10 Things About...Teenage Acne

by Annet King (as seen in Dermascope Magazine)

Skin care professionals often have the opportunity to ease the physical discomfort and the emotional trauma of dealing with teenage acne. By incorporating teenage services in the spa, you can also to help a young person develop healthy skin habits for life.

1. Prepare to encounter many more much-younger clients in the near future.

According to The Journal of Pediatrics, acne is now common among children ages 7 to 12. By their mid-teenage years, more than 40 percent of adolescents have had some form of acne and/or acne scarring.

2. Know the larger issues surrounding teenage acne.

There is a recent phenomenon, known in the science community as precocious puberty. There is much controversy regarding the cause of precocious puberty. In fact, not all medical authorities agree on a clinical definition of puberty. However, many well-documented cases identify the arrival of physical changes associated with puberty – breast development, growth of pubic hair, and the first menstrual period – in girls younger than 12 years old. In some cases, these indicators are present in girls as young as seven years old. At any age, acne often accompanies these changes.

One of the causes most commonly cited is the presence of Bisphenol A (BPA), an estrogen-mimicking compound originally developed as a synthetic estrogen, in our environment. More than one million pounds of BPA are released into the environment each year. BPA is found in many sources including hard plastics, dental sealants, and cash register receipts. Another ubiquitous compound, Polybrominated biphenyl (PBB), used as a flame-retardant in fabrics, is also under scrutiny as a possible contributor to precocious puberty. Other possible contributors include meat and milk containing bovine growth hormones, stress and obesity.

3. Understand the multiple causes of teenage acne.

It is essential to get past the overly simplistic view that teenage acne is all about the raging hormones. We now know that there may be an inherited genetic predisposition to acne. Another factor is the immaturity of the skin itself. In skin that is still maturing, follicular cornification and desquamation often cannot keep pace with the rapid, puberty-induced production of sebum. In other words, the skin literally cannot keep up with itself.

Excessive production of sebum, combined with hyperkeratinization (excessive shedding of skin cells), results in plugged follicles which become an ideal feeding and breeding ground for Propionibacterium acnes (p. acnes), the bacterium that causes most acne. And the teenage lifestyle often makes matters worse! Processed foods that are high in the glycemic index along with poor cleansing techniques also contribute to the incidence of acne in teenagers.

4. Know the difference between mom’s acne and her child’s acne.

Teenage acne usually begins with oiliness in the T-zone and small superficial comedones with outbreaks commonly occurring in the center of the face (cheeks and forehead), as well as on the back and chest. Because of the differences in causation and behavior, teenage acne must be treated differently than adult acne which arises on the U-zone (along the jawline and lower face). Adult acne is typically more inflamed and cystic in nature than teenage acne, with little incidence of the overall oiliness and comedones that teenagers commonly experience.

5. Learn how to communicate with adolescents – and pre-adolescents.

Often, teenagers are reluctant to seek treatment – especially boys. They may try to treat their own acne by picking, using metal implements, harsh scrubs, alcohol-based astringents, and by sunning and tanning in the hopes that heat will bake away the acne. All of these practices actually worsen acneic conditions. It is your mission as a skin care professional to educate them on proper treatments.

When treating teenagers, take the parent and the teenager to a private, quiet area. Speak to the teenager directly and respectfully, with the parent present. Allow the teenagers to speak for themselves, and use your Emotional Quotient (EQ) to read between the lines. Offer support in the form of information and a realistic at-home regimen to help between bi-weekly professional treatments.

Know that the teenager will still attempt to self-treat pimples, so offer a few suggestions. The first steps are to cleanse face and hands thoroughly and to warm up the skin to make it easier for the plug to exit. Show teenagers how to wrap both index fingers in tissue, make a mound around the breakout, then wiggle, rock and roll the impaction out.

6. Control excess sebum.

Teenage skin is often overflowing with sebum. You should explain to the teenager and the parent that, while controlling oiliness is key to treating and preventing acne, it is equally important not to dehydrate the skin in the process. Look for gentle cleansers and treatment products that slow secretions through ingredients like Niacinamide, African Whitewood Bark, Meadowsweet, Saw Palmetto and Sesame Seed.

7. Curb bacterial growth.

Benzoyl Peroxide is highly effective in slowing down the proliferation of p. acnes. Choose products that contain this powerful antibacterial or, for darker skin types that may hyperpigment easily, look for alternatives with the same action such as Colloidal Silver, Meadowsweet, Salicylic Acid, Tea Tree Oil and Sulfur.

8. Teach healthy skin habits.

As a result of the various changes, teenagers are usually uncomfortable in their own skin. They are a mystery to themselves as well as to their parents. One puzzling aspect can be their poor hygiene. The tween who loves makeup may not wash her face at night. She may share a concealer or mascara with her best friend at school in the morning. It is important to teach good hygiene. Encourage teenagers to use clean hands when sharing makeup. Educate them about the importance of proper double-cleansing of the face, morning and night. Help the teenagers develop this habit by introducing a gentle antibacterial liquid cleanser, and be sure that they know how to remove long-wearing cosmetics safely and thoroughly.

9. Stop inflammation.

Redness and irritation usually accompany acne and can worsen by picking and popping. Build soothing ingredients into your treatment and product prescription, including Green Tea, Camphor, Oleanolic Acid, White Birch Extract and Licorice.

10. Teach safe exfoliation.

Understandably, teenagers can become obsessive about their acne and may try to scrub it away. While rough handling makes matters worse, they may be on to something in the sense that consistent exfoliation is an important step in acne care. Demonstrate gentle exfoliation techniques, using products that may have chemical exfoliants or gentle microbeads versus harsh particles (ground stone, fruit pits and shells) with sharp edges that can tear skin and open up lesions. Teach them that virtually no pressure is needed and that effective products will begin to loosen cell-debris the moment they come into contact with the skin.

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10 Things About...Teenage Acne