Acne Treatments

Although often treated by dermatologists, your Pediatrician should be able to handle all but the most severe or difficult cases of acne.

It can be confusing to know what treatment is best though. Does your child need an antibiotic? Does she need more than one medicine? Which medicine is best? With all of the new medications available to treat acne, deciding what is best for your child can be difficult.

The first step is getting your child's acne classified. Is it mild, moderate, or severe? And what type of acne does your child have? Is it comedonal acne, with just blackheads and whiteheads? Or does your child have inflammatory acne, with red papules and pustules, either with or without comedones? Or does your child have nodulocystic acne, with deeper nodules and cysts.

You may think that a zit is a zit, but each type of acne is actually treated differently.

Comedonal Acne Treatments

If your child has simple comedonal acne, with whiteheads and blackheads, and no signs of inflammation, then she might be treated with just benzoyl peroxide and/or a topical retinoid. Various formulations include:

• Benzoyl Peroxide
  • available as various OTC brands, including Clean & Clear Persa-Gel, Clearasil, Neutrogena, Oxy, Stridex, etc.
  • and prescription brands, such as Benzac, Brevoxyl Gel and Creamy Wash, Triaz Gel, Cleanser, and Pads
• Topical Retinoids
  • Retin A
  • Retin A Micro - may be less irritating than other medications
  • Differin - may be less irritating than other medications
  • Tazorac - may be stronger, but also more irritating, than other medications
• Azelex

Inflammatory Acne Treatments

For inflammatory acne, with red papules and pustules, in addition to the above comedonal acne treatments, your child might be treated with topical and/or oral antibiotics.

Various treatments for inflammatory acne include:

• Topical Antibiotics
  • Clindamycin
  • Erythromycin
  • Benzamycin (a combination of Benzoyl Peroxide and Erythromycin)
  • Benzaclin (a combination of Benzoyl Peroxide and Clindamycin)
  • Duac (a combination of Benzoyl Peroxide and Clindamycin)
• Oral Antibiotics
  • Erythromycin
  • Tetracycline, Doxycycline, or Mincocycline (Minocin)
• Oral Contraceptives

Keep in mind that many children need a combination of these medications to get their acne under control, so they might be using a topical retinoid, topical antibiotic, and an oral antibiotic.

Nodulocystic Acne Treatments

In addition to the above treatments, children with severe nodulocystic acne may require treatment with Accutane. While very effective, Accutane can cause some very serious side effects, so it is important to discuss the risks and benefits of treatment with your dermatologist before starting it.

Other Acne Treatments

Under the care of a dermatologist, these other treatments may be available to you:

• Chemical Peels
• Comedo Extraction
• Drainage and Surgical Extraction (Acne Surgery)
• Phototherapy (Laser and Light Treatments)

Acne Treatment Tips

• Don't give up on your acne medicines too soon. It may take 6-8 weeks to see any real improvement after starting a new acne medication and you can usually expect your child's acne to get worse before it gets better.
• If your child's acne medicines aren't working, ask your Pediatrician about stepping up treatment by using a stronger form of the medicine, adding a new medication, or consider changing to something else.
• Consider asking for a gel formulation of his medicine if your child has oily skin, instead of a cream or lotion, which often work better for those with dry or sensitive skin.
• Ask for a referral to a dermatologist if your child's acne isn't eventually getting under control.