Many myths about the causes of acne, as well as a general lack of knowledge about the treatments for the disease, can leave significant psychosocial consequences in adolescents. In most cases, acne can be treated with very simple, over-the-counter remedies. Other, more serious cases require professional care.
What could be banaler than acne pimples in adolescence? In France, 80% of 12-18 year olds are affected by acne. “Adolescents in Western countries develop acne from puberty, during hormonal changes, up to a sometimes advanced age, explains Dr. Nina Roos, a dermatologist in Paris. But the appearance of pimples is variable depending on the development of the child, his skin type, his family history.
A peak around 16-17 years old
Overall, the first small lesions occur most often around 12-13 years old in both sexes, sometimes earlier in girls. “The peak of dermatology consultations is around the age of 16-17 years, with larger lesions, often inflammatory,” says the specialist.
The definitive disappearance of acne is difficult to determine because a “background” can persist for up to 30 years in boys, generally later in girls, who then develop a form of acne, called “adult”, different from that contracted in adolescence.
Doctors do not have no quick fix to ensure the total disappearance of acne; however, she tends to improve on her own after the age of 20.
The different types of acne in adolescents
- Retentional acne results in the production of comedones: blackheads and whiteheads. This is usually how affection begins.
- Inflammatory acne is characterized by large painful red pimples and cysts that can leave scars indented.
- Mixed acne combines blackheads and large red pimples. This is the most common case in adolescents. We speak of juvenile polymorphic acne.
- Acne conglobata is a severe form of acne that combines large nodules and cysts in a profuse fashion.
- Fulminating acne is a very rare form where the young patient presents with a high fever, diffuse joint and muscle pain, a sudden extension of his lesions, which become very inflammatory, ulcerated, crusty and painful. The evolution is slow, and impacts the general condition of the patient.
Consult as soon as possible to limit the psychological impact
The ordinary emotional and social stress of adolescence can become even more difficult to overcome in the presence of acne. This disorder affects the way adolescents feel about themselves and may even increase the risk of depression, anxiety, and social isolation. Although this skin disease is visible, the suffering it causes is rarely mentioned to parents, which is why it is sometimes essential to take the lead if you want to help your teenager. feel better in your body and in your head.
It is necessary to encourage adolescents to consult, as soon as acne pimples appear. Let us not forget that they attach great importance to their image at that age. It is also the time for them to adopt good hygiene and health habits.
Which specialist to consult?
“The main contact and acne therapist, whatever its form, is the dermatologist. He is trained on the mechanisms at the origin of acne and is regularly informed of advances by the specialized press, indicates Dr. Nina Roos, dermatologist. If general practitioners and pediatricians sometimes advise treatments, they rarely venture into combinations of molecules and cosmetics. Otherwise, they do not take care of the scars. Treatments from beauticians have no place in the therapeutic strategy for acne.
The importance of food and hygiene?
Contrary to popular belief, acne does not result from dirt on the skin. In fact, irritation from too frequent washing can promote this problem. Wash affected areas no more than twice a day, with a sweet product rather than soap, is already the first step.
Regarding diet, its effect is controversial. Studies suggest that a diet low in carbohydrates, rich in whole grains and legumes, appears to improve acne in adolescents. In some people, dairy products can make acne worse. In this case, try reducing your teenager’s milk intake and observe the effects on their skin.
Likewise, the large consumers of meat and of poultry, may be more likely to develop acne through a complex chain reaction that stimulates the fatty glands in the skin. But the influence of other dietary items like chocolate and fried foods on acne seems more of a myth than a fact.
Finding a suitable treatment is not an easy task …
The most important thing, experts say, is finding the right treatment. Over-the-counter remedies can helpeliminate bacteria that promote acne. They are generally effective and well-tolerated. But in the most serious cases, the intervention of a health professional is preferable, to avoid scarring.
The right treatment for acne depends :
- of type of lesions what the patient presents;
- of his genetic background;
- of contraindications or allergies;
- of his drug tolerance,
- of the presence of pregnancy
- and more generally, of the way of life of the adolescent to be treated.
“Overall, doctors start by prescribing local treatments. There are different types: those mainly targeting retentional lesions (vitamin A derivatives or fruit acids) and those targeting inflammatory lesions (antibiotics or benzoyl peroxide), explains dermatologist Nina Roos.
What to do when teenage acne is very severe?
When acne is severe as soon as it appears, with a risk of scarring, or in the event of failure of local treatments, the dermatologist suggests an antibiotic from the cyclin family be taken for three months (associated with local treatments), or even isotretinoin orally.
Isotretinoin is generally effective, but it is sometimes poorly tolerated and requires regular biological monitoring (blood test), a monthly visit to the dermatologist, and a contraception in girls (birth control pills reduce fluctuation in hormones and can calm acne). The National Agency for the Safety of Medicines and Health Products (ANSM) underlines the risk of neurodevelopmental disorders (mental retardation or retardation of motor functions) in children in the event of exposure to isotretinoin during pregnancy (notice published on February 18, 2021 – source 1).
In boys, the ANSM recommends monthly monitoring of biological and psychiatric parameters (opinion of May 5, 2021 – source 2).
Long-term follow-up to overcome pimples
The different acne treatments are generally available on prescription. These treatments work well, but they absolutely must be continued over a long period sometimes with local creams to be applied for several years. Rest assured: this skin disease is not inevitable! It can be treated, and we should not be discouraged, even if the doctor sometimes needs time to find and prescribe the right product.
Acne cannot be cured in a few months: it is a chronic disease, progressing by relapses, with phases of remission. When this skin disorder appears, it is therefore important to be followed by a dermatologist every two or three months for several years. In addition, acne changes over the years and requires changing the type of treatment as it evolves.
The young patient needs to be supported, listened to, and comforted ; he should not “be released into the wild” and fend for himself with his prescription and side effects. “Care must be regularly adapted to the clinical response, tolerance, the development of acne, other parameters (pregnancy, pathologies during treatment, etc.), changes in the climate, in particular in summer”, insists Dr. Nina Roos, dermatologist.