Family Doctor Health Advisor

Overview
Children
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Adolescent skin problems

The onset of adolescence often produces marked changes in the skin. Infantile eczema, which often affects younger children, may clear up altogether before or during adolescence. However, another form of eczema - contact eczema - may occur for the first time during this period. Contact eczema may result from contact with certain metals or cosmetics, causing an itchy, red rash. Other skin problems, such as psoriasis, may also develop for the first time during adolescence. However, the most noticeable skin changes during adolescence are caused by the rising levels of sex hormones. These hormones encourage the sebaceous glands in the skin to produce increasing amounts of sebum - an oily substance that helps to lubricate the skin. Not only does the increased sebaceous activity give the skin an oily appearance, but it also encourages the development of acne, which affects almost all adolescents to some extent.

1 Does your child have either of the following?

  • Inflamed red spots with white centres
  • Blackheads

Yes 2 No 3

Treatments for acne

There is no instant cure for acne, although many treatments are available that will improve the appearance of the skin. Before consulting your doctor, you should try over-the-counter lotions and creams containing benzoyl peroxide. This drug unblocks pores and kills bacteria, thereby reducing the number of spots. However, benzoyl peroxide can make the skin sore.

Moderate to severe acne should receive medical treatment. Your doctor may prescribe long-term low-dose antibiotics, which need to be taken for at least 6 months. Alternatively, he or she may prescribe a skin preparation containing a retinoid drug. These creams unblock pores by removing a fine surface layer of skin.

If treatment with antibiotics and/or retinoid creams is ineffective, your acne is very severe, or there is scarring, your doctor may refer you to a specialist for treatment with oral retinoids, such as isotretinoin. These drugs are usually very effective. However, because of the risk of side effects, regular blood tests will be needed while you are taking them. Women must not become pregnant during treatment with oral retinoids because these drugs can cause serious malformations in the fetus.

Self-Help Coping with acne

Understanding what causes acne and what does not will help you cope with the condition. The following measures may be helpful in controlling acne:

  • Wash your face regularly, but not more than twice a day. Use mild soap and water. Washing will not prevent acne, but it may stop it getting worse.
  • Remove any make-up at night.
  • Oily cosmetics and pomades for Afro-Caribbean hair should be used sparingly.
  • Sunlight can help to improve mild acne - but be careful to avoid sunburn.

There is no evidence that acne can be caused or made worse by having hair that hangs over the face. Nor are lack of exercise or eating sweets, chocolates, or fatty foods known to be factors. However, your general health will be improved by eating a healthy diet and exercising regularly.

Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.

The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.

Publication Date: 31 March 2009
Authorised By: RACGP

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