Transcription:

RadioMD Presents: Healthy Children | Original Air Date: Wednesday, January 21, 2015
Host: Melanie Cole, MS
Guest: Dr. Anna Bruckner

Melanie: You know; if you think adolescence isn’t hard enough, just add acne to the picture.  Kids and self esteem and going into high school and all of those things all over their face is enough to make a child want to cover up their face or not go to school at all.  We’re talking today with Dr. Anna Bruckner.  She’s the Director of Pediatric Dermatology at Children’s Hospital in Colorado. Dr. Bruckner, acne.  It sucks for kids.  I know my 14 year old son right now is trying to avoid it at all costs.  So first of all, is there a way to prevent it?  Will washing their face, using exfoliants, scrubbing their face, any of these things help prevent it?  Or is it just a given?  If it’s going to happen, it’s going to happen.  

Dr. Bruckner: Great questions.  You know; I think that, unfortunately, some degree of acne is going to be inevitable in all teenagers because it’s really the result of normal hormonal changes that their bodies are going through.  But I think that a good skin care program can certainly help to minimize the severity of acne for some teenagers.  What that really means is really just using, probably, a gentle type of wash to keep the skin nice and clean and avoiding products that are going to clog the pores.  We really do not recommend exfoliating, picking, scrubbing, those sorts of things, because unfortunately they tend to make the acne worse rather than better.  

Melanie: Yikes, really?  Every kid, it’s universal, they want to start squeezing them, which is disgusting.  

Dr. Bruckner: Its human nature.

Melanie: It’s human nature, so what do we tell them?  They’ve got this white thing sitting there, on their face, and they just want to go and get rid of it.  Is that really bad?

Dr. Bruckner: Yes, I mean we don’t encourage popping or squeezing because it can increase the risk of scarring, especially if the lesion is a deeper lesion.  There are a variety of over the counter products that can help to dry up those angry lesions, so a product with benzoyl peroxide in it might be a good place to start. Applying that twice a day, to help dry up the lesions is going to be better in the long run than picking or squeezing them.

Melanie: So if they’ve got a few of those white heads, run to the store and get them benzoyl peroxide and try to stop the kid, tie their hands down, so they don’t squeeze the thing.  But if they squeeze the thing, it seems to go away faster.  All of a sudden, it’s just a little red and then it’s not looking so nasty. Does the benzoyl peroxide make it go down, or does it take a few days and it still looks like something white?

Dr. Bruckner: Benzoyl peroxide has some anti-inflammatory and anti-microbial properties, so it should help to calm down the redness and to get the lesion to dry up.  If the child, though, is having a lot of bigger, deeper, red spots, that might be a case where they’ll need some prescription medication versus something over the counter.

Melanie: Those prescription medications that you’re talking about, if kids really have bad acne and you’re afraid of permanent scarring, what are some of those prescription medications and what do they do for them?

Dr. Bruckner: There are a whole slew of different acne treatments; the most common ones that we that we start with, for mild to moderate acne, are different types of creams and lotions that are applied to the skin.  Some of those medications work to help unclog the pores.  You were referring to these white bumps, which are sometimes called whiteheads.  There are also some black lesions on the skin that sort of look like open pores.  People often call those blackheads.  There are some medications that help to open up the pores and help minimize the development of those whiteheads and blackheads.  Then there’s a variety of products such as benzoyl peroxide and different antibiotics that work to dry up the redness and decrease the inflammation.  If a child is getting more serious, deeper lesions, that is a case where we need to do medicines that are given by mouth.  What we commonly start with are antibiotics.  That’s not because acne is an infection, the antibiotics are really working through an anti-inflammatory mechanism to calm down those deeper red spots, decreasing the inflammation and decreasing the risk of scarring over the long term.

Melanie: Okay, so how long would they be on an antibiotic?

Dr. Bruckner: Well, the standard course of treatment for acne starts with 12 weeks of treatment and it really depends on how the individual does.  In some cases the medications are continued for longer.  In other cases we stop the oral antibiotic but continue the use of skin medications, which are really very safe.  It all depends on how that child is responding.  

Melanie: You’re a pediatric dermatologist, Dr. Bruckner.  What do we tell our kids, what do you tell kids, when they come in to you at Children’s Hospital and they’ve got really bad acne and they’re teenagers.  What do you tell them about the whole self-esteem issue and the fact that it really seems to affect all of their high school years and can make them have a terrible memory of high school?

Dr. Bruckner: I completely agree.  I went through that myself.  I think it’s important for teenagers to understand that there is life beyond adolescence and high school.  I think that offering them hope and treatment to clear things up is really important.  It’s important for them to see that light at the end of the tunnel.  The treatment is important, the follow-up is important, and there are other medications above and beyond the antibiotics that we’ve talked about for kids with really severe acne.

Melanie: So what about sweets, sugar, chocolate, candy, Halloween?  I still use that method with my kids at Halloween time, when I think they’re going to go a little crazy. I say: “You know; that could cause zits.” They look at me and stop eating the candy right away.  Is there any truth to the myth that sugar or sweet things or greasy, fried foods causes acne or makes it worse?

Dr. Bruckner: I think that there is some validity to the idea that it makes it worse.  This is an area where we need better studies but there is some good physiological evidence that foods that either increase our blood sugars quickly or that have a high glycemic index, basically feeds into a pathway that can make acne worse.  It’s not the cause of acne but it’s definitely a factor that can contribute to worsening or more severe acne in prone individuals.

Melanie: Because their skin has so much oil in it, they should be staying away from any kind of skin moisturizers.  What about makeup?  Especially, girls are going to start wanting to wear makeup.  Can that make acne worse?

Dr. Bruckner: That’s a great question.  Ironically, I think many teenagers feel that their skin is oily and can be dry at the same time.  In many cases, I think that moisturizers can be used.  You want to stay away from moisturizers that are oil based.  There are a number of good products, though, that are oil free and have been tested to show that they do not cause acne or make acne worse and those types of products are acceptable to be used on the face.  The same things go with makeup.  We recommend staying away from foundations or cover-ups that are oil based and heavy, but the non-oil based makeup, especially things like powders, can be helpful in terms of absorbing some of the oil sheen and covering up the acne.  Again, there are many reputable products that have been tested and shown to be safe to use on adolescents and adults that tend to get acne.  

Melanie: Last 30 seconds, Dr. Bruckner.  Your best advice for parents listening that have children suffering from this hideous high school nightmare, what can they do?

Dr. Bruckner: Number one, again, acne is sort of a rite of passage, but that doesn’t mean a child should have to suffer with severe acne.  There are a number of treatments, both over the counter and through a physician that are very, very effective at minimizing or clearing up the acne.  I encourage those parents of children with severe acne to go and seek advice from their physicians.  

Melanie: Definitely good advice.  Seek advice from your pediatrician, from your physician, from a qualified pediatric dermatologist; someone that can help your children with acne because, gosh, no kid wants to go through high school looking like that. And tell them not to pop those things; that will make it worse.

You’re listening to Healthy Children, right here on RadioMD.  This is Melanie Cole. Thanks for listening and stay well.