OF the top 10 things I don't miss about being a teenager, breaking out is probably number 1.
Getting acne may be considered just a part of growing up, but it can still be really frustrating at the time.
Recently the North Shore News sat down with Dr. Francis Jang, a dermatologist at Skinworks clinic in Vancouver, to ask her a few questions about how to deal with those pesky pimples.
North Shore News: How common is acne?
Jang: Acne is almost a normal thing for teenagers as they reach puberty and their hormone levels start to turn on. Some people are more prone to it genetically, so we find that if their mothers or fathers had it in a more severe
way perhaps children could anticipate that as well.
North Shore News: What are the best treatment solutions?
Jang: Treatment solutions depend on how severe it is.
The kind of acne that leads to scarring, which is typically the cystic kind, the big, boily kind, which can occur on the face as well as the chest and back, are the ones where we really need to have some medical intervention sooner rather than later.
There are over-the-counter products and there are prescription products. In broad categories you're probably looking at:
- Exfoliants (including salicylic acid) - one of the more commonly used products for exfoliation and acne. It goes more towards oily areas so it is more attracted to the areas that are perhaps more problematic.
- Benzoyl peroxide - available over the counter in gel, lotions, washes, soaps as well as in higher concentrations of more than five per cent by prescription. These are bacteriostatic, they kind of arrest bacteria and exfoliate a little bit.
- Antibiotics, usually available by prescription, in oral and in lotion and gel forms.
- Retin As and all their relatives. Those ones work by exfoliating and are also bacteriostatic.
North Shore News: What over the counter brands would you recommend?
Jang: In general I like Neutrogena products. Obviously the stronger the concentration of any particular ingredient, the more quickly it may work or it might address a more severe case, but also the more it may tend to dry the skin. You want to be patient too. Just putting it on one or two nights is not going to solve your problem. You want it over a period of four weeks to sort of be preventing new ones from coming out.
North Shore News: Is it OK to pop a pimple?
Jang: We don't really like people to do that because invariably when you pop a pimple you actually push some of the oil into the middle layer of the skin and maybe inflame the skin even more. So while you de-bulk it, you kind of create a red mark on the skin.
North Shore News: Will popping pimples leave scarring?
Jang: People always say they have scarring from their acne and it's just marks. Brown and red marks of varying degrees left on their skin, post-acne, that can last for weeks to months. But true scars in a dermatologist's minds are depressed areas or areas that are bumped up but not necessarily discoloured. The discolouration eventually goes, and what we call that is post inflammatory hyperpigmentation. Bleaching creams and more aggressive exfoliation, or Retin As also help to lift the pigment.
North Shore News: So what can be done about "true scars" a.k.a. pockmarks?
Jang: We tend to use a combination of the new fractionated lasers that have been available for the last four years or so. What they do is poke tiny pixelated little holes in the skin to whatever depth we want, and what that does is causes new collagen generation. So that usually results in a softening of the scar but not a complete disappearance. And then we usually follow that up with fillers . . . to raise those scars.
North Shore News: How long will those treatments last?
Jang: For some reason I found that even though theoretically those products are temporary, they can actually be very long lasting in people with acne scarring.
North Shore News: How expensive is it?
Jang: To do the cheeks it's $300 to $500 a treatment and you have to do four to six of them.
North Shore News: If left untreated, can acne be a lifelong affliction?
Jang: Acne burns itself out generally, so even without intervention most people's will gradually die off. That being said, we see lots of people who get acne for the first time in their 20s or in their 40s. Or some people who get teenage acne and then it settles down for a while and crops up in a slightly different form in their 20s. And then we have the odd person that gets acne in their teens, it never settles down and goes into their 20s and they're pretty sick and tired of it.
North Shore News: What about the emotional side of it?
Jang: Kids often come in even with mild or moderate acne with their hoodies on and their baseball cap over their faces and they're not really proud to show their complexion. So it does impact people beyond what we might think, particularly at a time when people are feeling quite vulnerable anyway about who they are.
