Is It Time for Professional Help?

• Acne is caused by three things: bacteria, irregular shedding of dead skin cells, and excessive sebum (oil) production in the skin. Because hormones are largely responsible for oilier skin, acne is most common in the teen years, although adults can still get it too. Your teen should be encouraged to practice good hygiene. While you may have treated your acne with harsh cleaners and astringents and use of coarse "buff" puffs and washcloths, according to the American Academy of Dermatology (AAD), the old method of "scrubbing" away bacteria and oil causes more sebum production. Your teen should apply a mild cleanser to acne-infected areas at least twice daily and wash using only the fingertips or hands. A good cleansing is also suggested anytime after your teen sweats a lot, such as after a sporting event or other physical activity. Harsh toners and astringents should be avoided.
  
  Female teens should avoid using heavy foundations, acne concealers and sunscreens that contain oil. When helping your teen select make-up, look for the words "oil free," "nonacnegenic" and "noncomedogenic" on the packaging (the Mayo Clinic advises the use of powder make-up over that which is cream-based). Make-up should never be worn to bed, as it clogs the hair follicles, causing more acne to erupt.
  
  Despite your best efforts, you may be unable to help your teen find over-the-counter acne products that resolve even the mildest form of acne. Is it time to seek the help of a dermatologist? According to the AAD, medical treatment should be sought if your teen's acne causes him to be embarrassed, shy or depressed. Severe acne, such as nodular and cystic acne, can not only cause pain and disfigurement, it results in permanent scarring. Scarring can be prevented if the acne is addressed sooner rather than later. A dermatologist can help your teen find the best way to treat stubborn acne, no matter how mild or severe.
  
  

Mild to Moderately Severe Acne

• There are a variety of medical treatments for teen acne available. Prescription topicals are available that fight bacteria and encourage the sloughing of dead skin cells. However, not all topical treatments have the anti-inflammatory properties that your teen probably desires.
  
  For example, the antimicrobial benzoyl peroxide is effective in reducing the bacteria that cause acne, but it's not effective in reducing inflammation associated with pimples. Older retinoids such as Retin-A can cause skin to redden and peel, while newer ones, such as those containing adapalene are known to be effective in reducing inflammation. Before deciding on a topical treatment, your teen should communicate her concerns to her dermatologist.
  
  Oral antibiotics continue to be an effective treatment for acne. Because these work systemically, they are particularly effective in treating acne on all parts of your teenager's body, especially hard to reach areas, such as the back. Often, a combination of oral antibiotics and topical treatments are required to reduce your teen's acne.
  
  Light and laser therapies are emerging technologies in treating acne. Blue light therapy, which kills bacteria that causes acne, is currently the most popular form of phototherapy; studies using this technique have yielded the most positive outcomes, with 55 percent of research participants noting reducing in acne. However, because these treatments are considered experimental, they might not be covered by your insurance plan. The average cost of a single blue light treatment ranges from $100 to $200, and multiple sessions are required. So while these treatments may be ideal for the teen who forgets to take his antibiotics, they can be costly if you're paying out of pocket.
  
  

Teens With Severe Acne

• If your teen has severe acne that results in nodules and cysts that form underneath the skin, this requires a more aggressive approach to treatment that can only be provided by a dermatologist. Severe acne can cause extensive scarring to the face and body that necessitates costly cosmetic scar-removing procedures.
  
  Sometimes severe acne can be treated with a high dosage of antibiotics and prescription topicals. Individual cysts can be drained, excised, or injected with a dilute corticosteroid. However, cystic and nodular acne can also be treated with a round of oral medication called isotretinoin, which is taken daily for 16 to 20 weeks. This medication targets the major factors that cause acne--bacteria, dead skill cells and excess oil production--so it's considered the most effective way to resolve severe acne. Your teen will probably require only one round of treatment to see a profound improvement, but some teens may have to take the medication twice.
  
  Isotretinoin causes extensive damage to developing fetuses, so it's stringently monitored in use of females who are of child-bearing age, regardless if they are sexually active. Your female teen will be required to sign up for the U.S. Food & Drug Administration's federal monitoring program, take routine pregnancy tests during the course of treatment, and will probably be placed on oral contraceptives. If your teen is not yet sexually active, it's important to stress to her that these measures are required by law--not because you or her dermatologist do not trust her to make the right decision.