As a young girl I was fortunate to have very few encounters with teen acne, especially since the American Academy of Dermatologists states 85% of teenagers experience it. However, I often overheard my sister battling it out at the bathroom mirror. She had a nightly routine, always being sure to wash her face before bed, whereas I tended to go to bed makeup and all. Now, as the mom of a teenager, I have experienced hands-on the challenges of teen acne and how unbelievably frustrating it can be.
My son, currently 15, has mulatto skin and was born with the most beautiful, clear complexion – that is, until he reached sixth grade. I began noticing small acne breakouts along the edge of his face and also blackheads on his ears. At the time, I wasn’t worried because he was becoming more active in sports and I figured this was a normal “growing boy” concern. But I did decide it was time to start being more active in his skin care.
As you can imagine, personal hygiene – let alone a skin care regimen – isn’t the highest priority for an 11-year-old boy. I was able to get him to agree that he needed to do more than splash his face with a little water before hopping out of the shower. Uncertain of where to begin, I turned to my sister. I had basic questions like what type of cleanser to use at this young of an age, and how the cleansers would react with his darker skin. Although my son and sister have very different skin types, I knew how sensitive her skin was and how she reacted to various products. I thought it would be best to start with something very gentle. I didn’t want to over dry or damage his skin with a full-strength acne wash for teens that could be too harsh. I brought home a gentle face wash for him to use in the morning and at night before bed. I quickly found, however, that unless I was standing in the bathroom right next to him, he often just skipped the cleanser.
As time went on, the acne would clear up slightly but never really go away. I knew this was partially due to his inconsistent washing habits, but I decided I should also do some further investigation on skin care and acne treatment for biracial and multiracial skin types to see if there was something better he should be using. I quickly found there was very little professionally developed information on skin care for dark skin. Additionally, most of the acne sites I visited promoted treatments that had a 3- or 4-step process – not really a practical solution, since we struggled with consistency just using a single face wash. So we continued with our simple routine, occasionally trying an alternative cleanser to see if he would get better results. Overall, they all seemed to work the same.
It was in eighth grade when my son finally realized he needed to take this skin care thing a bit more seriously. I’m pretty sure this had to do with the fact that girls were starting to pay more attention to him. His breakouts weren’t just small whiteheads anymore. He started getting a lot of blackheads and also cysts under the skin that were quite painful. The acne had spread to his chest but even more dramatically to his back. This, and his newfound interest in clearing his skin, made me decide to take the problem to his pediatrician.
When we met with his doctor, she agreed he needed something stronger than an over-the-counter product. We discussed the different options she thought would be appropriate for his skin and age as well as use of a topical vs. an oral medication. I prefer to stay away from pills whenever possible, so the physician wrote him a prescription for a topical treatment: Benzamycin® – a combination of benzoyl peroxide, which has an antibacterial effect, and erythromycin, which is an antibiotic. He would have to apply the solution 2 times a day along with continued use of a gentle facial cleanser.
When I picked up the prescription, the pharmacist instructed me on how to use and store the topical. It needed to be kept in the refrigerator, which immediately gave me concern since it could not be kept in the bathroom, where my son usually performed his skin care routine. We began the treatment that night. My son would take care of his face and chest, and then I would help him cover his back. After a week of use, we were happy to see the problem areas clearing up.
Even though he had a positive response, again our challenge became keeping a consistent routine. We would go 3 or 4 days in a row applying as directed, and then he’d spend the night at a friend’s or come home late from a basketball game and we’d miss a couple days. This inconsistent pattern provoked quite a few arguments between us. What teenager wants his mom harassing him every night and morning about skin care and pimples? As most moms know, a teen’s attitude can be just as frustrating as the skin care problems.
With the continued use of the topical, I started noticing light patches on his skin that concerned me. I immediately went to the internet and found that hypopigmentation was a side effect of the Benzamycin. I was relieved to read that this wasn’t something severe and that it was a temporary side effect.
What really grabbed my attention, however, was the scarring. I noticed this one night after a lapse in his routine. He had a cyst that had left a very deep and large damaged area on his shoulder, I’d say about an inch wide. I felt absolutely terrible that I hadn’t paid closer attention and pushed harder for him to follow his doctor’s instructions. I wasted no time scheduling another appointment with the pediatrician, and this time we left with a prescription for tetracycline – an oral antibiotic.
This treatment simplified things quite a bit and took some of the tension out of our day-to-day routine. It was much easier for him to remember to take the pill in the morning and before bed. I also replaced his face wash with a face, chest, and back scrub that was 10% benzoyl peroxide. Since we had moved to the oral antibiotic I wanted to make sure he wasn’t missing the antibacterial effect from a topical medication.
This treatment seemed to be a better fit with his daily habits and a successful combination: his face and back began to clear up, and, more importantly, the cysts became a once-in-a-while occasion that were much smaller than before.
Today, almost 8 months into this new routine, he’s not completely acne free, but I assume for boys his age that acne free is not a realistic expectation. For me, I’m happy we’ve found a simple and maintainable routine that has eased my son’s stress and concern around his acne. For now, we are both happy with the results, but I’ll be paying close attention to see if we need to take another step – a trip to the dermatologist.