Getting ready to go anywhere -- school, out with friends, out to a party -- was a hassle during her high school years, recalls Sarah, now a 19-year-old college freshman in New York City.
The problem? Acne. "I hated not being able to just get out of the shower and go straight out," says Sarah, who asked that her last name not be used. Instead, she would carefully apply acne medication and then cover that up with makeup to camouflage the blemishes.
Her dedication to the dermatologist-recommended routine seemed futile at times, she says. "It was getting really frustrating. Nothing seemed to be working."
While the majority of teens may not have the severe acne that Sarah experienced, nearly 100% will have some acne -- ranging from an occasional breakout to chronic acne -- during adolescence. The skin problems can put a damper on social life and thwart self-confidence.
"It's not uncommon for a patient to come see me for the first time and have tears in their eyes," says Amy Derick, MD, a dermatologist in Barrington, Ill.
"Teens avoid school if they have lots of zits," says Cynthia Chen, MD, a resident in dermatology at the University of California, San Francisco, who surveyed teens with acne about their feelings.
The good news: research on skin conditions such as acne has progressed greatly even in the past 10 years, with more treatment options for acne than ever before.
The not-so-good news? Obstacles to treatment are common, dermatologists say, and that slows resolution of the skin problems.
Acne Treatments: A Host of Solutions
During the past decade, the number of acne treatments has expanded greatly, according to the American Academy of Dermatology. Among the significant advances:
- Newer topical products such as retinoids (derived from vitamin A), help unplug follicles. Although retinoids can irritate skin, new ones are made for different types of skin and promise to be less irritating.
- Combination treatments are becoming more common, with many doctors prescribing a topical retinoid together with a topical antimicrobial or an oral antibiotic to fight bacteria. Combination creams, putting ingredients such as the cleansing agent benzoyl peroxide and the antibiotic clindamycin in one product, are more common.
- Prescribing oral contraceptives for teenage girls with acne is becoming more accepted. At low doses, some types of birth control pills may help clear acne.
- Oral isotretinoin can help in severe cases that haven't responded to other medications. Because the drug has been associated with depression and suicidal thoughts, patients who use it are closely followed for any changes in mood. Blood tests monitor any potential adverse effects, such as elevated cholesterol levels.
When Should You Seek Treatment for Acne?
Even with the ever-expanding treatment arsenal, getting acne relief isn't typically easy or quick. Teens and parents often disagree about whether professional help is needed and, if so, which treatment is best.