What are the treatment options for juvenile acne on the face?

From the Guidelines

For juvenile acne treatment, I strongly recommend starting with a twice-daily face wash using a gentle cleanser containing benzoyl peroxide (2.5-5%) or salicylic acid (1-2%), as these have been shown to be effective in managing acne vulgaris 1.

Key Recommendations

• Apply an over-the-counter topical treatment containing benzoyl peroxide, adapalene (0.1%), or salicylic acid, as these are recommended for mild to moderate acne 1.
• For moderate acne, consider prescription-strength treatments like tretinoin (0.025-0.05%), clindamycin, or combination products like adapalene/benzoyl peroxide, which have been shown to be effective in clinical trials 1.
• Use a non-comedogenic moisturizer and sunscreen daily to help prevent further skin irritation and promote healing.
• Allow 6-8 weeks for visible improvement, as treatments work by preventing new acne formation rather than clearing existing blemishes immediately.

Additional Considerations

• If acne is severe or doesn't respond to these measures after 2-3 months, consult a dermatologist who may prescribe oral antibiotics (like doxycycline 50-100mg daily), hormonal treatments for females, or isotretinoin for severe cases, as recommended by the guidelines of care for the management of acne vulgaris 1.
• Avoid picking at acne, which can cause scarring, and maintain a balanced diet while staying well-hydrated, as these factors can influence skin health.
• Topical retinoids, such as tretinoin and adapalene, are important in addressing the development and maintenance of acne and are recommended as monotherapy in primarily comedonal acne, or in combination with topical or oral antimicrobials in patients with mixed or primarily inflammatory acne lesions 1.

From the FDA Drug Label

Adults and children 12 years of age and older: use once daily clean the skin gently and pat dry before applying the product cover the entire affected area with a thin layer. For example, if your acne in on the face, apply the product to the entire face.

• The adapalene drug label 2 provides guidance on the treatment of facial acne in juveniles 12 years of age and older.
• Key points for treatment:
  • Apply the product to the entire affected area with a thin layer.
  • Use once daily.
• For children under 12 years of age, the label advises to ask a doctor.

From the Research

Face Juvenil Acne Treatment

• Acne vulgaris is a common skin condition that affects nearly 50 million people per year, mostly adolescents and young adults, and can cause permanent physical scarring, negatively affect quality of life and self-image, and has been associated with increased rates of anxiety, depression, and suicidal ideation 3, 4.
• The treatment of acne vulgaris depends on the severity of the disease, with mild acne responding favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid, while moderate acne responds well to combination therapy comprising topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients 5.
• For severe acne, oral isotretinoin therapy is often used, and in female patients with moderate to severe acne, facial hair, loss of scalp hair, and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given 5.
• Topical therapies such as retinoids (e.g., tretinoin, adapalene), benzoyl peroxide, azelaic acid, and/or combinations of topical agents are first-line treatments for acne vulgaris, and combinations of topical agents with systemic agents (oral antibiotics such as doxycycline and minocycline, hormonal therapies such as combination oral contraception or spironolactone, or isotretinoin) are recommended for more severe disease 3, 4.
• Adapalene/benzoyl peroxide gel is a safe and highly effective treatment for acne vulgaris, with its efficacy, tolerability, and ease-of-use being superior to other topical acne therapies, and its use does not contribute to antibiotic resistance 6.
• The combination of adapalene and an oral antibiotic provides a superior and faster benefit than antibiotic therapy alone and should be considered at the initiation of treatment 7.