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My Child Has Acne: Information and a Guide My Child Has Acne: Information and a aGuide My Child Has Acne: My Child Has Acne: Information and Guide to Home Care for Parents My Child Has Acne: Information and a Guide Information and a Guide to Homeand Care Parents toto Home Care Parents My Child Hasfor Acne: Information a for Guide Home Care for Parents toMy Home Care for Parents Child Has Acne: Information and a Guide to HomeAbout CareAcne forInformation Parents They may also occur on the ears. Comedones are usually small Information About Acne and usually are not reddened (inflamed). to HomeAbout Care for Parents bumps They may also occur on the ears.doComedones usually small However, have more are severe This Information They maysome also preadolescents occur on the ears. Comedones are acne. usually small Isn’t My Child Too Young Acne to Have Acne? bumps and usually not reddened (inflamed). Information About Acne may bemay a sign that aare child more serious are acneusually later on. They also occur on the ears.do Comedones bumps and usually are will not have reddened (inflamed). Acne most commonly affects teenagers, but it is not just a condition of However, some preadolescents have more severe acne.small This Information About Acne Isn’t My Child Too Young to Have Acne? bumps and usually are not reddened (inflamed). However, some preadolescents do have more severe acne.small This They may also occur on the ears. Comedones are usually adolescence. Acne is often seen in children as young as 7 years old. In may be a sign that a child will have more serious acne later on. Isn’t My Child Too Young to Have Acne? Isn’t My Child Too Young to Have Acne? Should My Child’ s Acne Be Treated by Should My Child’s Acne Be Treated by Information About Acne However, some preadolescents do have more severe acne. This may be a sign that a child will have more serious acne later on. Acne most commonly affects teenagers, but it is not just a condition of bumps and usually are not reddened (inflamed). many preadolescent children, acne is theto first sign of puberty (sexual of Isn’t My Child Too Young Have Acne? Acne mostAcne commonly but it is not just a condition a Doctor? They also on the ears. are usually Doctor? may beHowever, a may sign that aoccur child willAcne have more serious acne later on. adolescence. isexample, oftenaffects seen inteenagers, children as young asseen 7 years old.the In Should My Child’s Be Treated by some preadolescents doComedones have more severe acne.small This development). For in a girl, acne may be before Information About Acne Acne most commonly affects teenagers, but it is not just a condition of adolescence. Acne is often seen in children as young as 7 years old. In Isn’t My Child Too Young to Have Acne? bumps and My usually are not reddened Should Child’s Acne (inflamed). Be Treated by many preadolescent children, acne is the firsthair, signand of puberty (sexual development of breasts, pubic and underarm first menstruaadolescence. Acne isexample, often seenin inteenagers, children as young asseen 7 years old.(sexual In of many preadolescent children, acne isacne the first sign of puberty Acne most commonly affects but it is not just a condition development). For a girl, may be before the tion (period). In aChild boy, acne can occur before the testicles and(sexual penis Isn’t My Too Young tosign Have Acne? many preadolescent children, acne is the first of puberty development). For example, in a girl, acne may be seen before adolescence. Acne is pubic oftenhair seen in children asvoice young as 7menstruayears old.the In development ofand breasts, andappear, underarm hair, and deepens. first enlarge, pubic underarm or the Acne most commonly affects but itthe issign not justpuberty abefore condition development). For example, in teenagers, aoccur girl,underarm acne may be seen the of development of breasts, pubic and hair, and first menstruamany preadolescent children, acne is the first of (sexual tionOccasionally, (period). In aacne boy, acne can before testicles and penis can even develop in babies or very young adolescence. Acne often seen inaoccur children as voice young asseen 7menstruayears In development ofand breasts, pubic and underarm hair, and first tion (period). InFor a isboy, acne can before the be testicles andold. penis development). example, in girl,oracne may before enlarge, pubic underarm hair appear, the deepens. children. When occurs, it hair is particularly important that the the many preadolescent children, acne isbefore theinfirst sign of puberty (sexual tionOccasionally, (period). In of athis boy, acnepubic can occur the testicles and penis enlarge, pubic and underarm appear, orbabies the voice deepens. development breasts, and underarm hair, and first menstruaacne can even develop or very young condition be evaluated by can a health care development). For example, in aparticularly girl,provider. seen before the enlarge, pubic andthis underarm hair appear, oracne theinmay voice deepens. develop babies or very young tionOccasionally, (period). In aacne boy, acne can occur before thebe testicles andthe penis children. When occurs, iteven is important that development of breasts, pubic and underarm hair, and first menstruaOccasionally, acne can even develop in babies or very young children. When this occurs, it is particularly important that enlarge,bepubic and underarm haircare appear, or the voice deepens. the condition evaluated by a health provider. What Causes Acne? tion (period). In boy, acne can occur the testicles andthe penis children. When thisaacne occurs, is particularly condition be evaluated by aiteven health carebefore provider. Occasionally, can develop in important babies or that very young enlarge, pubic and underarm hair appear, or the voice deepens. condition be evaluated by a health care provider. There areCauses fourWhen contributors to acne—the body’s natural oil (sebum), children. this occurs, it is particularly important that the What Acne? Occasionally, acne can develop in babies or very young clogged pores, (with scientific Propionibacterium What Causes Acne? condition bebacteria evaluated by the aeven health care name provider. children. this occurs, itreaction is particularly important that the There are fourWhen contributors to acne—the body’s natural oil (sebum), acnes, or Causes P. and the body’s tobody’s the above (inflammaWhat Acne? There areacnes), four contributors tohealth acne—the natural oil (sebum), condition be evaluated by a care provider. clogged pores, bacteria (with the scientific name Propionibacterium tion). Here’s what happens: What Causes Acne? There are four contributors to acne—the body’s natural oil (sebum), clogged pores, bacteria (with the scientific name Propionibacterium Causes Acne? acnes, or P. acnes), and the body’s reaction to the above (inflammaclogged pores, bacteria (with the scientific name Propionibacterium acnes, or P. acnes), and the body’s reaction to the above (inflamma1) Sebum is produced in glands in the deeper of oil the skin There areCauses four contributors to acne—the body’slayers natural (sebum), tion). Here’s what happens: What Acne? acnes, or P. acnes), andhappens: the body’s reaction to the above (inflammation). Here’s what and reaches the surface through the skin’s pores. An increase clogged pores, bacteria (with the scientific name Propionibacterium There are four contributors to acne—the body’s natural (sebum), 1) Sebum is acnes), produced glands inreaction the the deeper layers ofoil the skin tion). Here’s what happens: in certain hormones occurs around time ofabove puberty, andskin acnes, or P. andin the body’s to the (inflamma1) Sebum isthe produced in glands in the deeper layers of the clogged pores, bacteria (with the scientific name Propionibacterium and reaches surface through the skin’s pores. An increase these hormones trigger the oil glands to produce increased tion). Here’s what the happens: 1) Sebum is produced in glands in the deeper layers of the skin and reaches surface through the skin’s pores. An increase acnes, or P. acnes), and the body’s reaction theofabove (inflammain certain occurs around the to time puberty, and amounts ofhormones sebum. and reaches the surface through the skin’s pores. increase in certain hormones occurs around the timelayers ofAnpuberty, and 1) Sebum is produced in glands in the deeper of the skin tion). Here’s what happens: these hormones trigger the oil glands to produce increased 2) Pores withhormones excess oiltrigger tend tothe become clogged more easily. in certain hormones occurs around the time of puberty, and these oil glands to produce increased and reaches the surface through the skin’s pores. An increase amounts of sebum. 3) 1) At the same time, P. acnes— one glands ofinthe many types ofincreased bacteria Sebum isexcess produced inthe glands the deeper layers of the skin these hormones trigger to amounts of sebum. innormally certain hormones occurs around theproduce time of puberty, 2) Pores with oil everyone’s tend tooil become clogged more easily. that live on skin—thrives in the excess oiland and reaches the surface through the skin’s pores. An increase amounts of sebum. 2) Pores with excess oil tend to become clogged more easily. these hormones trigger the oil glands to produce increased 3) At the same time, P. acnes— one of the many types of bacteria andin creates a hormones skin reaction (inflammation). certain occurs around themany time of puberty, 2) 3) Pores with excess oil tend to become more easily. At the same time, P. acnes— one ofclogged the types of bacteria amounts oflive sebum. that normally on everyone’s skin—thrives in the excess oiland 4) At If athe pore ishormones clogged close toeveryone’s thethe surface, there istolittle inflammation. these trigger oil glands produce increased 3) same time, P. acnes— one of the many types of bacteria that normally live on skin—thrives in the excess oil 2) Pores with excess oil tend to become(closed clogged more easily. and creates skin reaction The result is athe formation of(inflammation). whiteheads comedones) or amounts of sebum. that normally live on everyone’s skin—thrives in the excess oil and creates a skin reaction (inflammation). 3)a pore At theis same time, one of theofismany types of bacteria 4) If clogged closeP.toacnes— theat surface, there littleskin. inflammation. blackheads (open comedones) surface the 2) Pores with excess oil everyone’s tend tothe become clogged more easily. and creates skin reaction 4) Ifthat a pore isathe clogged close to(inflammation). the surface, there is little inflammation. normally live on skin—thrives in the or excess The result isextends formation of whiteheads (closed comedones) or oil 5) A plug that to or forms a little deeper in the pore, one At the same time, P. acnes— one of the many types of bacteria 4) 3) If a pore is clogged close to the surface, there is little inflammation. The result is the formation of whiteheads (closed comedones) or and creates a skin reaction (inflammation). blackheads (open comedones) at the surface of the skin. that enlarges or(open ruptures, causes more inflammation. The result that normally live on everyone’s skin—thrives in the excess The result isextends the formation of whiteheads (closed comedones) or oil blackheads comedones) at the surface ofisthe the skin. 4) If a pore is clogged close to the surface, there little inflammation. 5) A plug that to or forms a little deeper in pore, or one is red bumps (papules) and pus-filled pimples (pustules). and creates aruptures, skin reaction blackheads (open comedones) atof(inflammation). the of the skin. 5) A plug that to or forms asurface little deeper in the pore, or one The result the formation whiteheads (closed comedones) that enlarges orisextends causes more inflammation. The result 6) If plugging happens in the deepest skin layer, the inflammation is or If a pore is clogged close to the surface, there is little inflammation. 5) 4) A plug that extends to or forms a little deeper in the pore, or one that enlarges or ruptures, causes more inflammation. The result blackheads (open comedones) at thepimples surface of theorskin. is red bumps resulting (papules) and pus-filled (pustules). more severe, in the formation of nodules cysts. The result isextends the formation ofpus-filled whiteheads (closed comedones) or that or ruptures, more inflammation. The result is red bumps (papules) and pimples 5)plugging Aenlarges plug that to causes or forms a little deeper in(pustules). the pore, orisone 6) If happens in the deepest skin layer, the inflammation blackheads (open comedones) at the surface of the skin. is red bumps (papules) and pus-filled pimples (pustules). 6) If plugging happens in the deepest skin layer, the inflammation is that enlarges or ruptures, causes more inflammation. The result more severe, resulting in the formation of nodules or cysts. Does Acne Look A that extends to or forms ain little deeper in(pustules). theorpore, orisone 6) 5) If plugging happens inDifferent the deepest skin layer, inflammation more resulting in thepus-filled formation ofthe nodules cysts. is plug red severe, bumps (papules) and pimples that enlarges or Than ruptures, causes more inflammation. The result more severe, resulting ininthe of Children? nodules cysts. 6) Acne If plugging happens the deepest layer, theorinflammation is Preadolescents information Older Does Look Different inskinpimples is red bumps (papules) and pus-filled (pustules). Does Acne Look Different in more severe, resulting in the formation of nodules or cysts. In most acneinisthe ain milder condition. Typically, chil- is 6) preadolescents, If plugging happens deepest layer, the inflammation Preadolescents Than Older Children? Does Acne Look Different inskin dren in this age group have whiteheads and ofblackheads (comePreadolescents Than information Older Children? more severe, resulting in the nodules or cysts. In most preadolescents, acne is ain milder condition. Does Acne Look Different in dones) and sometimes red pimples (papules) in theTypically, T Typically, zone ofchilthe Preadolescents Than Children? In most acne is aOlder milderand condition. children in thispreadolescents, age forehead, group have whiteheads blackheads (comeface—across the on and along the nose, and on the chin. In most preadolescents, acne is a milder condition. Typically, children in this age group have whiteheads and blackheads (comeDoes Acne Look Different in Preadolescents Preadolescents Than in Older Children? Does Acne Look Different in in the T zone of the dones) and sometimes red pimples (papules) dren this age group Children? have whiteheads blackheads (comedones) and sometimes red pimples (papules) in theon Tthe zone ofchilthe In in most preadolescents, acne isalong ainmilder condition. Typically, face—across the forehead, on and theand nose, and chin. Than in Older Preadolescents Older Children? dones) and sometimes red Than pimples (papules) innose, the Tand zone the face—across the forehead, on and along theand on of the(comechin. dren in this age group have whiteheads blackheads This two-page handout developed by Lawrence F. Eichenfield, MD, Anthony J. In most and preadolescents, acne a milder Typically, face—across thesometimes forehead, red on andis along the condition. nose, in and on the chin. dones) (papules) the zone ofchilthe Mancini, MD, Albert C. Yan, MD,pimples Sheila Fallon Friedlander, MD,Tand Hilary in this age group have whiteheads and blackheads (comeThisdren two-page handout developed by Lawrence F. Eichenfield, MD, Anthony J. face—across the forehead, on and along the nose, and on the of chin. E. Baldwin, MD is provided as a service from Elsevier, Inc. may—free This two-page handout developed by Lawrence F. Eichenfield, MD, Anthony dones) and sometimes red pimples (papules) in the zone of theJ. Mancini, MD, Albert C. Yan, MD, Sheila Fallon Friedlander, MD,T and Hilary charge and without requesting further permission—reproduce and distribThisface—across two-page handout developed by Lawrence F. Eichenfield, MD, Anthony J. Mancini, MD, Albert C. Yan, MD, Sheila Fallon Friedlander, MD, and the forehead, on and along the nose, and on the chin. E. Baldwin, iseducational provided as a service from Elsevier, Inc. may—free Hilary of ute copies ofMD this material toFallon patients and their parents. Mancini, MD, Albert C. Yan, Sheila Friedlander, MD, and Hilary Baldwin, MD is provided as a Lawrence service from Elsevier, Inc. may—free ofJ. They may also occur onMD, the ears. Comedones are usually small ThisE.two-page handout developed by F. Eichenfield, MD, Anthony charge and without requesting further permission—reproduce and distribE. Baldwin, MD is provided as a service from Elsevier, Inc. may—free of charge and without requesting further permission—reproduce and distribbumps and usually are not reddened (inflamed). Mancini, MD,educational Albert C. Yan, MD, Sheila Fallonand Friedlander, MD, and Hilary ute copies of this material to patients their parents. This two-page handout developed byaLawrence F. Eichenfield, MD, Anthony J. charge and without further permission—reproduce and distribute copies of thisrequesting educational material to have patients and their parents. However, some preadolescents do more severe acne. This E. Baldwin, MD is provided as service from Elsevier, Inc. may—free of Mancini, MD, Albert C. Yan, MD, Sheila Fallon Friedlander, MD, and Hilary ute copies of this educational material to patients and their parents. maycharge be a sign that a child willfurther have more serious acne later and without requesting permission—reproduce andon. distrib- There that more can look like acne acne,later so your mayarebeaanumber sign thatofa conditions child will have serious on. a Doctor? However, preadolescents do have severe Should My Child’s Acne Be Treated by child should be some examined and diagnosed by amore health care acne. practi-This a Doctor? may anumber sign thatmild child will have serious acne on. There are achild ofa conditions that more can that look likenot acne,later so your Should Child’s Acne Treated by tioner. Ifbeaare has (comedones are a Doctor? There abeMy number ofacne conditions thatBe can look likeinflamed acne, soor your child should examined and diagnosed by a health care practitoo numerous) and ifexamined theconditions condition is notcan bothersome to your child, There are a number of that look like acne, so your child should be and diagnosed by a health care practia Doctor? Should My Child’s Acne Be Treated by tioner. If a care childmay has be mild (comedones that point. are not inflamed or good skin allacne that isdiagnosed needed at by this child should examined and athat health care practitioner. If a be acne (comedones are not inflamed or There are achild number of conditions thatbothersome can look like acne, so your tooHowever, numerous) and ifhas themild condition is not toyou your child, your child’s health care provider will advise whether a Doctor? tioner. If a child has mild acne (comedones that are not inflamed or too numerous) and if the condition is not bothersome to your child, child be examined and diagnosed by a health care practigood skinshould care may be allanthat is needed at this point. your child needs tomay use over-the-counter ortoprescription There are number of conditions thatbothersome can look like acne, so your tooHowever, numerous) and ifhas thebe condition is not your child, good skin all that is needed at(OTC) this point. tioner. Ifapplied aacare child mild acne (comedones that are not inflamed or your child’s health care provider will advise you whether medication to the skin (topical medication), to use anwhether oral child should be examined and diagnosed by a health care practigood skin care may be all that is needed at this point. However, your child’s health care provider will advise you too numerous) and if the condition is not bothersome to your child, your child needs to use an over-the-counter (OTC) or prescription medication byhas mouth), orcare both. There will arethat several factors to be or tioner. If(taken ayour child mild acne (comedones are inflamed However, child’s health provider advise you whether your needs use over-the-counter (OTC) or good child skin care may be allan that is needed at this point. medication applied totothe skin (topical medication), tonot useprescription anchild oral considered when making the decision about whether a preadolescent too numerous) and if the condition is not bothersome to your your child needs to use an over-the-counter (OTC) or prescription medication applied to the skin (topical medication), to use anchild, However, your child’s careThere provider will advise youwould whether medication (taken by mouth),health ormedications. both. are several factors to beoral needs one or more prescription Certain findings good skin care may be all that is needed at this point. medication applied to the skin (topical medication), to use an oral medication (taken by mouth), or both. There are several factors to be your child needs to the use an over-the-counter orfollowing: prescription considered when making about whether a(OTC) preadolescent child make itHowever, more appropriate todecision start treatment. They include the your child’s health care provider will advise you whether medication (taken by mouth), or both. There are several factors to be considered when making the decision about whether a preadolescent medication applied to the skin (topical medication), to use anchild oral needs one or more prescription medications. Certain findings would your child needs toby use an (there over-the-counter or following: prescription considered when making the decision a(OTC) preadolescent child needs one or more prescription medications. Certain findings would 1) isappropriate more than mild is whether inflammation, or there are medication (taken mouth), orabout both. There are several factors to be make itAcne more to start treatment. They include the medication applied towhether the (topical medication), tothe use an child oral needs oneit or more prescription medications. Certain findings would make more appropriate toskin start treatment. They include following: many comedones, they are inflamed not). considered when making the decision about whether aor preadolescent medication (taken byprescription mouth), orscars both. There are several factorsare to be make itAcne more to start treatment. They include the following: 1) isisappropriate more than mild (there is have inflammation, or there 2) There some sign that acne developed. Scarring is needs one or more medications. Certain findings would 1) Acne is more than mild (there isinflamed inflammation, or therechild are considered when making the decision about whether a preadolescent many comedones, whether they are or not). most common whenmild acne is severe, but it caninclude happen even in make it more appropriate to start treatment. They the following: 1) Acne isisor more than (there is have inflammation, there are many comedones, whether they are developed. inflamed not). needs one more prescription medications. Certain or findings would 2) There some sign that acne scars Scarring is children with mild acne. many comedones, whether they are inflamed or not). 2) There is some sign that acne scars have developed. Scarring is make more tomild start treatment. They the following: 1) itAcne isisappropriate more than (there isbut inflammation, oreven there most common when acne is severe, it caninclude happen in are 3) The child having emotional problems because of the acne or 2) There is some sign that acne scars have developed. Scarring is most common when acne is severe, but it can happen even in manywith comedones, whether they from are inflamed or not). children mild acne. is experiencing negative comments children. isismore than mild (there isbut inflammation, there most common when acne isacne severe, it other can happen in are children with mild acne. 2) Acne There some sign that scars have developed. Scarring is 3) 1) The child having emotional problems because of theoreven acne or many comedones, whether they are but inflamed or children with acne. 3) The child ismild having emotional problems because ofnot). the acne or most common when acne is severe, it can happen even in is experiencing negative comments from other children. How Should the negative Face Be Washed? There is that acne scars have developed. Scarring 3) 2) The child is some having emotional problems because of the acne or is is experiencing comments from other children. children with sign mild acne. Everyone with acne should wash twice aproblems day— once inchildren. the most common when acne is severe, but it can happen is experiencing negative comments from other Face BeBe Washed? How Should the Face Washed? 3)Should The childthe is having emotional because ofmorning the even acne in or andHow oncechildren in the evening. It’s also important to wash the face as soon with mild acne. Should the Face Be Washed? is experiencing negative comments from other children. Everyone with acne should wash aactivities day— once theofmorning as possible after playing sports ortwice other thatincause a lot of or 3)Should The child isthe having emotional problems because the acne How Face Be Washed? Everyone with acne should wash twice a to day— in the and onceis inexperiencing the evening. It’s also important washonce the face asmorning soon sweating (such as bike riding). negative comments from other children. Everyone with should wash twice aactivities day— once incause the morning and once inacne the evening. It’s also important to wash face as of soon How Should the Face Be Washed? as possible after playing sports or other that a lot Acne does not come from “dirt,” andother scrubbing is not necessary to and once in the evening. It’s also important to wash the face as soon as possible after playing sports or activities that cause a lot of Everyone with acne should wash twice a day— once in the morning sweating (such as bike riding). get the skin clean. Dryness and irritation make that it harder for the How Should the Face Beactivities Washed? as possible after playing sports or other cause a lot of sweating (such as bike riding). and once in the evening. It’s also important to wash the face as soon Acne does not come from “dirt,” and scrubbing is not necessary to patient to(such tolerate acne medications and be avoided. Use a Everyone with acne should wash ascrubbing day— once incause the morning sweating asnot bike riding). come from “dirt,” andshould is not necessary as possible after playing sports ortwice other activities that athe lot to of get theAcne skindoes clean. Dryness and irritation make(such it harder for gentle touch when washing, and use airritation mild soap as those that and once in the evening. It’s also important to wash the face as soon Acne does not come from “dirt,” and scrubbing is not necessary to get the skin clean. Dryness and make it harder for sweating (such as bike riding). patient to tolerate acne medications and should be avoided. Use a the are labeled “for sensitive skin”), unless the health care provider as possible after playing sports oraother activities that cause athe lot of get the skin clean. Dryness and“dirt,” irritation make it be harder for that patient to tolerate acnefrom medications and should avoided. Use a Acne does not come and scrubbing is as not necessary to gentle touch when washing, and use mild soap (such those advises otherwise. Avoid using deodorant soaps as well. sweating (such as bike riding). patient to tolerate acne medications and should be avoided. Use a gentle touch when washing, and use a mild soap (such as those that get the skin clean. Dryness and irritation make it harder for the areMany labeled “for sensitive skin”), unless the health care provider preadolescents seem to have that tends to become irri- to Acne does notAvoid come from “dirt,” and scrubbing is necessary gentle touch when washing, and use askin mild soap (such as those that are labeled “for sensitive skin”), unless the health care provider patient to tolerate acne medications and should benot avoided. Use a advises otherwise. using deodorant soaps as well. tated or dry, so it’s important to be aware of this when using a nonpreget the skin clean. Dryness and irritation make itwell. harder for the areMany labeled “for when sensitive skin”), unless the health care provider advises otherwise. Avoid using deodorant soaps as gentle touch washing, and use a mild soap (such as those that preadolescents seem to have skin that tends to become irriscription acne “wash.” Some of these over-the-counter (OTC) products patient toso tolerate acneusing medications and should be avoided. Use advises otherwise. Avoid deodorant soaps as well. Many preadolescents seem toaware have skin that tends tocare become irri-a are labeled “for sensitive skin”), unless the health provider tated or dry, it’s important to be of this when using a nonprecontain ingredients such as salicylic acid and benzoyl peroxide that canthat gentle touch when washing, and use a mild soap (such as those Many preadolescents seem to have skin that tends to well. become irritated or dry, so it’s important to be aware of this when using a nonpreadvises otherwise. Avoid deodorant soaps as scription acne “wash.” Some ofusing these over-the-counter (OTC) products be very helpful in reducing skin bacteria and clearing surface oil from are labeled “for sensitive unless the health care provider tated orMany dry, acne so it’s important toskin”), bethese aware ofskin this when using abecome nonprescription “wash.” of over-the-counter (OTC) products preadolescents seem to have that tends to contain ingredients such asSome salicylic acid and benzoyl peroxide that canirrithe skin, but they may also cause irritation and dryness. advises otherwise. Avoid deodorant soaps asperoxide well. scription acne “wash.” ofusing these over-the-counter (OTC) products contain ingredients such as salicylic acid and benzoyl that can tatedhelpful or dry, soreducing it’s Some important to be aware ofclearing this when using nonprebe very in skin bacteria and surface oila from Many preadolescents seem to have skin tends to become irricontain ingredients such asSome salicylic acid and benzoyl peroxide that can be very in reducing skin bacteria andthat clearing surface oil from scription acne “wash.” ofirritation these over-the-counter (OTC) products the skin, buthelpful they may also cause and dryness. Are Acne Treatments Safe for Preadolescents? tated or dry, so it’smay important to beirritation aware ofclearing this when usingoila from nonprebe very helpful in reducing skin bacteria and surface the skin, but they also cause and dryness. contain ingredients such as salicylic acid and benzoyl peroxide that can Most acne treatments have not been formally tested in clinical trials scription acne “wash.” Some ofirritation these over-the-counter (OTC) products the skin, but they may also cause and dryness. Are Acne Treatments Safe for Preadolescents? be very helpful in reducing skin bacteria and clearing surface oilinfrom pediatric patients younger than 12 years old. However, these treatcontain ingredients such as salicylic acid and benzoyl peroxide that can Are Acne Treatments Safe for Preadolescents? theacne skin, but they may also cause irritation and dryness. Most treatments have not been formally tested in adults clinical trials in Treatments Safe for Preadolescents? ments have been fully tested innot adolescents and young and have be very helpful in reducing skin bacteria and clearing surface oil from Are Acne Treatments Safe for Preadolescents? Most acne treatments have been formally tested in clinical trials in pediatric patients younger than 12 These years old. However, these treatbeen found to bethey safe andalso effective. same treatments also have the skin, but may cause irritation and dryness. Most acne treatments have not been formally tested in clinical trials in pediatric patients younger than 12 years old. However, these treatAre Acne Treatments Safe for Preadolescents? ments havesafely been and fullyeffectively tested in adolescents and in young adults and have been used for many years preadolescents. pediatric patients younger than years old. However, these treatments have been fully tested in12 adolescents and young have Most acne not been formally tested inadults clinical trials in been found totreatments be safe andhave effective. These same treatments alsoand have Are Acne Treatments Safe for Preadolescents? ments have been fully tested in adolescents and young adults and have been found to be safe and effective. These same treatments also have patients younger than 12 years However, these treatbeenpediatric used safely and effectively for many yearsold. in preadolescents. Most acne have not formally tested in adults clinical trials in been found totreatments be safe and effective. These same treatments alsoand have been used safely and effectively for many years in preadolescents. ments have been fully tested in been adolescents and young have pediatric patients younger than 12 years old. However, these treatbeen used safely and effectively for many years in preadolescents. been found to be safe and effective. These same treatments also have i ments havesafely been and fullyeffectively tested in adolescents and young adults and have E. provided as a service from Elsevier, Inc.parents. may—free of been used for many years in preadolescents. uteBaldwin, copies ofMD thisiseducational material to patients and their been found to be safe and effective. These same treatments also have charge and without requesting further permission—reproduce and distribShould My Child’s Acne BeF.Treated by Thisute two-page handout developedmaterial by Lawrence Eichenfield, MD, Anthony J. Mancini, MD, Albert C. and Yan, effectively MD, Sheila for Fallon Friedlander, MD, and Hilary E.i been used safely many years in preadolescents. copies of this educational to patients and their parents. i ormation and a Guide ts n of . In xual the ruaenis ung a Doctor? Baldwin, MD is provided as a service from Elsevier, Inc. may—free of charge and without requesting further permission—reproduce and distribute copies of this i educational material to patients and their parents. There are a number of conditions that can look like acne, so your child should be examined and diagnosed by a health care practitioner. If a child has mild acne (comedones that are not inflamed or too numerous) and if the condition is not bothersome to your child, i i ii ii iiii ii ii Acne Treatments Acne Treatments Acne Acne Treatments Treatments Acne Treatments Facials and and other treatments to remove, squeeze, or “clean out”out” pimples Facials other treatments to remove, squeeze, or “clean pimples Acne Treatments Facials and other treatments to remove, squeeze, or “clean out” pimples Acne Treatments Facials other treatments to remove,the squeeze, or this “clean out” pimples are notand recommended. Manipulating skin in way can make are not recommended. Manipulating the skin in this way can make are not recommended. Manipulating the skin in way can make are Facials not recommended. Manipulating the skin init this this way can make acne worse andother can lead to scarring. It also makes more likely that the the and treatments to remove, squeeze, orit“clean out” pimples acne worse and can lead to remove, scarring. It also makes more that Facials and other treatments to squeeze, or “clean out”likely pimples acne worse and can lead to scarring. It also makes it more likely that the acneare worse can lead to scarring. Itmedications. also makes itFor more likely that the skin will notand be able to tolerate acneacne the same reason, not recommended. Manipulating the skin in this way can make skin will not be able tolerate medications. For the same reason, are not recommended. Manipulating the skin inFor thisthe way canreason, make skin will not be able to tolerate acne medications. same skin will not be able to tolerate acne medications. For the same reason, children should be can discouraged fromfrom picking at their pimples. acne worse and lead to scarring. It also makes it more likely that children should be discouraged picking at their pimples. acne worse and can lead to scarring. It picking also makes it more likely that the the children should be discouraged at pimples. children should betreatments discouraged from picking at their their pimples. What do acne do?from Medications for acne stop the formaskin will not able to tolerate acne medications. the same What doable acne treatments do? Medications for For acne stop thereason, formaskin will not be to tolerate acne medications. For the same reason, do acne treatments do? for acne stop the What donew acne treatments do?orMedications Medications foroil, acne stop the formationWhat of new pimples by reducing removing the bacteria, andformaother children should be discouraged from picking at their pimples. tion of pimples by reducing or removing the oil, bacteria, and other children should be discouraged from pickingthe at oil, their pimples. tion of new pimples by reducing or removing bacteria, and other tionthings of What new (like pimples byskin reducing or removing the oil, bacteria, and other things (like dead skin cells) that that clog the pores. They can also decrease do acne treatments do? Medications for acne stop the formadead cells) clog the pores. They can also decrease What dodead acne skin treatments do?clog Medications for acnecan stop thedecrease formathings (like cells) that the of pores. They also things (like dead skin cells) thatresponse clog pores. They decrease the inflammation or irritation the tocan bacteria. It can tion of new pimples byirritation reducing orthe removing theskin oil, bacteria, and other the inflammation or response of skin the toalso bacteria. It can tion of new pimples byirritation reducing or removing the oil, bacteria, andIt other the inflammation or response of the skin to bacteria. can the inflammation or irritation response of the skin to bacteria. Itdecrease can takethings fromfrom 4 to4dead 8toweeks before it isclog clear whether the the medication is is (like skin cells) that the pores. They can also take 8 weeks before it is clear whether medication things (like4dead skin cells) that clog the pores. Theythe canmedication also decrease take from to weeks before it is clear is takethe from to 8 8your weeks before it response ismedications clear whether whether the medication effective for4 your child. These medications dothe not “cure” the the condiinflammation or irritation of to bacteria. Itis can effective for child. These doskin not “cure” condithe inflammation or irritation response of the skin to bacteria. It can effective for your child. These medications do not “cure” the condieffective for your child. These medications do not “cure” tion—the acne because ofitthe medication, and itthe therefore take 4improves 8improves weeks before is whether the medication tion—the because of clear the medication, and itconditherefore take fromfrom 4 toacne 8toweeks before it of is clear whether theand medication is is tion—the acne improves because the medication, it tion—the acne improves because of the medication, and it therefore therefore must be continued in child. order to prevent return of do the acne lesions. effective for your These medications not “cure” the condimust be continued in order to prevent return of the acne lesions. effective for your child. These medications do not acne “cure”lesions. the condimust be continued in order prevent return of must beThere continued in order to prevent return of the the acneapplied lesions. There are many types of to acne treatments. Some are the tion—the acne improves because of the medication, and it to therefore are many types of acne Some are to the tion—the acne improves because of treatments. the medication, and itapplied therefore There are many types of acne treatments. Some are applied to the There arecontinued many types of acneand treatments. Some are applied to the skin (topical medications) and some are taken byofmouth (oral medmust be in order to prevent return the acne lesions. skin (topical medications) some are taken by mouth (oral medmust be continued in order and to prevent return of by themouth acne lesions. skin (topical medications) some are taken (oral medskinications). (topical medications) some are taken by mouth (oral medications). In are most cases ofand mild acne, the doctor willare start with There types of treatments. Some applied toa thea In many most cases ofacne mild acne, the doctor will start with There are many types of acne treatments. Some are applied to the ications). In most cases of mild the doctor will start with aa ications). Inmedication. most cases ofacne mild acne, the doctor will start with topical medication. MildMild isacne, the most common type seen in skin (topical medications) some are taken by mouth (oral medtopical acne isare the most type seen in skin (topical medications) andand some taken bycommon mouth (oral medtopical medication. Mild acne is the most common type seen in topical medication. Mild acne is the most common type seen in preadolescent children. If acne is more severe, if it does not respond ications). In most cases of mild acne, the doctor will start with preadolescent children. If acne is more severe, if it does not respond ications). In most casesIfofacne mild acne, severe, the doctor will not startrespond with a a preadolescent children. is if does preadolescent children. IfMild acneacne is more more severe, if it it does nottype respond adequately to topical medication, oris ifthe it ifcovers large body surface topical medication. most common seen adequately to topical medication, or itcommon covers large body surface topical medication. Mild acne is the most type seen in in adequately to topical or if it covers large body surface adequately to the topical medication, or if oral itantibiotics covers large body surface areas suchsuch as backmedication, andIf chest, oral are usually pre-prepreadolescent children. acne is more severe, if it does not respond areas as the back and chest, antibiotics are usually preadolescent children. If acne is more severe, if it does not respond areas such as back and chest, oral are usually areas such asInthe the back and chest, oralorantibiotics antibiotics are usually prescribed. In the most severe cases, isotretinoin maymay be used, butpreit is it is adequately to topical medication, it covers large body surface scribed. the most severe cases, be used, but adequately to topical medication, or ifisotretinoin it ifcovers large body surface scribed. In the most severe cases, isotretinoin may be used, but scribed. Insuch the most severe cases, isotretinoin may be used, butItit it is ispreuncommon to as need this last medication in preadolescents. areas the back and chest, oral antibiotics are usually uncommon to need this last medication in preadolescents. It is areas such astothe back andlast chest, oral antibiotics are usually It preuncommon need this medication in preadolescents. is uncommon tostart need this last medication inlikely preadolescents. It isit is always bestbest to with the agents least likely to may cause side effects, scribed. In the most severe cases, isotretinoin be used, but always to start with the agents least to cause side effects, scribed. In the mostwith severe cases, isotretinoin may be used, but it is always to least likely to cause side always best to start start with the the agents agents least likely to side effects, effects,It is such asbest topical medications, in mild disease. uncommon to medications, need in cause preadolescents. such as topical inmedication mild disease. uncommon to medications, need thisthis lastinlast medication in preadolescents. It is such as topical mild disease. such asSome topical medications, inresult mild disease. Some patients have awith good with just oneto medication, but always best to start the agents least likely cause side effects, patients have a good result with just one medication, but always best to start witha the agents least likely to cause side effects, Some patients have good result with just one medication, but Some patients ause result with just one medication, but many willas need tohave use agood combination ofdisease. treatments: twotwo or more such topical medications, in mild many will need to a combination of treatments: or more such aswill topical medications, in mild disease. many need to aa combination treatments: two or many willtopical need to use use combination ofwith treatments: two or more more but different agents or an oral plus aof topical medication. Some patients have aorgood result just one medication, different topical agents an oral plus a topical medication. Some patients have aorgood result with just one medication, but different topical agents an oral plus a topical medication. different topical agents or an oral plus a topical medication. Other treatments used for acne include corticosteroid injections, many will need to use a combination of treatments: two or more Other treatments used for acne include corticosteroid injections, many willtreatments need to use a combination of treatments: twoinjections, or more Other used for acne include corticosteroid Other used for acne include injections, which are treatments used to help relieve and to decrease the size and encourdifferent orpain anpain oral plus topical medication. which aretopical used toagents help and toacorticosteroid decrease the size and encourdifferent topical agents orrelieve an oral plus adecrease topical medication. which are used to help relieve pain and to the size which are used to help relieve pain and toinclude decrease thedermatologists size and and encourencourage healing oftreatments large, inflamed acne nodules. Also,Also, dermatologists someOther used for acne corticosteroid injections, age healing of large, inflamed acne nodules. someOther treatments used foracne acne includeAlso, corticosteroid injections, age healing of large, inflamed nodules. dermatologists someage which healing of used large, inflamed acne nodules. Also, dermatologists sometimes perform “acne surgery,” using a fine needle, a pointed blade, orencouranor an are to help relieve pain and to decrease the size and times perform “acne surgery,” using a fine needle, a pointed blade, which are used“acne to help relieve using pain and to needle, decreasea the size and encourtimes perform aa fine pointed blade, or times perform “acne surgery,” usingextractor fine needle, amechanically pointed blade, or an instrument known assurgery,” a comedone to mechanically cleanclean outan aout a age healing of large, inflamed nodules. Also, dermatologists someinstrument known as a comedone extractor todermatologists age healing of large, inflamed acneacne nodules. Also, someinstrument known as a comedone extractor to mechanically clean out aa instrument known as amust comedone extractor toneedle, mechanically clean out clogged pore. OneOne must always balance the risk for inducing a scar with times perform “acne surgery,” using a fine a pointed blade, or an clogged pore. always balance the risk for inducing a scar times perform “acne surgery,” using a fine needle, a inducing pointed blade, or anwith clogged pore. One must always balance the risk for aa scar with clogged pore. One must always balance the risk for inducing scar with the potential benefits of any procedure. Many health care providers will instrument known as a comedone extractor to mechanically clean out a the potential benefits of any procedure. Many health careclean providers will instrument known as a comedone extractor to mechanically out a the benefits of any procedure. Many health care providers will the potential potential benefits ofmust any procedure. Many health care providers will start out with topical or combination topical/oral treatment plans before clogged pore. One always balance the risk for inducing a scar with start out with topical or combination topical/oral treatment plans before clogged pore. One must always balance the risk for inducingplans a scar with start out with topical or topical/oral treatment before startthe out with topical or combination combination topical/oral treatment plans before using more invasive treatments. Some believe that priorprior treatment withwith potential benefits of any procedure. Many health care providers using more invasive treatments. Some believe that treatment the potential benefits of any procedure. Many health caretreatment providers willwill using more invasive treatments. Some believe that prior with using more invasive treatments. Some believe that prior treatment with topical retinoids can “loosen” whiteheads and and blackheads and and so make start out with topical or combination topical/oral treatment plans topical retinoids can “loosen” whiteheads blackheads sobefore make start out with topical or combination topical/oral treatment plans before topical retinoids can whiteheads and blackheads and so topical retinoids can “loosen” “loosen” whiteheads and blackheads and so make makewith it easier tomore physically remove suchsuch bumps. using invasive treatments. Some believe that prior treatment it easier to physically remove bumps. using more invasive treatments. Some believe that prior treatment with it to remove such bumps. it easier easier to physically physically remove such bumps. Heat-based devices as well aswhiteheads light and and laserblackheads therapy are being topical retinoids can “loosen” and so make Heat-based aswhiteheads well as light laser therapy being topical retinoids candevices “loosen” and laser blackheads andare so are make Heat-based devices as well as light and therapy Heat-based devices as well light and lasersuch therapy areinbeing being studied to see whether there is as any role for such treatments mild it easier to physically remove such bumps. studied to see whether there is any role for treatments in mild it easier to physically remove such bumps. studied see whether there is any role for such treatments in mild studied to see whether there iswell anythere for such treatments inare mild to moderate acne. At this time, there islight not evidence to make Heat-based devices as time, asrole and laser therapy to moderate acne. Atas this is enough not enough evidence to being make Heat-based devices well as light and laser therapy are being to acne. At this time, there is enough evidence to to moderate moderate acne. At this time, there is not not enough evidence to make make recommendations about their use. studied to see whether there is any role for such treatments in mild recommendations about their use. studied to see whether there is any role for such treatments in mild recommendations about their use. recommendations about their use.there is not enough evidence to make to moderate acne. At this time, to moderate acne. At this time, there is not enough evidence to make recommendations about their recommendations about their use.use. ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Topical Oral Topical Oral Topical Oral Medications Medications Medications Medications Topical Oral Medications Medications Medications Medications Topical Oral Benzoyl peroxide helps include tetracycline● Benzoyl peroxide helps● Antibiotics ● Antibiotics include tetracyclineTopical Oral Benzoyl peroxide helps ● Antibiotics include tetracyclineMedications Medications to fight inflammation and and ● class medicines (tetracycline, to fight inflammation class medicines (tetracycline, Benzoyl peroxide helps Antibiotics include tetracyclineMedications Medications to fight inflammation and class medicines (tetracycline, bacteria and and is believed and(tetracycline, doxycycline, which bacteria is believed to minocycline, minocycline, and doxycycline, which to●fight inflammation andto class medicines Benzoyl peroxide helps ● Antibiotics include tetracyclinebacteria and is believed to minocycline, and doxycycline, help prevent resistance of are all only in children 8 which years Benzoyl peroxide helps include tetracyclinehelp prevent resistance of● Antibiotics areused allmedicines used only in children 8 years bacteria and is believed to minocycline, and doxycycline, which to fight inflammation and class (tetracycline, help prevent resistance are all used in 8 bacteria to topical of or older); erythromycin; to fight inflammation andof (tetracycline, bacteria to topical ofmedicines age oronly older); erythromycin; help prevent resistance of to class areage all used only in children children 8 years years bacteria and is believed minocycline, and doxycycline, which bacteria to topical of age or older); erythromycin; antibiotics. trimethoprim-sulfamethoxazole; bacteria and is believed to minocycline, and doxycycline, which antibiotics. trimethoprim-sulfamethoxazole; to topical of age or older); erythromycin; help prevent resistance of and are all used only in children 8 years antibiotics. trimethoprim-sulfamethoxazole; Retinoids unplug the occasionally cephalexin or help preventto resistance are all used in children 8 years ● bacteria Retinoids unplug of the and occasionally cephalexin or antibiotics. trimethoprim-sulfamethoxazole; topical of age oronly older); erythromycin; Retinoids unplug the and occasionally cephalexin or oil glands helping azithromycin. These drugs may bacteria to by topical of or older); erythromycin; oil glands by helping azithromycin. These drugs Retinoids unplug the andage occasionally cephalexin or may antibiotics. trimethoprim-sulfamethoxazole; oil glands by helping azithromycin. These drugs may peel the layers of skin decrease bacteria and inflammation, antibiotics. trimethoprim-sulfamethoxazole; peel the of skin decrease bacteria and inflammation, oil bylayers helping azithromycin. These drugs may ● glands Retinoids unplug the and cephalexin peel the layers of skin bacteria and and other things are occasionally most effective for foror or Retinoids unplug the and occasionally cephalexin and other things plugging decrease and are most effective peel the layers ofplugging skin decrease bacteria and inflammation, inflammation, oil glands by helping azithromycin. These drugs may and other things plugging and are most effective for the opening ofhelping the glands. moderate-to-severe oil bylayers These acne. drugs may the opening of theskin glands. azithromycin. moderate-to-severe acne. andglands other things plugging anddecrease are most bacteria effective for peel the of and inflammation, the opening of the glands. moderate-to-severe acne. Antibiotics or or ● Hormonal treatment peel theother layers of skin decrease bacteria and inflammation, ● and Antibiotics (topical ● Hormonal treatment the opening of(topical the glands. moderate-to-severe acne. thingsand plugging andconsists are most for Antibiotics (topical or treatment oral)oral) fightfight bacteria usually ofeffective combination and other things andmoderate-to-severe are most effective for bacteria and ● usually consists of combination Antibiotics (topical orglands. ● Hormonal Hormonal treatment opening ofplugging the acne. oral) fight bacteria and usually consists of combination helpthe shrink the pimples. oral contraceptives (birth the opening of the glands. moderate-to-severe acne. help shrink the pimples. oral contraceptives (birth oral) fight bacteria and usually consists of combination ● Antibiotics (topical or control ● Hormonal treatment help shrink the pimples. oral contraceptives (birth Antibiotics commonly pills); spironolactone Antibiotics (topical orand ● Hormonal treatment Antibiotics commonly control pills); spironolactone helporal) shrink the pimples. oralusually contraceptives fight bacteria consists of(birth combination Antibiotics commonly control pills); spironolactone used in acne include also is sometimes used. oral) fight bacteria and usually consists of combination used in acne include also is sometimes used. Antibiotics commonly control pills); spironolactone help shrink the pimples. oral contraceptives (birth used in acne include also is sometimes used. clindamycin, erythromycin, ● Isotretinoin, a derivative help shrink the pimples. oral contraceptives (birth clindamycin, erythromycin, also ● control Isotretinoin, aused. derivative usedAntibiotics in acne include is sometimes commonly pills); spironolactone clindamycin, erythromycin, ● Isotretinoin, a derivative and combination agents of vitamin A, is a powerful Antibiotics commonly pills); spironolactone and combination agents● control of vitamin A, is a powerful clindamycin, erythromycin, Isotretinoin, a derivative used in acne include also isseveral sometimes used. and combination agents of A, a (such erythromycin/ drug with significant used inasacne also is sometimes (such as include erythromycin/ drug with significant andclindamycin, combination agents of●vitamin vitamin A, is isseveral a powerful powerful erythromycin, Isotretinoin, aused. derivative (such as erythromycin/ drug with several significant benzoyl peroxide). potential side effects. It is It is clindamycin, erythromycin, ● Isotretinoin, a derivative benzoyl peroxide). potential side effects. (such as erythromycin/ drug with several significant and topical combination agents reserved of vitamin A, iswhich a powerful benzoyl peroxide). side effects. It is Other agents for and combination agents of vitamin A, acne is aacne powerful ● (such Other agents potential reserved for which benzoyl peroxide). potential side effects. It isis is astopical erythromycin/ drug several significant Other topical agents reserved for acne which is include salicylic acid,acid, severe orwith when other (such as erythromycin/ drug with several significant include salicylic severe or when other Other topical agents reserved for acne which isIt is benzoyl peroxide). potential side effects. include salicylic acid, severe or when other azelaic acid, dapsone, medications have not It benzoyl peroxide). potential side effects. is azelaic acid, dapsone, medications have not include salicylic acid, severe or when other ● Other topical agents reserved for acne which is azelaic acid, dapsone, medications have not and sulfacetamide. worked well enough. Other topical agents reserved fororwell acne which and sulfacetamide. worked enough. azelaic acid, dapsone, medications have not include salicylic acid, severe when otheris and sulfacetamide. worked well enough. include salicylic acid, severe or when other andazelaic sulfacetamide. worked well enough. acid, dapsone, medications have not azelaic dapsone, medications haveenough. not and acid, sulfacetamide. worked well and sulfacetamide. worked well enough. General Information About Using Topical General Information About Using Topical General Information About Using Topical General Information About Using Topical Acne Medications Acne Medications Acne Medications General Information About Using Topical General Information About Using Acne Medications General Information About Using Topical ● Apply medication to clean, dry dry skinskin andand spread it around the the ● Apply medication to clean, spread it around ●Acne Apply medication to clean, dry and spread it Medications Topical Acne Medications ● entire Apply medication to face clean, dry skin and spread it around around the area of the affected byskin acne. Avoid the corners of the entire area of face the affected by acne. Avoid the corners of the Acne Medications entire area of the face affected by acne. Avoid the corners of the ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● entire areanose, of the face byin acne. Avoid the corners of the eyes, nose, and lips, asaffected the skin these areas is more ● Apply medication to dry skin and spread itsensitive. around eyes, and lips, asclean, the in these areas is around more sensitive. Apply medication to clean, dryskin skin and spread it the the eyes, and lips, as skin in these areas is sensitive. eyes, nose, andof lips, as the skin inlayer these areas is more more sensitive. Less isnose, usually better. Athe thin layer of medication isthe less likely to the area the face affected by acne. Avoid corners of ● entire Less is usually better. A thin of medication is less likely to entireisarea of the face affected by acne. Avoid theiscorners of the Less usually better. A thin layer medication less likely to Less isdryness usually better. Airritation thin layer ofin medication isisthe less likely torun. cause and irritation and willof save money in long run. eyes, nose, and lips, as the skin these areas more sensitive. cause dryness and and will save money in the long eyes, nose, andand lips, as the skin in these areas is in more sensitive. cause dryness irritation and will save money the long run. cause dryness and irritation will save money inthat the run. Redness a lot itchiness may that the child is to ●● Less iswith usually better. A and thin ofmean medication is long less likely Redness with a of lot of itchiness may mean the child is Less is usually better. A itchiness thin layerlayer of medication is less likely to Redness with a lot of may mean that the child is Redness a lot of itchiness may mean that Stop the child is allergic towith ortohighly irritated by the medication. using itrun.it cause dryness and irritation and will save money in the long allergic or highly irritated by the medication. Stop using cause dryness and irritation andbywill save money in Stop the long run. allergic highly irritated using it allergic to orhealth highly irritated by the the medication. medication. Stopthe using it and call to theor care provider. ● Redness with lot of itchiness mean child and call the provider. Redness with a health lotacare of care itchiness maymay mean thatthat the child is is and call the health provider. and callprevent theirritation health care To andprovider. dryness when first using a medication, allergic to or highly irritated by the medication. Stop using ● prevent To irritation and dryness when first using a medication, allergic to or highly and irritated by when the medication. using it it To irritation dryness first using aaStop medication, To prevent prevent irritation andcare dryness when first using medication, the health care provider may tell you to apply it every other day day or or and call the health provider. the health care provider may tell you to apply it every other andhealth call the health caremay provider. the care tell you to it other day or the care provider may tell youweeks. towhen apply it every every other day or too every third dayprovider for the first few weeks. Ifapply theIf child’s skin still too ● health To prevent irritation and dryness first using aismedication, every third day forand the first few the child’s skin is still To prevent irritation dryness when first using a medication, every third day for the first few weeks. If the child’s skin is still too every third for the first few weeks. Ifmilder the child’s skinorisother still too irritated, theday doctor may prescribe a milder medication give you the health care provider may tell you to apply it every day or irritated, the doctor may prescribe a medication or give the healththe care provider may tell you to apply it every other dayyou or you irritated, doctor may prescribe milder medication or give irritated, the doctor may prescribe milder medication or give you other instructions about using theaamedicine. every third day for the first few weeks. If the child’s skin is still too other instructions about using the medicine. every third day forabout the first few the weeks. If the child’s skin is still too other instructions using medicine. other instructions aboutmay using the medicine. The same medications often come various forms: cream, themedications doctor prescribe ainmilder medication or give you ● irritated, The same often come in various forms: cream, irritated, the doctor may prescribe a milder medication or give you The same medications often come in various cream, Theother sameinstructions medications often come in foam. various forms: cream, ointment, lotion, gel,about microsphere, or Useforms: the the formulausing the medicine. ointment, lotion, gel, microsphere, or foam. Use formulaother instructions about using the medicine. ointment, lotion, gel, microsphere, or Use the formulaointment, lotion, gel, microsphere, or foam. foam. Use the formulation thatsame has been recommended and don’t switch to other ● The medications often come in various forms: tion that has been recommended don’t switch tocream, other The same medications often come in and various forms: cream, tion that has been recommended and don’t switch to other tionointment, that has beeninstructed. recommended and don’t switch to other forms unless instructed. Some forms (such as gels) may be be lotion, gel, microsphere, or foam. Use the formulaforms unless Some forms (such as gels) may ointment, lotion, gel, microsphere, or foam. Use the formulaforms unless instructed. Some forms (such as gels) may be forms unless instructed. Somefor forms (such as gels) may more drying and less tolerable certain skin types. that has been recommended and don’t switch to be other more drying and less tolerable for skin types. tiontion that hasand been recommended andcertain don’t switch to other more drying less tolerable for certain skin types. more drying and less tolerable for certain skin types. Antibiotics and retinoids can can increase the skin’s sensitivity tomay the unless instructed. Some forms (such as gels) be ● forms Antibiotics and retinoids increase the skin’s sensitivity to the forms unless instructed. Some forms (such as gels) may be Antibiotics and can increase the skin’s sensitivity to Antibiotics and retinoids can increase the skin’s sensitivity to the the sun. Always useretinoids sunscreen! Generally, SPF 30skin is sufficient. more drying and less tolerable for certain types. sun. Always use sunscreen! Generally, SPF 30 is sufficient. more drying use andsunscreen! less tolerable for certain skin types. sun. Always Generally, 30 is sun. use sunscreen! Generally, SPF 30 is sufficient. sufficient. If skin looks orretinoids feels drycan or tight, a SPF light, nonoily moistur●●the Antibiotics increase the skin’s sensitivity to the IfAlways the skin looks or feels dry or tight, a light, nonoily Antibiotics andand retinoids can increase the skin’s sensitivity tomoisturthe If the skin looks or feels dry or tight, a light, nonoily moisturIf the skin looks or“noncomedogenic” feels dry or tight, aorlight, nonoily moisturizer (labeled “noncomedogenic” or “nonacnegenic”) can can be be sun. Always use sunscreen! Generally, SPF 30 is sufficient. izer (labeled “nonacnegenic”) sun. Always use sunscreen! Generally, SPF 30 is sufficient. izer (labeled “noncomedogenic” or “nonacnegenic”) can be izer (labeled “noncomedogenic” “nonacnegenic”) can be used. Apply moisturizers after putting onathe medication. ● If the skin looks or feels dry oror tight, light, moisturused. Apply moisturizers after putting on thenonoily medication. If the skin looks or feels dry or tight, a on light, nonoily moisturused. Apply moisturizers after putting the medication. used. Apply moisturizers after putting on“nonacnegenic”) the medication. Retinoids generally should be applied at bedtime as some can can (labeled “noncomedogenic” or ● izer Retinoids generally should be applied at bedtime as some izer (labeled “noncomedogenic” or “nonacnegenic”) can be be Retinoids generally should applied at bedtime as can Retinoids generally should beaafter applied atproduct bedtime asand some can be inactivated bymoisturizers sunlight. Ifbe retinoid and asome benzoyl used. Apply putting on the medication. be inactivated by sunlight. If a retinoid product a benzoyl used. Apply moisturizers after putting on the medication. be by If product and aa benzoyl be● inactivated inactivated by sunlight. sunlight. If aa retinoid retinoid product andbenzoyl benzoyl peroxide product are prescribed benzoyl peroxRetinoids generally beseparately, applied atthe bedtime as some can peroxide product areshould prescribed separately, the peroxRetinoids generally should be applied at bedtime as some can peroxide product are prescribed separately, the benzoyl peroxperoxide product are prescribed separately, the benzoyl peroxide should be applied during the day. be inactivated by sunlight. If a retinoid product and a benzoyl ide should be applied during the day. be inactivated by sunlight. If a retinoid product and a benzoyl ide should be applied during the ide should be applied during the day. day. Sometimes individual medications are not effective as a as comproduct are prescribed separately, benzoyl perox● peroxide Sometimes individual medications are as not asthe effective a comperoxide product are prescribed separately, the benzoyl Sometimes individual medications are not as effective as aaperoxcomSometimes individual medications areday. not as effective asneed combination of two or more agents. The doctor maymay need to try ide should be applied during the bination of two or more agents. The doctor to try ide should be applied during the The day. doctor may need to try bination of two or agents. bination of medications twoindividual or more more agents. The are doctor may need try several medications or combinations before finding theto one ● Sometimes medications not as effective as a comseveral or combinations before finding the one Sometimes individualormedications are not as effective asthe a comseveral medications combinations before finding one several medications or more combinations before finding the one thatbination is best for your child. of two or agents. The doctor may need to that is best for your child. bination of for two or more agents. The doctor may need to try try that is child. that is best best for your your child. When starting prescription acneacne medications, use onlyonly those medications or combinations before finding the one ● several When starting prescription medications, use those several medications or combinations before finding thethose one When starting prescription acne medications, use only When starting prescription acne medications, use only those agents for at least 2your weeks. After that time, if desired, a nonprethat is best for child. agents for at least 2 weeks. After that time, if desired, a nonprethat is best for your child. After that time, if desired, a nonpreagents for at least 2 weeks. agents forproduct at least 2OTC weeks. After that ifwash desired, a nonprescription such as an wash or cleanser can can be ● When starting prescription acne medications, use those scription product OTC such asacne antime, acne or cleanser be When starting prescription acne medications, use onlyonly those scription product OTC such as an acne wash or cleanser can be scription product OTC suchstop asAfter an acne wash orifOTC cleanser can be tried. If irritation develops, using the OTC product. agents for at least 2 weeks. that time, desired, a nonpretried. If irritation develops, stop using the product. agents for at least 2develops, weeks. After that time, ifOTC desired, a nonpretried. If irritation stop using the product. tried. If irritation develops, stop using theprocedures OTC or product. Facial waxing or any other traumatizing procedures cancleanser leadlead to exproduct OTC such as an acne wash can be ● scription Facial waxing or any other traumatizing can to exscription product OTC such as an acne wash or cleanser can be Facial waxing or any other traumatizing procedures can lead to Facial waxing orand anyand other traumatizing procedures cantherapy. lead to exexcessive irritation should be avoided during retinoid tried. If irritation develops, stop using the OTC product. cessive irritation should be avoided during retinoid therapy. tried. If irritation develops, stop using the OTC product. cessive irritation and should be avoided retinoid therapy. cessive irritation and should be avoided during retinoid therapy. Benzoyl peroxide fabrics andduring even hair. Don’t get it on ●● Facial waxing orbleaches any other traumatizing procedures lead toitexBenzoyl peroxide bleaches fabrics and even hair. Don’t on Facial waxing or any other traumatizing procedures can can lead toitget exBenzoyl peroxide bleaches fabrics and even hair. Don’t get Benzoyl peroxide bleaches fabrics and even hair. Don’t get it on on clothing, upholstery, linens, or carpeting. cessive irritation and should be avoided during retinoid therapy. clothing, upholstery, linens, or carpeting. cessive irritation and should be avoided during retinoid therapy. clothing, upholstery, linens, carpeting. clothing, upholstery, linens, or orfabrics carpeting. ● Benzoyl peroxide bleaches Don’t getonit on Benzoyl peroxide bleaches fabrics andand eveneven hair.hair. Don’t get it clothing, upholstery, linens, or carpeting. clothing, upholstery, linens, or carpeting. Side Effects of Oral Acne Medications Side Effects of Oral Acne Medications Side Effects of Oral Acne Medications Side Effects of Oral Acne Medications Side Effects ofminocycline, Oral Acne Medications ●Side Tetracycline, and doxycycline are are in the samesame ● Tetracycline, minocycline, and doxycycline in the Effects of Oral Acne Medications ● Tetracycline, minocycline, and doxycycline are in the same Side Effects of Oral Acne Medications ● class Tetracycline, minocycline, and doxycycline areside inside the same of drugs, andand theythey have several possible effects in in class of drugs, have several possible effects class of and they have possible side effects in class of drugs, drugs, they have several possible side effects in common. If you notice any ofseveral the following, stop using the ● Tetracycline, minocycline, and doxycycline are in using the same common. Ifand you notice any of the following, the Tetracycline, minocycline, and doxycycline are instop the same common. If you notice any of the following, stop using the common. Ifdrugs, youand notice anythe of health theseveral following, stopheadaches; using the in medication and notify the health care provider: class of and they have possible side effects medication notify care provider: headaches; class of drugs, and theythe have several possible sideheadaches; effects in medication and notify health care provider: medication and notify the care provider: headaches; blurred vision; sunhealth sensitivity; heartburn or stomach common. Ifdizziness; you notice any of the following, blurred dizziness; sun sensitivity; heartburn orusing stomach common. Ifvision; you notice any of the following, stopstop using the the blurred vision; dizziness; sun sensitivity; heartburn or stomach blurred vision; dizziness; sun sensitivity; heartburn orgums, stomach pain; irritation of the esophagus; darkening of scars, or or medication and notify the health care provider: headaches; pain; irritation of the esophagus; darkening of scars, gums, medication and notify the health care provider: headaches; pain; irritation of the esophagus; darkening of scars, gums, or pain; irritation ofcommon the esophagus; darkening of scars, gums, or teeth (more common with minocycline); nailheartburn changes; yellowblurred vision; dizziness; sun sensitivity; or stomach teeth (more with minocycline); nail changes; yellowblurred vision; dizziness; sun sensitivity; heartburn or stomach teeth (more common with minocycline); nail changes; yellowteeth (more common with minocycline); nail changes; yellowing of the skin (indicating possible liver disease); joint pains; or pain; irritation of the esophagus; darkening of scars, gums, or ing of the skin (indicating possible liver disease); joint pains; or pain; irritation of the esophagus; darkening of scars, gums, ing of the skin (indicating possible liver joint pains; or ing teeth of the skin (indicating possible liver disease); disease); joint pains;yellowor flu-like symptoms. (more common with minocycline); nail changes; flu-like symptoms. teeth (more common with minocycline); nail changes; yellowflu-like symptoms. symptoms. ● flu-like In● addition toskin the tetracycline drugs, many other oral medicaing of the possible liver disease); joint pains; In the addition to (indicating the tetracycline drugs, many other oral medicaof skin (indicating possible liver disease); joint or or ● ing In to the tetracycline drugs, many other oralpains; medica● tions In addition addition to cause theirritation tetracycline drugs, many of other medicacan can cause andand a sensation burning (heartflu-like symptoms. tions irritation a sensation of oral burning (heartflu-like symptoms. tions can cause irritation and of burning tions can cause and aa sensation sensation ofthe burning (heartburn) or pain in the esophagus. To reduce riskoral of(heartthese ● In addition toirritation tetracycline drugs, other medicaburn) ortopain in the esophagus. To many reduce the of these ● In addition the tetracycline drugs, many other oralrisk medicaburn) or pain in the esophagus. To reduce the risk of water these burn) or pain in the esophagus. To reduce the risk these kinds of problems: (1) always take the pills with lots of tions can cause irritation and a sensation of burning (heartkinds of problems: (1) always take the pills with lots of water tions can cause irritation and take a sensation ofwith burning (heartkinds of problems: (1) always the pills lots of water kinds of (2) problems: (1) always take the pills with lots ofbed—stay water and (2) don’t takein a the pill rightright before getting into bed—stay burn) or don’t pain To reduce the risk of these and take a esophagus. pill before getting into burn) or pain in the esophagus. To reduce the risk of these and (2) don’t take pill right before into andkinds (2) for don’t take pillhour. right before getting getting into bed—stay bed—stay upright least 1aa hour. ofat problems: always of water upright for at least kinds offor problems: (1) 1(1) always taketake the the pillspills withwith lotslots of water upright at least 1 upright for atdon’t leasttake 1 hour. hour. and (2) a pill right before getting into bed—stay and (2) don’t take a pill right before getting into bed—stay For For further information about acne, including more information further about acne, including more information upright forinformation at least 1 hour. further information about including more information upright for least 1 hour. For further information about acne, including more information on For this disease inatadolescents andacne, young adults, the following twotwo on this disease in adolescents and young adults, the following on disease adolescents and young adults, the following two on this this disease inrecommended: adolescents and young adults, the more following two Internet sites arein For further information about acne, including information Internet sites are recommended: For further information about acne, including more information Internet sites are recommended: Internet sites are recommended: on this disease in adolescents and young adults, the following on●this in adolescents young adults, the following twotwo American Academy of Dermatology: ● disease American Academy ofand Dermatology: sites are recommended: ●Internet American Academy of Dermatology: Internet sites are recommended: ● http://www.aad.org/skin-conditions/dermatology-a-to-z/acne American Academy of Dermatology: http://www.aad.org/skin-conditions/dermatology-a-to-z/acne http://www.aad.org/skin-conditions/dermatology-a-to-z/acne ● http://www.aad.org/skin-conditions/dermatology-a-to-z/acne National Institute of Arthritis Musculoskeletal and and SkinSkin Diseases: ●● American Academy of and Dermatology: National Institute of and Musculoskeletal Diseases: ● American Academy of Arthritis Dermatology: National Institute ● http://www.niams.nih.gov/Health_Info/Acne National Institute of of Arthritis Arthritis and and Musculoskeletal Musculoskeletal and and Skin Skin Diseases: Diseases: http://www.aad.org/skin-conditions/dermatology-a-to-z/acne http://www.niams.nih.gov/Health_Info/Acne http://www.aad.org/skin-conditions/dermatology-a-to-z/acne http://www.niams.nih.gov/Health_Info/Acne http://www.niams.nih.gov/Health_Info/Acne ● National Institute of Arthritis and Musculoskeletal and Skin Diseases: ● National Institute of Arthritis and Musculoskeletal and Skin Diseases: http://www.niams.nih.gov/Health_Info/Acne http://www.niams.nih.gov/Health_Info/Acne ●