Q: My 13-year-old is starting to break out on his face. What kind of skin-care products should he use, and any to avoid?

Courtesy of La Roche-Posay

A: Acne remedies have come a long way from the old, “put some toothpaste on it.” Now grocery stores and pharmacies devote multiple aisles to skin care. And there are numerous online options. The acne-treatment industry is currently valued at over $9 billion as companies market a wide array of products promising treatments to self-conscious teens and tweens. To help narrow the search, let’s review a few simple guidelines.

Acne is categorized as mild, moderate, or severe. For mild acne, which comprises most teen and tween acne, starting with a benzoyl peroxide-based face wash in the morning is a great first step. If that’s not doing it, adding a thin layer of a topical retinoid at bedtime is the next step. Don’t use the benzoyl peroxide at the same time as the retinoid — use the face wash in the morning and the retinoid in the evening. Topical retinoids include Retin-A, which is a prescription, and adapalene which is now available over the counter (Differin gel). Side effects of retinoids include skin redness, irritation and peeling, so start with two days per week and work up to nightly based on tolerance. Retinoids also increase the risk of sunburn, so it is crucial to add a light facial moisturizer with SPF in the morning after cleansing.


For moderate or severe acne, treatments may include higher potency topical retinoids, topical antibiotic creams, oral antibiotics, or possibly Accutane for nodular or cystic (scarring) acne. Most teens will need a referral to a dermatologist to start Accutane. For hormonal acne in females, combined oral contraceptives (birth control pills) can be helpful. All of these options are prescriptions and take up to four to six weeks to be effective, so don’t hesitate to schedule a visit with your pediatrician to get started. And save that toothpaste for your teeth.

If you’re looking for more expert advice from Dr. Baynham, check out her column here!

Dr. Allison Baynham
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