From the Guidelines
Acne treatment in teenagers should start with topical benzoyl peroxide, topical retinoids, or oral doxycycline, as strongly recommended by recent guidelines 1. For mild acne, topical treatments containing benzoyl peroxide (2.5-10%) or salicylic acid (0.5-2%) can be used, applied once or twice daily to affected areas. These work by killing bacteria, reducing inflammation, and helping to unclog pores. A basic regimen might include gentle face washing twice daily with a mild cleanser, followed by application of a benzoyl peroxide product. For moderate acne, topical retinoids like adapalene (0.1% gel) can be added, applied thinly at night, as they help prevent clogged pores and promote cell turnover. For more severe or persistent acne, oral antibiotics such as doxycycline (50-100mg daily for 3-6 months) may be prescribed, or for females, hormonal treatments like certain birth control pills. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy 1. Consistency is crucial for any acne treatment, and results typically take 6-8 weeks to become noticeable. Teenagers should avoid picking at acne, use oil-free, non-comedogenic skincare products, and maintain a healthy diet and lifestyle to support skin health. Some studies have shown the effectiveness of isotretinoin in treating severe acne, with significant improvements in lesion count and treatment success rates 1. However, the primary consideration for acne treatment in teenagers should be based on the most recent and highest quality guidelines, which prioritize benzoyl peroxide, topical retinoids, and oral doxycycline as first-line treatments 1.
Key considerations for acne treatment in teenagers include:
- Starting with mild topical treatments and gradually increasing to more potent options as needed
- Avoiding the overuse of systemic antibiotics and combining topical therapies with multiple mechanisms of action
- Considering oral isotretinoin for severe or scarring acne, under close medical supervision
- Maintaining a consistent skincare routine and healthy lifestyle to support skin health. The goal of acne treatment is to reduce morbidity, mortality, and improve quality of life, and recent guidelines provide a clear framework for achieving this goal 1.
From the FDA Drug Label
The use of isotretinoin for the treatment of severe recalcitrant nodular acne in pediatric patients ages 12 to 17 years should be given careful consideration, especially for those patients where a known metabolic or structural bone disease exists Use of isotretinoin in this age group for severe recalcitrant nodular acne is supported by evidence from a clinical study comparing 103 pediatric patients (13 to 17 years) to 197 adult patients (≥18 years) Results from this study demonstrated that isotretinoin, at a dose of 1 mg/kg/day given in two divided doses, was equally effective in treating severe recalcitrant nodular acne in both pediatric and adult patients In studies with isotretinoin, adverse reactions reported in pediatric patients were similar to those described in adults except for the increased incidence of back pain and arthralgia (both of which were sometimes severe) and myalgia in pediatric patients
Treatment options for acne in teenagers include:
- Isotretinoin (PO) for severe recalcitrant nodular acne in patients 12-17 years old, with careful consideration of potential side effects and monitoring of bone density 2
- Benzoyl peroxide (TOP) for mild to moderate acne, with caution to avoid skin irritation and sun exposure 3 It is essential to consult a healthcare professional to determine the best course of treatment for acne in teenagers, as the severity and type of acne can vary greatly between individuals.
From the Research
Treatment Options for Acne in Teenagers
The treatment of acne in teenagers can be approached in several ways, depending on the severity and type of acne.
- For mild acne, topical treatments such as benzoyl peroxide, azelaic acid, and antibacterials are generally used for inflammatory lesions, while topical retinoids are effective for noninflamed lesions 4.
- Combination therapies are useful for mixed lesions, and oral antibacterials such as tetracyclines and erythromycin may be prescribed for moderately severe acne 4, 5.
- For severe nodular acne, isotretinoin is the treatment of choice, and it has also been used to treat patients with moderate acne that has not responded to other systemic therapies 4, 6.
Considerations for Treatment
When treating acne in teenagers, it is essential to consider the potential for scarring and psychological disability, as well as the presence of other conditions such as polycystic ovary syndrome (PCOS) 5, 6.
- The choice of therapy should be based on the type of lesion and the severity of the acne, as well as the individual patient's needs and circumstances 4.
- Physical therapies, such as extractions and blue light therapy, may also be used as adjuncts to drug therapies 4.
Special Considerations for Younger Patients
While there is limited literature on acne treatment in children, it is reasonable to extrapolate findings from studies on adolescents and adults, with the exception of the use of tetracycline derivatives 7.