Teen acne: what are next steps after Tretinoin and Aczone?

[Anonymous]

My 17yo daughter has been on Tretinoin and Aczone for about three years and they seemed to work for a while but things have gotten worse in about the past year. She is very embarrassed about it but seems (to me) to do nothing about it. ?

I booked her for an appt at the dermatologist but we cannot get in until late Jan. But am just wondering: what would the next steps be, medically? I mentioned birth control to her but she was horrified and said she would rather just have the acne on her face than have her hormones controlled. I just do not know what to do.

As an aside, if this contributes, she, while also fit and an athlete, also eats junk food constantly at her part-time job and then squirrels it away to eat at school or at home, and feigns ignorance when I tell her that diet is probably contributing to the acne. Is this actually true, or is this outdated advice?

Thank you.

[Anonymous]

LOL I would have laughed in her face at the hormone comment. Oh, honey, when you go through menopause please tell me how you enjoy the natural hormone cycle...

What kind of acne is it? Just face or face and body?

My son had fantastic results from tropicals and antibiotics for his face. Did nothing for his body. Accutane is the only cure for acne and especially for body acne.

[Anonymous]

Diet 100% contributes to acne. She needs to clean up her diet and drink a ton of water.

Less dairy, less sugar, more whole unprocessed foods. Suggest to her to do a 4 week reduction of junk food to see if it helps and if it doesn’t you won’t bug her about it again. Suggest a food diary to see if any particular food connects with the flare ups.

[Anonymous]

Diet has limited contribution for most people. There are more options for females than males luckily. DD had luck with the pill and spironolactone. I was personally nervous about their use even after the dermatologist who I respect recommended them. It was our pediatrician who convinced me to try after she told me that’s how she manages her own acne. In the end, it’s been a very effective solution for DD. Suggest to your daughter that she can always stop if she doesn’t like it. Of course, that’s assuming your derm feels it will be helpful. There are many topicals left to try.

DS has had a harder time. He has failed all topicals and even Accutane. He is pretty down about it.

[Anonymous]

NP. I don’t know about causes of acne but I know this: kids who swim every day for water polo or swim team or whatever seem to rarely have acne problems. I’m in California so this is year-round outside, I can’t speak to indoor swim.

I have kids in multiple sports and kids with water sports seem to have remarkably clear skin. Idk if it is the chlorine or the sun but it works.

[Anonymous]

Spironolactone worked for me.

[Anonymous]

Anonymous wrote:NP. I don’t know about causes of acne but I know this: kids who swim every day for water polo or swim team or whatever seem to rarely have acne problems. I’m in California so this is year-round outside, I can’t speak to indoor swim.

I have kids in multiple sports and kids with water sports seem to have remarkably clear skin. Idk if it is the chlorine or the sun but it works.

Or those who struggle are on accutane because body acne is hell in a swimsuit

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. I don’t know about causes of acne but I know this: kids who swim every day for water polo or swim team or whatever seem to rarely have acne problems. I’m in California so this is year-round outside, I can’t speak to indoor swim.

I have kids in multiple sports and kids with water sports seem to have remarkably clear skin. Idk if it is the chlorine or the sun but it works.

Or those who struggle are on accutane because body acne is hell in a swimsuit

This. I know tons of swimmers -- include one of my kids -- who went on Accutane. Swimmers do not have less trouble with acne than other kids.

[Anonymous]

Anonymous wrote:NP. I don’t know about causes of acne but I know this: kids who swim every day for water polo or swim team or whatever seem to rarely have acne problems. I’m in California so this is year-round outside, I can’t speak to indoor swim.

I have kids in multiple sports and kids with water sports seem to have remarkably clear skin. Idk if it is the chlorine or the sun but it works.

Not true for my DS who was a 6 day a week swimmer. Ultimately, he went on Accutane with great success.

[Anonymous]

My swimmer has bad back acne.

Challenge your daughter to do some research —she’s afraid of taking hormones but not afraid of eating junk food. Ask her to look into the things that go into her body.

[Anonymous]

I don’t think she’s eligible for accutane if she won’t use birth control

[Anonymous]

Anonymous wrote:I don’t think she’s eligible for accutane if she won’t use birth control

Oh good point.

OP did she get these strange beliefs on birth control from you, school or friends?

Fwiw back acne is purely hormonal so nothing is going to fix that for boys other than Accutane.

[Anonymous]

I had ulcerative colitis and I would never, ever agree to put a kid on Accutane.

[Anonymous]

Anonymous wrote:I had ulcerative colitis and I would never, ever agree to put a kid on Accutane.

Why?

[Anonymous]

I went on Accutane as a teenager in the 90s (I’m 50 now) after failing many, many conservative treatments under the care of a dermatologist. It completely cleared my skin and it’s been clear literally ever since. I didn’t have to go on birth control, but I do remember taking monthly pregnancy tests as a condition of the treatment. Things may be different now, of course.