Teen Skin Care: Battling Blemishes and Beyond

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"Parents just don't get it." That's not the quibbling complaint of a pimply-faced kid, but the disappointed observation of Manhattan area dermatologist Bruce Katz, M.D., who for more than 18 years has helped hundreds of acne-plagued patients banish their blemishes.

What's clear to Katz's teenage patients is also critical for their parents to understand, says the doctor: Acne is no trivial cosmetic problem to be waited out until the pimples disappear on their own, but a medical condition that, left untreated, can leave youngsters with unsightly scars that lead to emotional pain and social inhibition. "Acne should be taken very seriously," Katz says. "Because of the stage of life when it's most common — during puberty — breakouts can be very depressing for young people."

Acne is by far the most common skin complaint among teenagers, affecting nearly all of those in the 12-to-17 age frame at least occasionally, according to the American Academy of Dermatology. The condition, fortunately, is as treatable as it is common. "Dermatologists love to take care of acne," says Marianne O'Donaghue, a Chicago dermatologist and vice president of the American Academy of Dermatology, "because we do it well and can get people back into the community with their self-esteem restored."

Home Acne Fighters
You might think that a bad diet and stress are huge contributors to acne breakouts. Not true. Experts say ordinary day-to-day stress is not an important factor. And, while eating a balanced diet always makes sense, scientific studies haven't found a connection between a diet and acne. Even so, if avoiding chocolate, French fries, or other food seems to keep your acne at bay, then doctors say it's a good idea to avoid them.

It's airborne grease that's a more likely culprit when pimples appear, so working at a fast-food restaurant is more likely to trigger breakouts than eating at one. There are steps short of quitting your fast-food job that you can take to keep your skin healthy:

• Wash your face gently a couple of times a day with mild soap and warm water to remove excess surface oils and dead skin cells. Because acne is caused by oily buildup, not dirt, scrubbing won't help control blemishes and can actually irritate the skin and further inflame pimples. Some lifestyle factors — playing football with the helmet's chin strap in friction with your face, for example — can increase oily buildup and make regular skin cleansing even more important. If you want to wipe the oil from your face but you're not near soap and water, O'Donaghue recommends carrying face-cleansing pads to wipe your face during a break.

• Shampoo your hair regularly. But avoid oily shampoos, hair gels and conditioners, which dermatologist Katz says can cause acne when your hair rubs against your face during the day or while you sleep.
• Don't use oil-based makeup or other products. For example, girls who wear foundation should look for the word noncomedogenic or nonacnegenic on the label. Avoid moisturizers all together — they aren't needed for oily skin — or if you need a moisturizer for dry portions of skin, look for the same words on the label, and apply the product only to the dry sections.
• Don't kid yourself that a summer tan can outwit acne. A tan can mask your pimples, but only temporarily. Wearing an oil-free sunscreen, such as a gel or light lotion, won't aggravate your acne and can help you avoid potentially deadly skin cancer in your adult years. Some acne treatments can actually increase your skin's sun sensitivity, making it even more important to wear sunscreen when outside. When these steps alone don't control your acne, two main categories of medicines may help suppress mild cases without a doctor's help:
• Benzoyl peroxide. Available in creams, lotions, and gels, benzoyl peroxide can destroy the bacteria associated with acne, typically taking two weeks to work.
• Salicylic acid. Available, like benzoyl peroxide, in lotions and creams as well as some pads, salicylic acid helps to unclog pores to treat and prevent blemishes.

Stepping Up the Fight Against Acne
If your skin problems persist though you've tried over-the-counter products, a dermatologist can tailor a more potent acne treatment for your skin type and condition.

Following are the most commonly used treatment options, each of which carries risks that your doctor should discuss with you.

• Antibiotics. This class of medicines can kill acne-causing bacteria and are often taken in combination with other drugs that unclog pores. Oral antibiotics can help more severe types of acne than the topical ones (placed on the skin).

• Accutane and Other Retinoids. Topical forms of these products help unclog pores to clear up moderate to severe acne. A well-known oral retinoid generically called isotretinoin and often referred to by the brand name Accutane can be effective in severe cases of acne, but requires a doctor's careful supervision because of its serious risks, most notably the possibility of birth defects and potentially serious depression.
• Oral contraceptives (for females only). The combination of hormones differs among brands of pills, some of which are more effective in clearing acne.
• Corticosteroids. A dermatologist may inject this type of anti-inflammatory medication into inflamed acne lesions to help them heal.

In addition to using these medications for pimple prevention, a dermatologist may use a variety of procedures in the office to remove existing lesions. Don't squeeze or pick at blemishes yourself, though, because only experienced health professionals can remove pimples without the risk of spreading inflammation and leaving scars.

If it does occur, though, scarring, too, can be treated with a doctor's help, often using a skin resurfacing technique such as chemical peel, microdermabrasion, or laser resurfacing. Katz has seen skin resurfacing's "dramatic" aesthetic and psychological impact "over and over and over again" in his patients. He recalls one patient in particular who came to his office two weeks after laser resurfacing. He was "a different person — confident, smiling, standing straighter, looking me in the eye where he had looked down before for a lack of confidence."

Other Than Acne
While acne is hands-down the most common skin problem among teens, it is far from the only one. Other skin conditions that affect young people more than other groups include:

• atopic eczema (makes your skin itchy, oozy and crusty, usually on the face and scalp)
• pityriasis rosea (appears as pink patches, sometimes hundreds of them)
• tinea versicolor (causes skin to take on uneven color and appear scaly).

Because many skin rashes or spots can be hard to tell apart and can sometimes signify diseases that run the gamut from harmless to potentially serious, be on the safe side: Seek treatment advice from a health professional when your skin's appearance changes unexpectedly.