AcneNet Article
Early Acne Often Predicts Severe Acne

When acne begins early, between 8 and 11 years of age, it often means severe acne as a teenager. Treating the acne before it becomes severe can:

  • Prevent severe acne

  • Reduce the risk of acne scars

  • Avoid lifelong emotional stress

Studies Confirm Link Between Early Acne and Severe Acne
Two large-scale U.S. studies looked at how acne develops during adolescence. One of these studies evaluated the severity of acne in 468 boys who ranged in age from 9 to 15 years. About half of the boys were African-American and half were Caucasian. The researchers found that acne becomes more common and more severe in adolescent boys as they mature. The researchers concluded that keeping an eye on acne in preadolescents and young adolescents can help determine when treatment, which can prevent severe acne from developing, should begin.

To expand upon these findings, the researchers evaluated acne in girls. This study followed 871 girls for 5 years. Again, about half of the participants were African-American and about half were Caucasian. At the beginning of this 5-year study, the girls were in 4th or 5th grade. Following the girls over a five-year period showed results similar to the previous study. The researchers found that the number of acne lesions and the severity increased as the girls matured. The girls who had significantly more acne lesions at age 10, when the study began, had the most severe acne at age 15. The researchers concluded that the best way to predict how severe acne will be at age 15 is to determine the severity at age 10.

Early Treatment Helps Prevent Physical and Emotional Scars
When acne is severe, large, red bumps called “cysts” form. Cysts can be painful and may cause permanent scarring. While not life threatening, these physical effects often cause extreme emotional distress that can last a lifetime.

Anxiety, loss of self-esteem, and depression are common in people who have acne. Even mild and moderate cases cause emotional distress. When asked to talk about how acne affects them, patients often mention feelings of inferiority, embarrassment, and depression. One teenager said, “I was more self-conscious about my skin, and at times very shy because I felt my acne made me very ugly.” A college student confessed that he avoided asking girls out because he thought, “She won’t be interested because of how I look.” Another patient confided, “I got severely depressed, and sometimes I wouldn’t go to school because I had a particularly large pimple, and I just didn’t want to be seen like that.”

Severe or long-lasting acne can cause feelings of insecurity that last a lifetime. One study found that people who had acne for a significant amount of time tend to feel “scarred for life.” Long after the acne clears, they may have low self-esteem and feelings of inferiority.

To avoid these physical and emotional scars, dermatologists recommend that early acne be properly treated and that treatment continue for as long as necessary to prevent the acne from recurring.

How Dermatologists Treat Early Acne
Today, there are a number of effective acne treatments and virtually every case of acne can be controlled. However, what clears one person’s acne may not work for another person. This is why appropriate treatment begins with an evaluation by a dermatologist.

During the evaluation, the dermatologist will determine the severity and types of acne lesions present. The doctor may ask questions to learn how the acne affects the patient. Sometimes the acne worries the parents; however, a young adolescent may not be concerned about appearance. The dermatologist also will want to learn if the patient is willing to follow an at-home treatment plan.

After the evaluation, the dermatologist will decide what, if any, treatment is appropriate. For a young adolescent who has mild acne, the dermatologist may prescribe a low-dose topical retinoid or benzoyl peroxide. It is important to realize that appropriate treatment may require more than one medication. Sometimes a topical antibiotic is part of the treatment plan. Severe acne may require an antibiotic in pill form as well as topical medication.

Proper skin care plays an important role in acne treatment. The dermatologist can provide tips for taking care of acne-prone skin as well as provide product recommendations for everything from cleansers to sunscreen. 

Using Medication as Directed Gets Results
To get clearing, acne medication should be used as directed. Some medications must be taken daily; others may be used intermittently. Before leaving the dermatologist’s office, be sure that you understand how to use the medication and when to use it.

If using the medication as directed becomes a problem or the treatment plan does not seem to work, be sure to tell your dermatologist. There are many effective treatments available today.

It is important to realize that acne cannot be cured, but it can be effectively controlled.  Keeping acne under control may require long-term treatment. Acne often returns when treatment is stopped, so continue to use your medication until your dermatologist tells you to stop. This helps prevent new acne lesions from forming.

A Lifelong Difference
Acne sometimes appears earlier than parents expect. If early acne develops, teaming up with a dermatologist can help keep acne from becoming severe as well as prevent physical and emotional scars. Preventing severe acne can make a difference that lasts a lifetime.  

References:
Eichenfield LF et al. “Acne and Your Pediatric Patient: A Roundtable Discussion of Treatment Modalities and Other Factors.” Cutis. 2005 November;76(5S):5-17.

Koo J. “The psychosocial impact of acne: Patients’ perceptions.” Journal of the American Academy of Dermatology. 1995 May;32(5 Pt 3):S26-S30.

Leyden JJ. “A review of the use of combination therapies for the treatment of acne vulgaris.” Journal of the American Academy of Dermatology. 2003 September;49(3):S200-S210.

Lucky AW. “A Review of Infantile and Pediatric Acne.” Dermatology. 1998;196(1):95-97.

Lucky AW et al. “Acne vulgaris in early adolescent boys. Correlations with pubertal maturation and age.” Archives of Dermatology. 1991 February;127(2):210-216.

Lucky AW et al. “Predictors of severity of acne in young adolescent girls: results of a five-year longitudinal study.” The Journal of Pediatrics. 1997 January;130(1):30-39.

White GM. “Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris.” Journal of the American Academy of Dermatology.1998 August;39(2 Pt 2):S34-S37.


All content solely developed by the American Academy of Dermatology

 

 

 
 
 

 

 
 

 

© American Academy of Dermatology, 2011  All rights reserved.
 

Disclaimer         Copyright Information