11 year old acne

Acne

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If you’re almost a teen, chances are pretty good that you have some acne. About 8 in 10 preteens and teens have acne, along with many adults. In fact, about 17 million people in the United States have acne. Acne is so common that it’s considered a normal part of growing from a kid to an adult.

But knowing that doesn’t make it easier when you look in the mirror and see a big pimple on your chin! The good news is that learning about acne and taking some simple steps can help you feel better about your face.

Acne is a skin condition that shows up as different types of bumps. They include whiteheads, blackheads, red bumps (pimples), and bumps that are filled with pus (called pustules). What causes these annoying bumps? Well, your skin is covered with tiny holes called hair follicles, or pores. Pores contain sebaceous (say: suh-BAY-shus) glands (also called oil glands) that make sebum (say: SEE-bum), an oil that moistens your hair and skin.

Most of the time, the glands make the right amount of sebum and the pores are fine. But sometimes a pore gets clogged up with too much sebum, dead skin cells, and germs called bacteria. This can cause acne.

If a pore gets clogged up, closes, and bulges out from the skin, that’s a whitehead. If a pore clogs up but stays open, the top surface can get dark and you’re left with a blackhead. Sometimes the walls of the pore are broken, allowing sebum, bacteria, and dead skin cells to get under the skin. This causes a small, red infection called a pimple. Clogged-up pores that open up deep in the skin can lead to bigger infections known as cysts.

Why Do So Many Kids Get Acne?

A lot of kids and teens get a type of acne called acne vulgaris. It usually appears on the face, neck, shoulders, upper back, and chest. Teens and kids get acne because of the hormone changes that come with puberty. As you grow up and your body begins to develop, these hormones stimulate the sebaceous glands to make more sebum, and the glands can become overactive. When there is too much sebum, that oil clogs the pores and leads to acne.

If your parent had acne as a teen, it’s likely that you will, too. Stress may make acne worse, because when you’re stressed, your pores may make more sebum. Luckily, for most people acne gets better by the time they’re in their twenties.

What Can I Do About Acne?

If you’re worried about acne, here are some ways to keep pimples away:

  • To help prevent the oil buildup that can lead to acne, wash your face once or twice a day with warm water and a mild soap or cleanser.
  • Don’t scrub your face. Scrubbing can actually make acne worse by irritating the skin. Wash gently, using your hands instead of a washcloth.
  • If you wear makeup, moisturizer, or sunscreen, make sure they are “oil-free,” “noncomedogenic,” or “nonacnegenic.”
  • When you wash your face, take the time to remove all of your makeup.
  • If you use hair sprays or gels, try to keep them away from your face because they can clog pores.
  • If you have long hair, keep it away from your face and wash it regularly to reduce oil.
  • Baseball caps and other hats can cause pimples along the hairline. Avoid them if you think they are making your acne worse.
  • Wash your face after you’ve been exercising and sweating a lot.
  • Try not to touch your face.
  • Don’t pick, squeeze, or pop pimples.

Many lotions and creams are sold at drugstores to help prevent acne and clear it up. You can try different ones to see which helps. Products with benzoyl peroxide (say: BEN-zoil peh-ROK-side) or salicylic (say: sal-uh-SIL-ick) acid in them are usually pretty helpful for treating acne. Benzoyl peroxide kills the bacteria that can lead to acne and it also can reduce swelling (puffiness) of pimples. Salicylic acid is another acne-fighting ingredient. It causes skin to dry out and peel, which can help get rid of pimples, too.

When you use a product for acne, be sure to follow the directions exactly. Don’t use more than you’re supposed to because this can make your skin very red and very dry. It’s also good to try just a little bit at first to be sure that you’re not allergic to the product. Don’t give up if you don’t see results the next day. Acne medicine can take weeks or months to work.

What If I Get Pimples Anyway?

Some kids will rarely get a pimple — those lucky ducks! But many kids will get some pimples, even if they take steps to prevent acne. It’s totally normal. In fact, some girls who have a handle on their acne may find that it comes out a few days before they get their periods. This is a common problem called premenstrual acne and is caused by hormonal changes in the body. Boys undergo hormonal changes, too, and may be more likely to suffer from severe forms of acne.

Even if you get acne, you don’t want to make it worse. That’s why it’s important to keep your hands off your pimples. Try not to touch, squeeze, or pick at a pimple. When you play around with pimples, you can cause even more inflammation by poking at them or opening them up. Plus, the oil from your hands can’t help! The worst part, though, is that picking at pimples may lead to scars on your face.

Some people will tell you that sitting out in the sun helps acne. But this isn’t true. A suntan can make acne look less severe by hiding pimples, but it won’t help them go away. And too much sun isn’t a good idea anyway because it can give you a sunburn today and wrinkles and skin cancer later in life.

Kids who have serious acne can get help from their doctor or a dermatologist (a doctor who treats skin problems). Doctors can prescribe stronger medicine than you can buy at the store. Acne prescriptions can include stronger creams that prevent pimples from forming or antibiotics that decrease swelling (puffiness) and kill bacteria that cause pimples.

If you have acne, now you know some ways to improve your skin. And remember that you’re not alone. Look around at your friends and you’ll see that most kids and teens are in it together!

Reviewed by: Patrice Hyde, MD Date reviewed: June 2014

Doctors: Face of acne is younger

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A skin problem that mortifies many teens is now appearing in younger kids.

More pre-adolescent children, ages 7 to 12, are developing acne, dermatologists say.

“It is common for 9- to 11-year-olds to have early acne, and sometimes this can be quite significant,” says Lawrence Eichenfield, chief of pediatric and adolescent dermatology at Rady Children’s Hospital in San Diego. The earlier onset of acne has been linked to the start of puberty at younger ages, he says.

Boys are experiencing puberty six months to two years earlier, according to a study last year in the journal Pediatrics, and a 2010 study found that the percentage of girls who had breast development at ages 7 and 8 is greater than for girls born 10 to 30 years earlier.

During puberty, a rise in hormones can make skin and hair oily, contributing to clogged pores and acne.

Acne, a common skin problem in teens and adults, can include whiteheads, blackheads, pimples, nodules and cysts. It can leave blemishes and scars, and it can cause emotional distress. It “can have a tremendous negative psychological impact,” Eichenfield says.

Pre-adolescent acne can progress from whiteheads to inflamed bumps. It occurs mostly on the forehead, nose and chin, the so-called T-zone.

Early acne is a little more common in girls than boys, Eichenfield says. In girls, the stimulation of the adrenal-related hormones tends to start earlier.

Pre-adolescent acne that is mild can be treated with over-the-counter products, such as benzoyl peroxide gels and washes. More severe acne can be treated with oral antibiotics and topical medications by prescription; topical treatments include antibiotics and retinoids. Therapies can combine some of these products.

Back-to-school physical exams are a good time for parents to address skin concerns with their kids’ doctors, dermatologists say. They can help assess whether the acne is significant enough to start therapy, says Eichenfield, professor of pediatrics and medicine at the University of California-San Diego.

Doctors also can check whether a child has a hormonal imbalance, says Andrea Zaenglein, professor of dermatology and pediatrics at Penn State Hershey Medical Center in Hershey, Pa.

A girl’s early onset of whiteheads and blackheads can be a predictor of more severe acne in adolescence, she adds.

Through the American Acne and Rosacea Society, Eichenfield and Zaenglein helped develop guidelines for the diagnosis and treatment of pediatric acne. The guidelines recommend treatment by age and acne severity. The American Academy of Pediatrics endorsed and published the guidelines in Pediatrics in May.

Latanya Benjamin, a dermatologist at Lucile Packard Children’s Hospital at Stanford in California, also says she sees “more and more patients coming in for treatment.” Benjamin, an assistant clinical professor of dermatology and pediatrics at Stanford School of Medicine, says it’s hard to determine whether greater awareness contributed to the increase.

ADVICE FOR PARENTS

Zaenglein offers these tips for parents:

• Encourage good cleansing habits, such as face washing with a gentle cleanser twice a day.

• Start treatment with over-the-counter benzoyl peroxide products.

• If acne gets worse, see a board-certified dermatologist to start therapy.

• Stay involved in your child’s treatment routine. Children may need parental guidance to apply topical medications or take oral antibiotics consistently.

Childhood acne: When to worry

WAILEA, HAWAII – Acne arising in a 1- to 7-year-old means “it’s time to worry,” according to Dr. Lawrence F. Eichenfield.

Acne originating in this midchildhood age range is very uncommon. It signals the need for a detailed endocrinologic work-up. Possible underlying causes include precocious adrenarche, congenital adrenal hyperplasia, Cushing’s syndrome, precocious puberty, and a gonadal or adrenal tumor, he noted at the Hawaii Dermatology Seminar sponsored by the Global Academy for Medical Education/Skin Disease Education Foundation.

Dr. Lawrence F. Eichenfield

“If you want to take it on yourself you can, but the standard is going to be an evaluation that includes a growth chart, a bone age assessment, Tanner staging, and measurement of total and free testosterone, LH , FSH , prolactin, DHEAS , andrestenedione, and 17-hydroxyprogesterone. Generally we say refer to a pediatric endocrinologist,” said Dr. Eichenfield, professor of clinical pediatrics and medicine (dermatology) at the University of California, San Diego.

He noted that acne occurring at age 1-7 is prominently identified as a red flag in guidelines for the management of pediatric acne developed by the American Acne and Rosacea Society and subsequently approved by the American Academy of Pediatrics. Dr. Eichenfield was cochair of the expert panel that crafted the guidelines.

The comprehensive guidelines – the first ever to specifically address acne in the pediatric age range – include a general acne categorization scheme based upon age. While acne in a 1- to 7-year-old is characterized as a cause for concern, acne arising in a seemingly healthy slightly older preadolescent – roughly age 7-12 – is not.

“Acne in a child in this age group who otherwise looks well and has no signs or history that would make you suspicious of an underlying endocrinopathy is essentially a normal variant we now call preadolescent acne. You do not need to refer that patient for further evaluation,” the pediatric dermatologist explained.

Nonworrisome preadolescent acne presents as comedone-predominant disease typically concentrated on the forehead and midface, with truncal involvement much less frequent. The acne may precede other signs of puberty. There is solid evidence that the more pronounced the expression of early preadolescent acne – that is, the greater the number of facial comedones present – the more severe the acne will be in adolescence. Indeed, severe preadolescent acne is often a harbinger of the later need for isotretinoin.

Acne developing within the first 6 weeks of life is most often an erythematous papulopustular eruption categorized in the guidelines as neonatal acne, also known as neonatal cephalic pustulosis. It is not true acne, but rather a self-limited condition associated with Malassezia globosa and M. sympodialis.

In contrast, infantile acne is true acne, mainly comedonal, which typically doesn’t show up until a baby is several months old and lasts for up to about a year.

The guidelines put forth detailed treatment algorithms featuring multiple options available for each acne age category and degree of severity. Of note, benzoyl peroxide is listed as a first-line treatment across the board, either as monotherapy or in combination with an antibiotic or topical retinoid.

“There is a theme that whenever one is using an antibiotic – whether a systemic drug or a topical product like clindamycin – benzoyl peroxide is advised in the regimen of care because of the feeling that if you use an unopposed antibiotic, you can have the development of bacterial resistance,” Dr. Eichenfield noted.

He reported receiving research grants for clinical investigations from half a dozen pharmaceutical companies.

SDEF and this news organization are owned by the same parent company.

But, Eichenfield said, “it’s important to use antibiotics appropriately.” One reason is because acne-causing bacteria have become less sensitive to common antibiotics in the past couple decades, due to widespread use of the drugs.

Another is that antibiotics can have side effects, such as stomach upset, dizziness and, in girls, yeast infections.

When acne is severe and other treatments have failed, the AAP said, doctors and parents might consider the prescription drug isotretinoin — brand-names including Roaccutane (formerly known as Accutane) and Claravis.

The drug is very effective, but it can cause birth defects, so girls and women have to use birth control and get regular pregnancy tests if they go on the medication. Isotretinoin also has been linked to inflammatory bowel disease, depression and suicidal thoughts in some users — although it’s not clear the drug is to blame, the AAP said. (Severe acne itself can cause depression and suicidal thoughts, for example.)

Dr. David Pariser, a dermatologist not involved in the recommendations, said they are “based on sound evidence” and reflect the “best practices” in battling acne.

When should parents consider taking their child to a doctor for acne treatment? It depends on how severe the problem is, and how bothered the child is, said Pariser, who sits on the board of directors of the American Academy of Dermatology.

Some kids can deal with skin eruptions, but Pariser said he sees others who refuse to leave the house.

Both he and Eichenfield said it’s important to dispel kids’ (and sometimes parents’) acne myths. “Acne is not caused by dirt or poor hygiene,” Eichenfield said, and harshly scrubbing your face will probably make the situation worse.

It’s best to wash your face gently twice a day, with a soap-free pH-balanced cleanser, the AAP said. Facial toners — which commonly come in pre-packaged acne regimens — can help clear away oil. But the group suggested going easy on toners, since they can irritate the skin.

And what about food? “The medical community has swung back and forth on that over the years,” Pariser said. Years ago, people thought that certain foods, like chocolate, sugar and iodine, promoted breakouts, but studies starting in the late 1960s failed to confirm that.

The face of acne is getting a lot younger, say dermatologists across the country, who are starting to see more cases of pediatric acne – as in kids as young as 7.

The problem has become widespread enough to prompt the leading group of pediatric dermatologists to establish new guidelines for treating kids of all age groups, something that has also been endorsed by the American Academy of Pediatrics.

Doctors believe it’s likely linked to earlier onset puberty, which causes hormones called adrenal androgens to start increasing, triggering pimples to erupt sooner on these young faces.

Dr. Andrea Zaenglein, a co-author of the new treatment recommendations, estimates that she now sees around 10 or 15 new cases of pediatric acne every month.

“The principals of therapy for adolescent acne and pre-adolescent acne are exactly the same,” says Zaenglein, who this week presented the information at the American Academy of Dermatology’s summer meeting. “You want to treat it as aggressively as you need to, to get it under control.”

Most of these younger children have mild acne – mostly a spattering of whiteheads and blackheads, called comedones, on the forehead, nose and chin. In these cases, the recommended treatment is an over-the-counter product containing benzoyl peroxide; if that doesn’t work, a combination therapy involving benzoyl peroxide, an antiobiotic and/or a retinoid may be prescribed.

There’s a glimmer of an upside here: In cases of kids with acne, the parents are more likely to be more heavily involved, making sure their child sticks to the treatment prescribed by their dermatologist. But Zaenglein points out that while parents of teenagers know to watch out for skin problems, it may not occur to parents of younger children that this is a problem that may require professional care.

In girls especially, Zaenglein says, pre-teen acne “can be a predictor of more severe acne in adolescence. And you want to make sure that those girls get treatment throughout their teenage years.”

Emotionally, acne is awful no matter how old you are. “But it’s a lot harder when you may be the only kid in your class that has it,” Zaenglein says.

“So it’s important to recognize the problem, and don’t ignore the fact that it’s there, because puberty lasts a long time and there’s no reason to think it gets better on its own,” she says.

It’ll come as no shock you to learn that boys and girls in these modern-day United States, fed on country-fried steroidal chicken breasts and good ol’ American colas, have begun to hit puberty at earlier ages than they ever have before. This might actually be a good thing in some respects, since early adolescence may point to improvements in our overall nutrition (modern people no longer eat straw and pebbles like their 17th-century ancestors), as well as give kids a longer grace period during which to familiarize themselves with their own sexuality. Early puberty may also, unfortunately, give kids a longer bout with the great scourge of adolescent self-esteem, acne.

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According to some grim, soothsaying dermatologists interviewed by USA Today, early puberty means earlier appearances of acne for kids as young as seven, which is really a shitty way to be purged of childhood innocence and be rudely, prematurely introduced to the crippling self-consciousness of adulthood. The report paints a (fairly broad-stroke) picture of grade schools populated with acne-riddled nine-year-olds, who, rather than playing freeze tag at recess, are trading skincare regimens:

More pre-adolescent children, ages 7 to 12, are developing acne, dermatologists say.

“It is common for 9- to 11-year-olds to have early acne, and sometimes this can be quite significant,” says Lawrence Eichenfield, chief of pediatric and adolescent dermatology at Rady Children’s Hospital in San Diego. The earlier onset of acne has been linked to the start of puberty at younger ages, he says.

That’s about as deep into the data as USA Today is willing to wade — the only real proof of this early acne development is a 2010 study in Pediatrics that found “the percentage of girls who had breast development at ages 7 and 8 is greater than for girls born 10 to 30 years earlier.” Kids are hitting puberty faster, so, ipso facto, acne happens earlier, too, which is a real bummer considering that there’s an entire industry of self-conscious adults waiting to prey on the deepest insecurities of newly-awkward preteens by offering rosters of skincare products and tips for ways to spend more time in the mirror, fretting.

Case in point: after introducing the idea that seven-year-olds can now expect a smattering of pimples, the USA Today article spends the rest of its time giving out obvious skincare tips. Back to school, kids! Hold that mirror close to your faces and fret — you’re growing up so fast.

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Image via Cheryl Casey/ .

Acne in Children

What is acne?

Acne is a disorder of the hair follicles and sebaceous glands. Hair follicles are the areas around the base or root of each hair. Sebaceous glands are the tiny glands that release oil (sebum) into the hair follicles. The sebum moistens the skin and hair. The sebum and hair get to the skin surface through tiny holes called pores.

Acne is very common. Most children and young adults between ages 11 and 30 will have acne at some point. Acne most often begins in puberty. But it can happen at any age. There are different types of acne that affect newborns, infants, younger children, and adults.

Acne may occur when the pores gets clogged with dead skin cells and oil. Bacteria that are normally on the skin may also get into the clogged pore. Acne comes in several types. One type is a comedone. This is a plug of sebum in the hair follicle. They are either closed whiteheads, or open blackheads. These are not inflamed or infected.

Inflamed acne causes red, painful bumps or sores. The sores may be infected with bacteria. This type of acne includes:

  • Pustule: Bacteria cause the hair follicle to be inflamed. Pustules are closer to the skin surface.
  • Papule: The wall of the hair follicle gets irritated. Papules are deeper in the skin.
  • Nodule: These are larger, deeper, and more solid.
  • Cyst: This is a nodule with pus.

What causes acne?

The cause of acne is not fully understood. Acne is linked with:

  • Hormonal changes during puberty, pregnancy, and the menstrual cycle
  • Rising levels of male sex hormones (androgens) in both boys and girls during puberty that causes more sebum and more dead skin cells
  • Using makeup or cosmetics that block the pores
  • Using certain products to wash the skin
  • Wearing clothes that rub or irritate the skin
  • High levels of moisture in the air (humidity) and sweating
  • Taking certain medicines, such as corticosteroids

Who is at risk for acne?

Being a teen (adolescent) is the greatest risk factor for acne. A family history also increases the risk for severe acne.

What are the symptoms of acne?

Acne can occur anywhere on the body. It is most common in areas where there are more sebaceous glands, such as:

  • Face
  • Chest
  • Upper back
  • Shoulders
  • Neck

Symptoms can occur a bit differently in each child. They can include:

  • Small bumps that are skin-colored or white (whiteheads)
  • Small bumps that are dark in color (blackheads)
  • Red, pus-filled pimples that may hurt
  • Solid, raised bumps (nodules)
  • Darker areas of skin
  • Scarring

The symptoms of acne can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is acne diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. He or she will look at the areas of the body with acne. The provider may advise that your child see a doctor who specializes in skin care (dermatologist).

How is acne treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The goal of acne treatment is to improve the skins appearance and to lessen the chance of scarring. Treatment for acne will include gentle, regular skin care. Your child’s healthcare provider may advise:

  • Non-prescription cleansers and creams, lotions, gels, or other products
  • Prescriptions that are put on the skin (topical) or taken by mouth (oral)
  • Other therapies or procedures, such as laser therapy, light therapy, or chemical peels
  • Draining of a cyst, or injecting it with medicine

Topical medicines are often prescribed to treat acne. These can be in the form of a cream, gel, lotion, or liquid. These may include:

  • Benzoyl peroxide: This kills bacteria.
  • Antibiotics: These help stop or slow down the growth of bacteria. They also reduce inflammation.
  • Tretinoin: This stops new comedones from forming. It also encourages new skin cell growth and unplugs pimples.
  • Adapalene: This helps stop new comedones from forming.

Medicines to take by mouth may be prescribed, such as:

  • Antibiotic medicines: These may include tetracycline, doxycycline, or erythromycin. They are used to treat moderate to severe acne.
  • Isotretinoin: This may be prescribed for severe acne that can’t be treated by other methods. It helps to prevent new acne and scarring.

What are possible complications of acne?

Acne can cause problems with self-esteem. It may cause emotional problems. It may result in depression, anxiety, and even suicidal thoughts. Severe or long-term acne may cause scarring. Serious infections may also develop.

Living with acne

Acne can be a long-term condition. Early treatment can help to prevent or lessen severe acne. Help your child by:

  • Reminding your child to not pick, pop, or squeeze acne, which can spread infection and cause scars
  • Talking with your child’s healthcare provider if over-the-counter treatments don’t work well
  • Considering taking your child to a dermatologist for long-term or severe acne
  • Making sure your child stops acne treatment slowly, not quickly, once acne clears
  • Having your child treat acne a few times a week to prevent it from returning, if needed
  • Making sure your child does skin care regularly and gently

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if:

  • Your child is upset by his or her acne
  • The acne is getting worse
  • Over-the-counter treatments are not working

Key points about acne

  • Acne is a disorder of the hair follicles and sebaceous glands.
  • Acne may happen when the pores gets clogged with dead skin cells and oil. Bacteria that are normally on the skin may also get into the clogged pore.
  • Most teens and young adults between 11 and 30 years old will have acne at some point.
  • Both over-the-counter and prescription medicines are available to treat acne.
  • Acne can have an emotional effect. This can lead to depression, anxiety, and even suicidal thoughts.
  • Scarring can result from severe or long-term acne.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:

  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

My teen has been experiencing lots of breakouts recently. What’s the safest, most effective way to treat acne?

If you’re a teenager or adult, you’re probably familiar with the pains of acne. Acne is the most common skin disorder in teenagers, affecting more than 80 percent of American teens between 11 and 30. It occurs when an overproduction of oil causes the follicle (pore) of the skin to get clogged. This causes whiteheads, blackheads, and inflammatory acne. During the teenage years, hormone levels increase which can stimulate oil production. Paired with genetics, certain medications, or even makeup, acne can especially affect teenagers. Though teens may not be able to avoid acne, there are ways for you and your dermatologist to help them treat it. Here are a few methods you can use to start controlling your child’s breakouts:

  • Do not pop pimples. Teens should treat their skin as gently as possible by refraining from touching or scrubbing their skin. Squeezing the pimple pushes bacteria and pus deeper into the skin, causing more swelling and redness. The best way to eliminate acne is to encourage leaving the pimple alone for a week, and apply an acne cream that contains two to five percent benzoyl peroxide.
  • Moisturize regularly. Some over-the-counter treatments your teen may be using for acne management could be drying out their skin. Flaky, dry skin cracks allow bacteria to seep in and cause acne. To prevent dryness, give your teen a gentle oil-free moisturizer after washing their face, to prevent dryness.
  • Monitor hair and makeup products your teen is using. Some oil-based shampoos, hair sprays, gels, pomades and makeup may be agitating the skin. If the oil in the product comes in contact with the face, it could also seep into pores on the forehead and cheeks, causing more acne. Look for words like non-comedogenic or non-acnegenic on your teens’ skin care and hair care products.
  • Use over-the-counter treatments.To dry problematic pimples out a little faster, have your teen apply a gel or cream containing a small percentage of benzoyl peroxide or salicylic acid. Carefully monitor how the skin reacts and give it at least a week to respond to the treatment.
  • If acne worsens or does not respond, see a dermatologist. If you notice your teen avoiding school or social events due to a breakout, schedule an appointment with a dermatologist. He or she can provide ways for kids to cope with acne, as well as provide stronger medications to help treat their specific needs.

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