New combination topical products offer some advantages, she observed. For example, benzoyl peroxide or a retinoid promotes desquamation, so combining these with a topical antibiotic helps an antibiotic better penetrate the skin. And zinc helps overcome antibiotic resistance. Furthermore, adolescentsespecially boys, who dislike putting anything on their skinmay have better compliance when given a combination product.
Noting that skin care may be a low priority in this age group generally, she recommended telling adolescents to just apply their medication at night even if they are too tired to wash their face. "It's not a problem of dirt or not removing oil," she said. "It's a problem of not doing the treatment."
Resorting to oral antibiotic therapy should be based on several factors, but age is not one of them, she said. Instead, this therapy should be initiated whenever a child has inflammatory lesions and topical therapy has failed, or when the acne can be seen from across the room, is cystic, or involves the trunk. In addition, "I go much more quickly to oral treatment in boys with inflammatory acne because they will take pills much more willingly than they will put products on their skin."
"You should treat with oral antibiotics for a minimum of 6 months," she said. "And it's typical to treat for several years because it's not a short period of time that acne is a problem."
Birth control pills should be considered for acne treatment in older girls.
Finally, if adolescents wish to treat acne scars, they must be free of any new lesions for at least a year, said Dr. Wagner.
She reported having no conflicts of interest relevant to her presentation.
'Probably the thing that worsens acne more than anything else is working too hard to get rid of it.'
Source DR. WAGNER
Adolescentsespecially boys, who dislike putting anything on their skinmay do best with a combination product.
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