Helpful Hints for Acne in Adolescents

• Reassure your teenage patient that over 90% of people of their age also have acne and that there are many excellent treatments available that can induce a sustained remission.

• Tell your patient that there is no, one best treatment for acne, there are many—the key is to find the right combination that will work for the patient's particular type of acne and skin type and will easily be incorporated into the patient's routine.

• Assess level of motivation, is it the patient who is bothered by the acne or is it a family member? Key questions to ask: Is the patient very self-conscious about their acne? Are they withdrawing from activities?

• Use the least aggressive and simplest regimen that will lead to prolonged remission.

• Teens will be more likely to stop using a treatment if they see that a particular treatment is not working, if the regimen is too complicated, or if they are experiencing side effects.

• For preadolescents (8 to 11 years) showing prominent sebaceous glands and early comedones suggest getting into the habit of washing their face twice daily with a mild acne wash such as Neutrogena Acne wash with salicylic acid 2%.

• For acne with a significant comedonal component always incorporate a topical retinoid such as adapalene (mildest), tretinoin, or tazarotene (strongest). For patients with dry or sensitive skin use a cream or lotion and avoid gels.

• Anticipate side effects and discuss them openly:

  • All acne treatments can dry out the skin, reassure patients that this is expected and will improve with continued use. The following suggestions can help counteract dryness: apply only a small amount of medication (pea size amount is enough for the entire face); decrease frequency of use to every other day; use a noncomedogenic moisturizer daily or twice daily on top of the topical acne medication.

  • Temporary redness immediately after application of acne medication can occur.

  • Topical acne treatments will make the skin burn more easily when exposed to the sun. Patients should use adequate sun protection when going out in the sun.

  • If prolonged burning or stinging occurs, stop using the medication.

• Counsel of avoidance of picking and squeezing pimples and over scrubbing.

• Provide clear, simple written instructions and hand out to patient at every visit.

Helpful Hints

• Remember to ask your patient how much they are bothered by their acne. If it is primarily mom who cares, then it is less likely that the acne medication will be used.

• Some acne medications are available in pumps, a pump allows for easy one-step medication dispensing.

• Placing acne treatments in strategic locations such as night treatment on the nightstand and morning treatments near the toothbrush may make it easier for patients to remember to apply their medication.

• Place acne washes in the shower.

Point to Remember

• Topical antibiotics should not be used as monotherapy for acne as this can lead to the development of bacterial resistance.