Acne comes of age earlier | aad.org

Acne comes of age earlier

NEW YORK (Aug. 1, 2013) —

Dermatologists seeing younger kids facing acne due to earlier onset of puberty

Overview: 
For many teenagers, acne has become an all-too-familiar rite of passage. Many teens and their parents brace themselves for this common skin condition, but a growing number of pre-adolescents also are experiencing acne. The reason? Dermatologists believe an earlier onset of puberty may be to blame, causing hormones to trigger the start of acne sooner.

Now, a leading group of dermatologists considered experts in pediatric acne has developed new recommendations for treating acne in children of all age groups, which recently have been endorsed by the American Academy of Pediatrics.¹

American Academy of Dermatology expert
Information presented at the American Academy of Dermatology’s Summer Academy Meeting by Andrea L. Zaenglein, MD, FAAD, a board-certified pediatric dermatologist and professor of dermatology and pediatrics at Penn State/Hershey Medical Center in Hershey, Pa. Dr. Zaenglein also is a co-author of the newly published pediatric acne guidelines.

Age and acne severity dictate treatment
Acne occurring in pre-adolescents (defined as 7- to 12-year-olds) is not typically severe and usually includes comedones (whiteheads and blackheads) on the “T-zone” area of the forehead, nose and chin. Dr. Zaenglein noted that larger, inflammatory lesions are uncommon in this age group. 

When determining the most appropriate acne treatments for preadolescents, dermatologists consider the child’s age and type of acne. For mild acne, dermatologists recommend an over-the-counter benzoyl peroxide product. If the acne does not respond to this treatment, dermatologists may offer topical therapy consisting of a combination of benzoyl peroxide, an antibiotic and/or a retinoid.

  • Pre-adolescents with larger areas of comedonal acne with or without inflammatory lesions, which may include pimples or nodules, may require combination topical therapy and the addition of an age-appropriate oral antibiotic. Dr. Zaenglein notes that more frequent monitoring by the dermatologist is needed in these cases to determine improvement or progression of acne.
  • Although rare in younger age groups, inflammatory acne with pimples and nodules has the potential for scarring. Dermatologists may order a blood work-up to rule out a hormonal imbalance. Combination topical therapy along with an oral antibiotic will be prescribed initially. If acne does not respond to initial treatment, isotretinoin can be used safely in this age group with close and continual monitoring by a dermatologist for any adverse side effects. 

Therapy can control acne for several years, but Dr. Zaenglein advised that the condition needs to be monitored by a dermatologist throughout puberty for signs that acne may be worsening, as early onset of comedonal acne can be a predictor of more severe acne in teens or adults.

Dr. Zaenglein’s tips for parents

  • Don’t panic: Start with over-the-counter benzoyl peroxide products to see if acne improves.
  • Encourage good cleansing habits: Twice a day with a gentle, non-irritating, pH balanced cleanser.
  • If acne is worsening, see a board-certified dermatologist to start combination therapy without delay.
  • Stay involved in the child’s treatment routine to increase compliance because it is unrealistic to expect young children to apply topical medications or take oral medications every day without parental guidance.
  • Daily skin care and acne treatment need to become a habit, similar to brushing teeth.
  • Parents and kids need to remember that improvement will not occur overnight; rather, it may take up to three months to see improvement in acne.

American Academy of Dermatology expert advice:
“Acne at any age can be frustrating, but it can be especially distressing for kids and parents when it develops sooner than expected,” said Dr. Zaenglein. “It is important for parents not to put off treatment thinking acne will go away on its own, especially if a child has severe acne or any scarring. Puberty lasts several years, as does acne, so proper treatment is essential.”  

Celebrating 75 years of promoting skin, hair and nail health
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org. Follow the Academy on Facebook (American Academy of Dermatology) or Twitter (@AADskin).


1
Eichenfield, LA, et al. Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne. Pediatrics 2013; 131-S163.

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