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 There is probably nothing more uncomfortable than being a teenager except perhaps being a teen with acne. Anything that directly affects our outer appearance in a time of life when appearance truly is everything would be excruciating. Even adults are sometimes prone to it.

 Many skin conditions are systemic problems and it isn’t easy to eliminate them with just one thing. Finding the right combination of treatments is often tricky.

For the most part, in both teens and adults acne is due to an imbalance between hormones. Testosterone has the most negative effects on skin which is why its more common in teen boys than girls. In adults, it often affects women in their thirties and is also due to imbalance between testosterone and estrogen. Birth control pills are sometimes an effective treatment because they help rebalance these hormones but that is not a viable option for young men and they aren’t always effective for women either.

 As always, I encourage people to try natural treatments and to keep it simple whenever possible. The simplest thing to try if skin changes start to bother you is an over the counter acne preparation that contains benzoyl peroxide, a form of hydrogen peroxide that can be used on the skin. Often in a mild case, using a topical preparation of this product after washing your face, will help eliminate problems. Use mild soaps as drying soaps can actually irritate the skin more. Then a gentle toner such as witch hazel extract or an herbal preparation followed by the benzoyl peroxide and a non-greasy moisturizer or sun screen. This procedure should be followed twice daily.

If that doesn’t work, it is time to try dietary changes to see if they have an impact. Your diet should include lots of fruits, vegetables and high quality proteins. Nuts and good fats are essential to healthy skin so if they are not in the diet, they need to be given as an oral supplement – omega fatty acids. Fried foods, pizza, large amounts of cheese and white bread will affect your skin negatively. While a poor diet may not be the only cause of skin problems it will only make them worse.

 Certain nutrients are essential to healthy skin. Most American teens are deficient in nutrients due to the poor quality of their diet. Rather than spend all your time trying to convince a teen to change what he eats, just make sure he gets those vitamins and minerals. Vitamin D, A, E, beta carotene, zinc, and selenium all play a major role in skin health. Selenium deficiency has been implicated in a severe form of acne called cystic acne. A good quality multivitamin should provide all of these nutrients in one bottle so it shouldn’t be too difficult to get your teen to take it. Even if the bottle says take it three times per day, just assume during school no pills will be taken, so give them all at once at breakfast or dinner.

 Again, I stress the importance of good fats to healthy skin. All the omega fatty acids that have been touted to cure everything from depression to menopause also help skin conditions. Children in our country are notoriously deficient in these fats. They are available in foods in the form of nuts, vegetable oils such as olive or sesame, or avocados.

 Any natural treatment for acne will take up to two months to be effective. Mineral deficiencies take a long time to correct just by taking vitamins. In general the lifespan of skin cells is about 6 weeks so it will take that long to see an change.

 There are several other topical acne medications available in high doses by prescription or over the counter in lower doses. One is Salicylic Acid; it acts as a mild chemical peel by peeling the surface layer of the skin and opening the pores. If you use this, be very careful because the skin will be irritated and red and VERY sun sensitive. Retin A does a similar thing in that it induces a chemical peel of the skin and allows the pores to open and heal but it also changes the structure of the skin by acting like vitamin A.

If acne becomes severe, it is unlikely to respond to the above treatments. While it is definitely a last resort, and I would encourage you to try anything before you do, you may need to consider prescription drugs. The three categories are, antibiotics, hormonal therapies and accutane.

 Antibiotics help kill the bacteria that seem to cause pimples or blackheads. When they are prescribed they are taken at a low dose over a long period of time. The problem with antibiotics is that they kill good bacteria in addition to the ones you want to get rid of, a set up for long term intestinal problems with yeast or overgrowth of resistant bacteria. Regularly taking probiotics such as acidophilus or sachromyces boulardii – a yeast that competes with candida for gut space – will prevent future problems.

Hormonal treatments fall into two categories. Birth control pills help regulate estrogen and progesterone levels and are obviously only for women. Often they can help a teen’s skin clear up fairly quickly. Anti-androgen pills are pills that suppress the effect of testosterone on the body. One such pill is spironolactone. It is a diuretic that acts on the adrenal hormones lowering the testosterone level.

 Accutane is the drug used for cystic acne and severe acne that does not respond to other treatments. It acts similar to vitamin A and Retin A in that it regulates cell proliferation, it also acts to modulate immune activity of the cells and has a direct effect on the skin’s oil-producing glands that seems to shrink them. How it works is not completely understood. As with all very powerful drugs, the list of side effects is lengthy.

 The most dangerous and controversial side effect is the possibility that accutane has an effect on behavior. It has been associated with several suicides in teen boys and is now the only drug with a suicide warning attached to it. This makes it rather scary to give to a young person and shows the degree of desperation caused by acne. The number of suicide incidents attached to this drug is very low but cannot be ignored. So if you plan to consider this drug keep a close eye on your child.

 One other very natural treatment for acne is the sun. Besides helping the mood and bones, sunshine without a burn can help clear up mild acne and minimize severe acne. If you are not taking Retin A, salicylic acid or accutane, try a dose of playing outside in the sun before starting those medications.


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