Transcription:
Managing Your Teen's Acne

Scott Webb (Host): Acne is so common for teenagers, and family history and hormones are mostly to blame. And joining me today to tell us more about the causes and treatment options is Dr. Nora Fahden. She's a general pediatrician with Stanford Medicine Children's Health.

Host: This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb. Dr. Fahden, thanks so much for your time today. I was mentioning that I have a couple of kids, one's a little bit older and sort of out of the acne phase, if you will, but I have a 15-year-oldear old as well. So, I'm right here in the trenches with other parents dealing with their kids, trying to help them. When should a parent be concerned about their child's acne?

Dr. Nora Fahden: Great question. Yeah. Thanks for having me. I'm glad to be here to talk about one of my favorite topics. So when should a parent be concerned? Number one is, you know, how upsetting is it to your child? Sometimes acne is really mild, but it's, you know, devastating to the teenager. And in that case, that's a perfect reason to talk to your pediatrician and get some guidance, even if you only end up needing over-the-counter acne treatments, it can still be helpful to have a plan.

Sometimes teens have awful acne and it's really upsetting to the parents, but the teenager kind of doesn't care. And so, that's another situation where kind of talking to your teenager, is it bugging you? Is it not? Do you want to do anything about it? If it's not scarring, causing scars, it will go away as they get through adolescence. And so sometimes just time is all that that child needs. If the acne is more severe, it's upsetting to the teen and it's starting to cause scars, then absolutely I would make an appointment with your pediatrician.

Host: Yeah, it seems like it's sort of a rite of passage, right? We were all kids once and then now we have kids, and it just seems like it's a rite of passage that when kids are, you know, 14, 15, 16, they're going to have acne to different degrees. I'm just wondering in general, how common is it? It feels like it's incredibly common because I see my daughter and her friends at the high school. But maybe it's just not. Is it just something, I guess, essentially that all sort of parents and teens can expect?

Dr. Nora Fahden: It's super common. It would be the exception for the teen to not have acne. So, it's estimated about 80-85% of young people, you know, around the ages between 12 and 30 will experience some degree of acne.

Host: Sure. Are there certain risk factors? I mentioned before we got going that, you know, my daughter, she plays a lot of sports and so when she comes home and she's exhausted, sometimes showering, you know, we try to negotiate with her, "Just think how good a shower would feel." And sometimes, you know, she's just not feeling it. So, we always encourage her, "Okay. Well, at least brush your teeth, wash your face. Get that dirt and sweat and all that." So in addition to sports, what are some of the other risk factors? Is there any genetics and family history to it? From your perspective, what puts teenager or anyone at higher risk?

Dr. Nora Fahden: Certainly, family history is significant when the acne is severe. So often, if it's really severe acne with a lot of scarring, I'll talk to the parent and they say, "Oh, you know, I had to go on Accutane," which is a medicine for severe acne. You know, I had really bad acne as a teen." But other than family history, sports or no sports, eating chocolate, not eating chocolate, you know, I think it's kind of a misconception that teens have where, you know, something that they're doing or not doing is causing their acne. And honestly, it's just their age, it's just their hormones. It's hormones. So, it's normal for the hormones at that age to be telling the skin follicles, "Hey, make more oil, make more oil," as part of, you know, the rest of the changes that their body is going through. So, athlete or not, vegetarian or not, you know, all these things, you're eating too many sweets, you know, those things don't have a huge impact on the skin. But certainly, good hygiene of course helps. Using a gentle cleanser in the morning and at night, using sunscreen every day, whether it's sunny or not, those are things that all teens can do to help prevent the severity of the acne. But at the same time, if they forget to wash their face one night, that's not going to like tip the scales about, you know, whether or not they're going to have bad acne.

Host: So if we think of it that way, that it's just something that's going to happen to most teens, how do you treat acne? And what's being done in the way of treatment and what should parents, you know, if they're walking the aisles trying to help their kids, what should they maybe stay away from in this case?

Dr. Nora Fahden: Yeah. That's a great point. So, yes, on one hand, acne is a rite of passage. It's extremely common and it's treatable. So if it's bothering your child, we can treat your acne, granted they have a little bit of patience, so that's kind of the hardest part of acne treatment, is that it will never go away overnight and nor even in a couple of days. It's really more weeks to months is the timeline, which is really hard for teens, you know, and adults. But that's a difficult part of acne treatment.

Regarding what to look for in the drugstore, that can be so tricky because the acne isle is its own aisle. There's a million products.

Host: There really are.

Dr. Nora Fahden: Yeah. But there's actually just a handful of ingredients that parents need to know, , or teens need to know. So, the first one is called benzoyl peroxide. This is anti-inflammatory and it also fights the bacteria that cause acne. Acne has a component of inflammation and a component of infection, meaning just the bacteria on the skin are causing the pimples. So, the benzoyl peroxide fights the inflammation and the infection part of acne. So, benzoyl peroxide, it's usually going to say 5% or 10%. If your child has more sensitive skin, you want to use the 5% version, and that can come in a face wash or like a gel that the teen applies to their face and leaves on morning and night, just a small amount. But that's a really common one and very effective. So, that's the first one, benzoyl peroxide.

The second one is called salicylic acid. This is only going to help for the very mild forms of acne. And it's usually 2% strength of salicylic acid. And the same thing, it'll either be a face wash or it'll be a topical treatment. And what this does is help keep the pores open, so that they don't clog up and fill up with all of that oil that the hormones are telling the teen's body to produce. So, keeping the pores open, keeps them from filling up with the gunk that causes the pimples. The next step up from salicylic acid, which is really helpful, and you can buy it over the counter now is called adapalene. I'm probably not supposed to say a brand name, but you know, adapalene, which usually comes as Differin gel is available, it's like 15 bucks and you can buy it in the acne aisle, and that's like a stronger version of the salicylic acid. And it's really effective if your teen has the type of acne that's more of like whiteheads and blackheads.

Host: You mentioned sort of we're not trying to do commercials here, but we're all, you know, consumers, shoppers. So, you know, I see things like Proactiv, these types of things, and I'm never sure exactly what they are. Are those more preventative? Is that to prevent acne? Or is it to treat acne? Maybe you can, again, without us doing a commercial for anybody particular, those types of things, what are they for?

Dr. Nora Fahden: I'm so glad we're talking about those because, you know, for parents and teens who feel really frustrated by their acne and they feel nothing's helping, they don't know what to do, so there are things marketed to them. There are even subscription services where you take a quiz online and they send certain things to your home, et cetera, et cetera. Now, that you guys know about benzoyl peroxide, salicylic acid, adapalene, clindamycin gel is another common acne treatment, so I would just encourage parents to read the back of those sometimes very expensive bottles and they'll find ingredients that are, you know, far more affordable that can be either prescribed by your pediatrician or purchased just for a couple of bucks, like at a drugstore.

For some of those services, it comes with a degree of support in terms of, I think you have access sometimes to someone you can ask questions about the skin, but you can ask your pediatrician. So, you know, we're happy to talk about skin stuff. So for those, it's up to the family. If they feel like it's a good fit, those services and it's working, then go for it. But I would never want a family to feel financial strain or stress over those things because we can treat the acne together using things that are affordable and readily available.

Host: So, doctor, you said that patience is necessary. But what if patience isn't really possible? Let's just say a teen has something like a high school dance, a prom or something, and they've got the big pimple, unsightly pimple in the middle of their forehead. Is there anything they can do that day to just sort of take the focus off, deemphasize it a little bit? Like what would be your recommendations when patience isn't really possible?

Dr. Nora Fahden: Totally. That's such a hard situation. The first thing would be don't pick at it, don't try to squeeze it or pop it. That will really increase the inflammation of the pimple that you're most worried about. It'll make it bigger, more red. The best thing a teen can do is just try not to bother it even more. , They do make these neat little like sticker patches, and those can just kind of cosmetically help. If you find one that you know matches your skin tone, if you can put the little sticker over the big pimple that can help just cosmetically if you need to have photos taken or something like that.

Host: Definitely. Well, this has been fun and educational today. Doctor, as we wrap up, you know, when we're dealing with our kids whom we love, right? And we want the best for them. As you say, some kids care about acne, some don't. But we're dealing with the physical part of it, right? The physical manifestation of the acne, but also the mental part of it. We're dealing with these humans that we love at a very stressful time for many of them. What's your best advice framed through this conversation or the lens of acne, but in general, trying to maintain the mental and physical wellness of our teens? What's your best advice?

Dr. Nora Fahden: Absolutely. There's actually a lot of research. Evidence that acne has a huge impact on the mental health of teens. So, my takeaway advice to parents is to listen to your child. If they're in tears, if they're upset, they're angry about their acne, please come talk to your pediatrician about it so we can treat the acne and help your teen feel better. Sometimes just talking to your doctor, getting a plan, working on something that your teen is telling you is bothering them, that alone sometimes brings a lot of relief. So, not minimizing it, not saying, "Oh, I had acne. It'll go away because to a teenager, the fact that it will go away in several years is no consolation.

Host: It really isn't. No.

Dr. Nora Fahden: Yeah. And acne is treatable. So, I would say really listen to your kids. If it's bothering them, you know, it's bothering them and, there are things we can do to support them and help them feel better.

Host: Doctor, thanks so much for your time today. This was fun. I told you before we got rolling, you know, I always enjoy these because I have kids. I was a kid and I have kids and it's great free medical advice for me, for listeners. So, thanks so much. You stay well.

Dr. Nora Fahden: Thank you. Thanks for having me.

Host: And for more information, go to stanfordchildrens.org. And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.