimens will not find success, she said.
Boys versus girls
Boys are harder than girls when it comes to addressing acne, according to Antaya.
Both genders suffer pimples, but boys tend to get more severe and longer-lasting cases, the AAD said.
Partly it’s because acne is triggered by androgen, a male hormone. And partly it is because boys are less willing to ask for help, buy specialized products or stick with multistep, long-term treatment regimens.
The 2007 OXY Acne report found that boys are less likely than girls to admit acne lowers their self-confidence, but are slightly more likely to avoid social situations because of acne outbreaks.
It’s not that boys don’t care. It’s that they don’t know how to ask for help, said Antaya.
For boys, the best advocate is mom, he said. But moms need to tread carefully on the sensitive issue.
One-fourth of the boys surveyed said unsolicited acne advice likely would annoy them.
They also admitted to being less inclined to seek out solutions, purchase acne products for themselves or even ask friends for recommendations — all things girls generally are willing to do.
Antaya’s advice to moms: “Basically, even if he seems annoyed with you, your son could use your help because he may not know where to start, and most of the skincare products are directed to women.”
He suggests moms mention a product or better yet, anonymously buy one and leave it in the bathroom for their sons. According to the OXY Acne Report, 35 percent of boys say they use acne products that have been purchased for them, without being asked.
The biggest factor in any acne treatment is following a regimen and sticking with it, Lott said.
Overall, boys have less follow-through, especially if a treatment involves multiple steps, Lott said.
Lucky for them, many companies are coming out with single- step and easier to use treatments, such as NeoBenz one-time use, medicated sponges. They are about the size of a quarter, and teens simply squeeze the medicated packet and cleanse with the sponge, Lott said.
Working with teens
The best thing parents can do is help their teens develop good skin-care routines, Lott said.
They may want to consider electronic products that are earning rave reviews. Lott is a big fan of Clarisonic ($195), a hand-held skin-care brush created by the makers of the Sonicare toothbrush. The brush provides gentle but deep cleansing without causing irritation.
Also popular is the Zeno ($150). Dubbed the zit zapper, Zeno uses heat to kill the bacteria in a pimple before it surfaces.
“The only negative I hear is the amount of time it takes — two minutes, three times a day for each pimple,” Lott said. “For teens, two minutes is a long time.”
Which is why treating acne can be difficult. Regardless of the product used, it can take weeks or months to see any visible effects. Lott tells her clients to use a product as directed religiously for three months before trying something new.
“That is not the mindset of teens. They want it yesterday,” Lott said.
411 for acne control
1. Wash your face twice a day. Pat dry. Look for the terms “oil-free” and “noncomedogenic” (non-acne aggravating) when selecting a facial cleanser.
2. When using an acne cleanser, look for the ingredients benzoyl peroxide or salicylic acid. Remember: Acne is not caused by dirt.
3. Use your bare hands to wash your face. Don’t use scrubs or astringents. Avoid scrubbing skin too hard. All are drying to the skin, thus breaking down skin’s natural barrier and making it more fragile and susceptible, says Dr. Ann Lott, Lincoln dermatologist.
4. Commit to a regular skin care regimen for at least six to eight weeks.
5. Keep hair and hands off your face. Avoid getting hair gels and sprays on your face, as they can clog pores.
6. Take care when putting items on or near the face, such as cellphones or chin straps from helmets; they can irritate skin and build up bacteria.
7. Do not pop or pick pimples. Although Lott says there is a right way and right time for popping pimples, most of us never get it quite right and can actually make the problem worse by squeezing zits.
8. Look for “noncomedogenic” cosmetics and toiletries that have been formulated so that they will not cause acne. Avoid heavy foundations and cream eye shadow and blush. If you use a make-up sponge, wash it frequently because it can harbor bacteria.
9. Follow the five basics to overall good health:
— Get plenty of rest.
— Drink water.
— Eat a balanced diet.
— Exercise.
— Moderate your stress.
While stress does not cause acne, it can make it worse by increasing the body’s production of cortisol, a hormone that is metabolized as androgen — a primary culprit in increasing oil production and triggering acne.
10. Don’t be afraid to seek help. If you are unsure what over-the-counter products to buy, ask your pharmacist. If you see no visible improvement after three months of acne treatment, contact your doctor for further advice.
Acne myths
Myth 1: Acne is caused by poor hygiene.
Acne is not caused by dirt or surface skin oils. Avoid vigorous scrubbing and excessive washing, as it can irritate skin and make acne worse.
Myth 2: Acne is caused by bad-for-you foods, such as french fries, pizza and chocolate.
Scientific studies find no connection between food and acne. According to the American Academy of Dermatologists, if your acne is being treated properly, there is no need to worry about food affecting the acne.
Myth 3: Acne is caused by stress.
The ordinary stress of day-to-day living is not an important factor in acne. Severe stress that needs medical attention is sometimes treated with drugs that can cause acne as a side effect. And as a general rule, too much stress can affect your overall health.
Myth 4: Acne is just a cosmetic disease.
Acne does affect people’s appearance. But it also can result in permanent physical scars if not properly treated. And, studies have found acne has lead to lasting emotional issues — especially in how people view themselves.
Myth 5: You just have to let acne run its course.
Acne is treatable and controllable. If the acne products you use haven’t worked, consider seeing a dermatologist.
Source: American Academy of Dermatology
Reach Erin Andersen at 473-7217 or eandersen@journalstar.com.