Wednesday 18 September 2019

Dear Dr Nina: My teenage son has terrible acne

Dr Nina Byrnes
Dr Nina Byrnes

Q. My teenage son has terrible acne, but he refuses to see the doctor about it. I suspect that there must be some pills that would help him. How can I persuade him to seek advice?

Dr Nina replies: Acne occurs in over 90pc of people at some stage of their lives. For most, this is during adolescent. However, for some, it can extend into or start in adult life.

So what causes acne? Hormones do play a role — the increase in androgens during puberty causes an increase in sebum secretion and makes congestion more likely. There is a genetic predisposition to acne, especially in male relatives. Stress can play a role, however, the exact mechanism is not known.

Bacteria in the pores can also make the situation worse, but acne is not a condition of poor hygiene.

There is no evidence that greasy food and chocolate can cause acne, but it is well known that a diet high in unrefined carbohydrates (ie. sugar) can make acne worse. Conversely, a low-GI diet can help improve the condition.

It is important to intervene with treatment early in the course of acne. Teenagers should not be left to “grow out of it” as scarring can be permanent.

A gentle conversation with your son as regards seeing acne as a treatable medical condition may help. Helping him avoid scarring is the ultimate goal.

Doctors see people all the time with skin problems, so please do reassure him that we are happy to help.

While he is deciding, some gentle advice may help him feel more in control. There are a few simple home rules: washing regularly will help clear sebum and shed keratin, but over washing exacerbates it. Wash twice a day. Bacteria can live on facecloths, so either use hands or a disposable wipe.

Squeezing pimples won’t get rid of them, but make them worse.

The treatment of acne lies in clearing the hair follicles, reducing inflammation and treating infection.

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