I've been dreading this moment.
January 8, 2014 8:05 PM   Subscribe

Jeoc jr. just turned 11, and is starting to get a few pimples. Both me and Mr. Jeoc had terrible skin as teenagers (and I still struggle with occasional breakouts and general skin texture issues). Her skin still has that luminous amazing child-like glow, but she has gotten a few pimples and her pores on her nose are clogged.

I don't want to make her self-conscious, but she asked for assistance/advice about how to care for her skin and deal with pimples and I'm not sure what the current state of the art is for these things.

She has tried a Burt's Bees tea tree oil stick and a generic OTC salicylic acid cream, but she found both painful. She is very low-maintenance about her appearance and even basic things like tooth-brushing can require nagging. So a regimen that is simple, appropriate for sensitive skin, and effective would be great.

I also feel like she is dealing with a genetic time-bomb, since both Mr. Jeoc and me had pretty bad skin as teenagers. My husband's skin is in pretty good shape now, but he definitely had some tough years. For me, the past 25+ years have been an ongoing dance of adjustment with a variety of products to try to keep things in balance. My skin is very sensitive to scarring and darker (in my case, redder) spots. I went to a dermatologist as a teenager, but the benzoil peroxide cream he prescribed burned my face and I would rather not have my kid on random antibiotics if avoidable. Has dermatology improved since I was a teen?

I have mostly made peace with the fact that my skin is kind of crappy and just deal, but if she has a shot to get through adolescence without scars and redness, I would love to give it to her.

tl; dr - tween daughter needs a simple and effective skin care routine for someone with sensitive skin and a strong genetic predisposition to breakouts and scarring
posted by jeoc to Clothing, Beauty, & Fashion (52 answers total) 20 users marked this as a favorite
I've used just about everything (and my experience was much like yours!) and the first thing that has made my skin perfect is this: Obagi.

You can do the three steps or just the face wash. For me, the face wash alone will prevent acne, but with the others the blackheads will also be under control. It's the first acne product that hasn't burned or hurt my sensitive skin AND also worked. The benefit to doing all the steps is that she could potentially catch it before it gets out of control. I would imagine that this (unlike brushing her teeth) would be something she is motivated to do, so long as it works.

Good luck. I've really tried everything and I wish I had this when I was her age.
posted by guster4lovers at 8:15 PM on January 8, 2014

So 11 might be considered too young for this, but I swore that if I ever had kids I wouldn't let them suffer with bad skin for years on end (like I did) and skip right to the Accutane. It's rough stuff, but worked miracles for me. Truly. If it's too early for that, what about trying something like Proactiv? It's got lots of steps, but maybe you could do it together - a mom/daughter routine?
posted by cecic at 8:15 PM on January 8, 2014 [14 favorites]

I struggled with acne for a long time and it was definitely a genetic thing. There wasn't much I could do to really prevent breakouts (until I took Accutane), but I did work out some ways to at least make it manageable.

I would suggest washing with a really gentle cleanser (Cetaphil) and moisturizing. I realized that a lot of my breakouts came from drying out my skin too much and it leading to an overproduction of oil. It seems counter-intuitive, but an oil-free moisturizer can go a long way. Also, I haven't tried this myself, but acne.org seems to have a really basic regimen that has helped a lot of people and it seems to consist largely of just using their cream regularly. It's made of benzoyl peroxide but maybe it is less harsh than the one you tried?
posted by thebots at 8:15 PM on January 8, 2014 [4 favorites]

First question: what exactly is she washing her face with? Because in my experience, allergic reactions and even just irritation beget pimples, etc., and I personally minimized breakouts almost entirely by using extremely gentle and minimalist cleansers on an extremely consistent basis. When my mom got a water softener installed, that also helped a lot.

I recommend against Proactiv, by the way. None of my friends with sensitive skin have been able to tolerate it at all, and my friends with lots of breakout issues but hardier skin have all said the effectiveness wears off before they run out of the product.
posted by SMPA at 8:16 PM on January 8, 2014 [1 favorite]

Just take her to a dermatologist. You know she will suffer for years with acne. I did too, until Accutane. She may not even need Accutane but you don't know that. I wish my parents had taken me. What a different face I could have had!
posted by ancient star at 8:19 PM on January 8, 2014 [39 favorites]

My mother put me on Retin A and I have much less scarring than my husband, who also had acne but got no medication. They do have better things than the stuff you were prescribed now.

I would talk to a dermatologist about your options before buying anything else. She might not need anything strong. You don't have to take their recommendation, but you need more information.

And I have been told that clogged nose pores are not necessarily infected...trying to obsessively clean them usually just damages your skin. And doesn't work.
posted by emjaybee at 8:23 PM on January 8, 2014 [1 favorite]

Teach her how to properly wash her face, getting into the creases of her nose, under her jawline, up by the hairline, etc. This made a big difference for me in early adolescence. Even now, I have sensitive skin that will reliably break out if I fall asleep without washing my face (regardless of whether I've had on makeup). I would try a cream-based acne cleanser, like one of the Neutrogena products with salicylic acid. For me once at night works great, as washing again in the morning just irritates my sensitive skin.
posted by aspen1984 at 8:24 PM on January 8, 2014 [1 favorite]

I would recommend going to a dermatologist you can get a personal recommendation for, and ideally someone who practices "integrative dermatology" -- these MDs are more likely to look into things like diet as well as generally seem to be more "with it" when it comes to new treatments. I'm an adult who has been through the lifelong wringer of treatments just like you, and I recently went to a new dermatologist and was surprised to be given a treatment to use that I had never even heard of. There is new stuff under the sun and good dermatologists are prescribing it more thoughtfully than they did 15 years ago (in my opinion).

As a teen I was very low maintenance too (even down to the toothbrushing reluctance!) so I never wanted to wear makeup, well into my 20s, but I wish now that my mom had at least set me up with a tinted moisturizer or something. Sometimes the best you can do, which is really not that bad, is to conceal the blemishes you have. BB creams are the new hotness, they're completely idiot proof to apply, and most have the added bonus of sun protection. A no rinse cleansing cloth is a good alternative for washing/makeup removal if there's resistance to that as well; I like the Simple brand.

With that said, acne is not the end of the world -- I had terrible acne as a teenager that has never completely gone away, but I made it through adolescence and beyond just fine. Lately it has been coming to light that longterm antibiotic use (e.g. for acne) and Accutane can cause or at least trigger autoimmune disorders, in particular ulcerative colitis. If anything like that runs in either of your families, I would be very, very wary of using either of those treatments.
posted by telegraph at 8:27 PM on January 8, 2014

If your daughter is into "simple," that might be to her advantage here - my mom went the opposite route, and as a result I blasted my skin with lots of really astringent products (like Ten-O-Six - ouch!) simply because my mom had used them when she was young and they were still available. She was also a makeup counter regular, which complicated my routine considerably in ways I'm only backing away from just now. I definitely had at least mild acne in my early teens, but I'm certain most of the fallout (like scarring) came from the cycle that thebots describes.

I emphatically second the advice from thebots and SMPA about sticking to cleansers (and moisturizers - if they're even necessary) that are as minimalist and gentle as possible. Cetaphil is a good one; Purpose is another option. Both are available at the drugstore, Target, etc. I also tried Proactiv, but found it to sting something fierce - I don't know how anyone with sensitive skin could continue to use it.

Of course, if her breakouts start to exceed what you or she feels is "normal" for teenage skin - or her comfort level - a visit to a dermatologist would be the best way to go.
posted by Austenite at 8:29 PM on January 8, 2014 [1 favorite]

The acne.org regimen and products might be helpful (does contain benzoyl peroxide, which some people find irritating, but others tolerate just fine...it is a lower dose than drugstore products and definitely much lower than whatever you were prescribed), though the steps seem a bit overly detailed.

Not irritating her skin is probably going to be the most helpful thing, overall, though. If she has sensitive skin, she needs a cleanser and treatment that will be very gentle, and probably a moisturizer as well. CeraVe products (hydrating cleanser and the moisturizer) are available at the drugstore and are very good for this. Cetaphil gentle cleanser and moisturizer is another similar option.

The makeupalley.com skin care board is great for questions like this and for product suggestions.

I personally would be wary of putting an 11-year old with very sensitive skin on Accutane or Retin-A, as both can make skin sensitivity and dryness worse, but that's why you would ask a dermatologist and not me.
posted by Ouisch at 8:29 PM on January 8, 2014 [3 favorites]

The thing about Accutane that would make me hesitate to recommend it for an 11 year old girl is that in order to get a prescription for it you have to prove that you are on birth control pills or are otherwise unable to bear children, as it causes severe birth defects. If your daughter is already menstruating then this could be an uncomfortable thing for her to deal with, and if anyone in her class finds out that she is on the pill at 11, they will fucking torment her and ostracize about it for the rest of her school career.

If she hasn't started her period yet, then go for it, if her doctor agrees that it's appropriate. But the birth control issue will come up as soon as she starts her period.
posted by elizardbits at 8:38 PM on January 8, 2014

I grew up with oily hair & skin + my dad had really bad acne in his teens.

I know this is kinda weird, but at some point in my teens I got SO frustrated, I started putting neosporin on my breakouts.

Instant healing. No scarring.

I know it's weird, but it's a trick I've used successfully into my 30's - and I have really really sensitive skin, very fair. Any scars would show, and the neosporin was just amazing.

Back in the day, I've been known to smear the emollient gel-type neosporin on 2/3'rds of my face (checks, forehead, chin) during a major break-out during my teens/20's, and it always worked.

Into my 40's, I still use a gently paste of baking soda to exfoliate and keeps my pores clean, especially since I left my teens and lost my patience doing weekly clay masks, etc. The baking soda mixed with a little water or moisturizers works better than any commercial productive I've ever tried. I think the baking soda might normalize the PH, it certainly never feels drying, FWIW.

So, that's what I did. It's easy to try and you'll know within a few days if it works or not.

I never use harsh soap on my face.
posted by jbenben at 8:38 PM on January 8, 2014 [1 favorite]

If I could have my time again I would turn to Paula's Choice for sure. Simple, effective products which do not contain any colour or fragrance and are gentle.

You can buy a kit or the individual products to suit. I am 30 and have very oily skin, whenever I have a break out I turn to Paula.

Do Google her and check out her website.

I don't think you need to consult a dermatologist yet, and the advice I hear people tell me that they got from the dermatologist makes me cringe.
posted by Youremyworld at 8:49 PM on January 8, 2014 [2 favorites]

The way you describe the "clogged pores" on her nose makes me think they are actually sebaceous filaments. These are normal and not a harbinger of bad skin or anything. Retinol clears mine up; a bha (salicylic acid) may also help. But try to have her resist the urge to squeeze them out or use pore strips as these can do more harm than good.

Paula's Choice (I'm having a devil of a time linking from mobile so it's http://www.paulaschoice.com/) has some really effective products, and their customer service is great if you just call them up and ask what they suggest (they will send samples, too). Warning, they may try to sell you a whole routine with 6-7 products, different things for day and night, weekly treatments... just emphasize to them that you want the bare bones routine. You can do without a toner for example, and if her skin is not dry she may not need a moisturizer.
posted by payoto at 8:50 PM on January 8, 2014 [2 favorites]

Ah, young me! With something akin to my genetics!


Nthing dermatologist visit. There are so many variables. And so many good treatments now, fortunately, but many are prescription-only (but in many cases, not harsh at all). There are new options out there that weren't for us...

(I started using Retin-A when I was about 12; a quarter century later I'm still using it. More than once I have had a "You're so lucky!!"-type response from a doctor, in re. quarter century of Retin-A use. Interestingly.)

I can't imagine a derm going straight to Accutane here, but when/if the suggestion comes up -- please take it. It is a miracle drug.

If you are not yet at the see-a-derm point, my recommendation, given the sensitive skin and low tolerance for fussy methods, would be acne patches. You used to be able to buy these everywhere in N America around the turn of the century, but apparently we didn't catch on, and they disappeared from shelves. But you can still buy them; they're apparently huge in Korea. This kind is a hydrocolloid covering -- when a pimple has popped and is oozing, you slap one of these on. Here's a medicated one. These have tea tree oil and salicylic acid. When you just need to spot treat and want to avoid fussing with the rest of the face, the patches are -- I have no explanation for why they disappeared from shelves here. Between rapidly shrinking (and keeping germs out of) the pimple, and giving it a hydrocolloid bandage to ooze into, patches even do wonders for scarring potential.
posted by kmennie at 8:51 PM on January 8, 2014 [1 favorite]

One thing I've discovered about Neosporin: it's a lot cheaper to try a thick cream or petroleum-based ointment (think in terms of pure Vaseline or Aquaphor) first. The major benefit I get from the stuff is that part, rather than the prevention-of-infections part.
posted by SMPA at 8:53 PM on January 8, 2014

Nthing take her to see a dermatologist. It hasn't been mentioned here yet but Differin is another great Rx option.
posted by hush at 9:08 PM on January 8, 2014

Please go to a dermatologist. My husband is still, in middle age, self-conscious about the damage done by acne that was treated as a moral failure and just in need of the right soap until he was too old to undo the damage. I, too, have enlarged pores that could have been prevented at 14 and were already pretty much set for life by the time I got help a few years later.

You can initially ask to go low-intervention, but let a professional at least assess and recommend a skincare regimen to start from.
posted by Lyn Never at 9:12 PM on January 8, 2014 [4 favorites]

If her skin is oily, a pillowcase made of terry cloth will absorb more oil from her skin than a regular pillowcase does (instead of her lying in her own skin oil all night) and also is super-cozy. Sometimes dermatologists recommend sleeping on a towel for this reason but it takes all of two minutes to just whip up a pillowcase from a big towel or terry cloth fabric.

It might make her hair more prone to tangling but she can always sleep with it in a ponytail or whatever.
posted by Eyebrows McGee at 9:22 PM on January 8, 2014

Pills and potions aside, I wish I had figured out much earlier what a big role towels and pillowcases can play in transmitting the bacteria that cause and/or worsen acne.

It's normal (and environmentally friendly) to re-use a bath towel between washes, but when you're prone to acne it's a really bad idea to shove your face into a towel that's anything less than scrupulously clean. Bacteria that would be harmless on your body can wreak havoc on your face, especially if your skin is already broken or irritated. Similarly, your pillowcase spends eight hours every night soaking up the oil in your hair and skin and probably the drool from your mouth, too. After a few days use, your pillowcase is really not a sanitary place to put a sensitive acne-prone face.

One thing you could do to support your daughter, without pushing her to use a lot of cosmetic products, would be to buy her a huge stack of new linen. Give her enough cotton pillowcases that she can change them every night if necessary. Provide dedicated hand towels to be used only for drying her face and which can be washed after every use. If her skin shows any benefit from the new routine, suck it up and tolerate the explosion in laundry that results (or enlist her to wash and dry it herself, with your support and encouragement).

I remember when I was that age, I was made to feel really guilty about producing too much laundry - both from a cost perspective and because it created more housework overall. Having explicit permission to be a little bit "wasteful" on this front during puberty would have made a world of difference to my skin and my confidence. If you're worried about making your daughter feel self-concious about her skin in particular, you could work this new routine into a larger discussion about how our hygiene needs change as we reach puberty.
posted by embrangled at 9:29 PM on January 8, 2014 [6 favorites]

Retin-A Micro worked miracles on my face when I was a young teenager. And my skin was truly awful. I regret all the time my family and I spent screwing around with over-the-counter crap. My skin was sensitive, too, so it was a bit of adjustment. Also, "worse before it gets better" is a massive understatement. But the Retin-A Micro was a lot easier on my skin than regular ole Retin-A, and it worked.

Here was the regimen my dermatologist put me on:

1) Wash face with very gentle, unmedicated stuff.
2) Wait for face to completely dry, put on tiny bit of Retin-A Micro.
3) Wash it off in the morning, put on sunblock moisturizer.
posted by Coatlicue at 9:39 PM on January 8, 2014 [1 favorite]

As she is so young, and you are at a stage where you might be able to start more of a preventative routine rather than treatment, have you thought of Oil Cleansing Method (OCM)? It sounds counter-intuitive for oily skin but for many people it works. A lot of people also use honey if there are acne problems.
I am not saying this for some hippy-dippy 'medicine is the devil' kind of reason - if it doesn't work, she may need to see a dermatologist - but often bad acne is as much that we didn't get a good effective skin cleansing routine before we hit our teens, and then were given bad advice to deal with it. So perhaps starting with something gentle might have long term benefits, and will not have the side effect of making her skin extremely sun sensitive.
posted by Megami at 10:27 PM on January 8, 2014 [2 favorites]

I have met at least two people who swear by Proactiv. They both said Proactiv worked after everything else didn't, so there's that.
posted by zardoz at 11:08 PM on January 8, 2014

Please take her to a dermatologist and be really, really thorough in investigating Accutane if someone recommends it. Accutane does work, but using it can cause damage to the lining of the stomach and reproductive organs. It is a serious drug and should only be used as a last resort.

Similarly, ProActiv can be a godsend, but it screws with the natural balance of the skin and can cause severe breakouts later if she ever goes off of it (this is part of the scheme to keep people subscribed to the company's automatic delivery service).
posted by These Birds of a Feather at 11:35 PM on January 8, 2014 [2 favorites]

Argh, you're going to get a million different answers, because that's what questions about acne seem to get. It's not a silver bullet. It's more like silver buckshot on a moving target.

I would talk to her first. Tell her that this might be A Thing, because of your family history, and tell her how you felt about it, and how Daddy feels about it. Because even you guys have different experiences.

Let her have at least a minimal choice in the matter—don't just haul her off to the dermatologist (even though my brain/experience is screaming to) because doing that might instill some negative pressure that might be actually worse than the acne itself.

And beside - dermatology, in my experience, can be trial and error. What is a magic drug for one person can be the absolute worst for another. Make sure she actually even cares, and is willing to go through the endless appointments that may or may not help.

Reassure her that she's a gorgeous fucking person, regardless of what her skin looks like, because she is.


What didn't work for me: Retin-a, Tazorac, gentle washes, the Oil Treatment so loved by MeFi (sorry...), tea tree oil, anything OTC from the drug store.

What did work for me, somewhat: Proactiv (keeps it really under control, but never seems to actually clear it up and I'll never be able to stop using it, it seems), sea salt toner/spray (just mix some sea salt and bottled water)

What WICKED worked for me: cortisol injections to cysts (which can leave scars on the cysts she hopefully doesn't have), and antibiotics (which she'll hopefully never need)

What I'm irrationally or possibly rationally scared of: Accutane (Anything that makes me go on birth control is a no-go, as it makes me absolutely batshit nuts)


See? It's individual. She's almost nearly old enough to recognize that's she's an individual about her self-care, and should have some say. I'd say DEFINITELY at 13, 11 might be a little early.

If she's cool about going to the dermatologist, find a really nice, non-judgemental one who listens well and will treat her like a relative grown up. One who will level with her that this might take some work.

Good luck! Tis time for grownup talks. I wish I'd had a few. :)
posted by ulfberht at 11:36 PM on January 8, 2014

If it's just a few pimples with otherwise "luminous, amazing" skin, save the big guns for later, if/when the monstrous breakouts do occur. In the meantime she can learn a gentle cleansing routine, and good habits like not touching her face too much, keeping her bangs clean, changing her pillowcase frequently, and if she wants to wear makeup - always remove it before bed! At this stage a simple topical pimple cream might be all she needs to reduce them.
posted by Naanwhal at 12:56 AM on January 9, 2014 [2 favorites]

Cetophil is what has worked best for me. It's not harsh in any way. The reason it works is because it is pH balanced. You can get it at most drug stores or grocery stores in the US, if that's where you're at. I didn't discover it until I was in my late 20's and was past the worst of my acne years, so I don't know how it would work with a bad case, but if I could go back in time to when I was a teenager it would be the first thing I would try.
posted by sam_harms at 1:03 AM on January 9, 2014

Seconding the Oil Cleansing Method -- it's the only thing that's consistently worked for me. Her skin sounds somewhat similar to mine (from your brief description) -- I use a 50/50 castor blend, and follow it up with a soybean and vitamin E oil as moisturizer. To be honest, I think most of my adolescent skin problems came from dehydrated skin and allergic reactions to harsh cleansers.

I've found Caroline Hiron's blog extremely clear and helpful, and she's yet to steer me wrong.
posted by femmegrrr at 1:39 AM on January 9, 2014

I agree with Naanwhal: don't break out the heavy stuff right away. She may not have genetics on her side, but that doesn't guarantee she'll have serious acne. If she's getting one pimple at a time and going days or weeks without any, and if the pimples aren't the super-painful deep cystic kind, she doesn't need the dermatologist just yet. Start with gentle cleansers, spot treatments when needed, and keeping linens clean. And, disappointingly, patience: overtreating a pimple doesn't make it go away faster, and often leaves dry flaky skin in its wake.

If the breakouts get more severe, by all means, see a dermatologist. Just not yet.
posted by Metroid Baby at 4:31 AM on January 9, 2014

A good dermatologist will start with the most gentle treatments and work up to the nuclear option. I think it took well over a year of stuff not working before our dermatologist recommended Accutane. The stuff works. My son's skin cleared up and stayed clear. Our daughter has been able to control hers without ever resorting to the Accutane option. I think the key factor is having a dermatologist willing to keep trying until you find something that works, or decide it's time to drop the Accutane bomb.
posted by COD at 6:03 AM on January 9, 2014 [1 favorite]

Start with the regimen at acne.org.

But personally, I'm with all the people who suggest nuking it from orbit with Accutane. I wish my parents had done that for me in my youth. My kids are younger, but I expect them to be in the same boat in a few years and I want to save them from years of suffering.
posted by ellenaim at 6:22 AM on January 9, 2014 [1 favorite]

I had severe acne growing up in high school. I tried ProActive and some other cheap acne remedies, like Benzoyl Peroxide but none of them worked. Accutane worked.

She may also try eating more spinach and try Beta Carotene supplements for a bit. If I my skin gets too oily, I dry it out with spinach over a few days.
posted by DetriusXii at 6:40 AM on January 9, 2014 [1 favorite]

I had acne in middle and high school that at the time seemed like The Worst, but in actuality was Not That Bad, though it didn't really completely go away until I was around 18. I was definitely pimply, but they were always just garden-variety zits (nothing major/cystic) and there was no scarring. I found many of the treatments other commenters have suggested to be way too strong for me - they caused my skin to burn and flake. To be honest the only thing that really ever worked for me was waiting patiently (hard when you're a teenager!).

As a couple others have noted, there's no guarantee she'll have a serious case of damaging acne. My suggestion would be to implement a gentle skin care routine (Cetaphil or another mild cleanser, plus a gentle moisturizer if necessary) now and visit a dermatologist if things get worse. Honestly, most teenagers get zits, and unless the acne turns out to be truly awful, I don't see the value in making A Thing out of it.
posted by schroedingersgirl at 7:02 AM on January 9, 2014 [1 favorite]

Oh, and forgot to add-- I've had really terrific success with Lush skincare products. If you want to try something still gentle but a bit "fancier" than drugstore brands, give it a shot. I like Coalface and Fresh Farmacy for cleansing, and Greased Lightening for the occasional spot.
posted by schroedingersgirl at 7:04 AM on January 9, 2014

Adding to your varied responses, I've had success with Differin, Retin A, Paula's Choice and diet and pretty terrible results from everything else.

Paula's Choice - The Paula's Choice website has incredible information about acne and some recommendations for products other than Paula's Choice. You can't go wrong here.

Diet, diet, diet! - I am very surprised at the few comments about diet. My dad told me when I was 15 that dairy caused breakouts and it took me 15 years to believe him. When I remove dairy from my diet (allowing the occasional yogurt and cheese but NO daily drinking of milk), the inflammation from breakouts disappears. I've tested this repeatedly. I find now that if I go on a no dairy, no grains, no sugar diet that my skin is the best it ever has been. Recent research on inflammation backs up my dad's story and these results.

Lastly, regardless of what else, I agree with scrupulously clean towels and pillow cases. I also stay away from anything that hasn't worked for me in the past and am extremely careful about putting anything on my skin so no experimenting with new face makeup or soaps or even laundry soaps. There is one sunscreen I use (Obagi) on my face and while it isn't perfect it is the best I've found for not drying out or breaking out my skin or giving me an instant rash.

Good luck and good on you for taking this care. I wish my mother had done the same.
posted by RoadScholar at 7:11 AM on January 9, 2014

Please, please, please take her to a dermatologist straight away!!!! Shop around for a great one, if possible.

My 12 year old just had her first derm appointment, and the doctor assured us that it was the absolute best thing to be treating this medically right from the beginning. She says that this early teen acne does not cause scarring, it's the acne of the later teen years that does. And if she gets it treated now, it could greatly reduce/prevent bad skin in those later teen years.

In the meantime, she needs to start a face care routine. Morning and night. Have her wash with a gentle cleanser (dove unscented bar) just using her fingertips to massage the cleanser into skin (no scrubbing with a facecloth or anything). Then after patting dry she needs to apply benzoyl peroxide cream/gel (start with 2.5%) to all the affected skin areas where she is getting the pimples. Like nose, chin, forehead, wherever they are. Don't just apply to already established blemishes, but the whole area where they seem to appear. (She can add a toner/astringent step in the middle of these two, if it doesn't dry her skin too much. My daughter likes this step the best as she says it make her skin feel great/clean). Regardless she must do at least the cleanser and benzoyl peroxide twice every day. It might dry her skin out at first, but stick with it. An unscented oil free moisturizer can also be used if necessary.

The routine of doing it twice everyday is very important, acne is a constant battle. She will probably soon be personally motivated enough (social/peer influences) to do these steps herself everyday, even those you say she is low maintenence. In the meantime, you can be the one encouraging/supervising her to make sure it gets done.

As they (whoever they are) figure that acne is mostly genetic, your daughter has a double whammy if both you and her father were afflicted. Anyone who says acne is not that big of a deal has obviously never had really bad acne. It can be awul and life altering. Please get her started on a good medical regimine as soon as possible to battle this!

Memail me if you want to commisterate over this issue, my daughter is facing this as well.

Good luck.
posted by fourpotatoes at 7:27 AM on January 9, 2014 [3 favorites]

The only thing that's ever worked for me is swabbing my skin with pure tea tree oil when I've had a break-out. That clears it right up.
posted by Polychrome at 7:51 AM on January 9, 2014

I would agree with the dermatologist route if there weren't so many who did their work badly.

I have recently started going the simple way with just a mild cleanser (find out what your daughter likes and what her skin tolerates best) and Avene Cleanance K at night, which mildly peels the skin to get rid of old skin cells and thus - hopefully - prevent breakouts. It seems to be the most effective method for me, but when I'm stressed or eat too much junk, I will break out nonetheless. I guess that's just life.
You could have your daughter try this kind of routine (I think brands other than Avene make similar creams), but she should be using a sunscreen during the day if she does. (Which I guess she should be doing anyway if you can find one that does not break her out.)

Good luck!
posted by LoonyLovegood at 8:33 AM on January 9, 2014

If she's got great skin, with a few clogged pores and pimples, I don't think seeing a dermatologist is necessary yet.

I had pretty great skin as a teenager, with occasional breakouts. I tried some pretty aggressive stuff, like oxy pads and astringents and crap that irritated and burned my skin. Eventually I discovered that my skin was happier and I got less breakouts if I stopped most of the stuff I was trying. Cetaphil for daily washing and a spot treatment cream with salicylic acid for pimples and blackheads worked well for me.
posted by inertia at 10:30 AM on January 9, 2014

I am an educator and I work with some of the most privileged teenagers in the country. When I first got here, I looked around and I was like, "How the hell are all of these kids so goddamned good-looking?" And then I learned. When I was a teenager, surrounded by other teenagers, our natural skinniness and smooth, unlined faces were offset by breakouts and greasy hair and the other torments of youth, the way God intended (joke).This simply is not true anymore. I swear to God, I haven't seen a person with more than an isolated pimple in more than five years of working here. Why?

Acne is curable now.

Yes, it costs money. Yes, it takes time. Yes, you might have to try more than one treatment, and even more than one dermatologist, before you figure out what works. But if this is something you care about, please do not waste a single second screwing around with a bunch of over-the-counter pads and old home remedies. Find her a doctor and keep going to appointments until it's fixed. Things are different than when we were young, and things have changed so rapidly that most suggestions you're going to get on this website are based on outdated information. There are really effective solutions out there, of which most adults are unaware, because they didn't exist when we were young. Go find them.

Edit: Oh, and obviously a good dermatologist isn't going to jump straight to Accutane. You don't have to figure out what medication your daughter's system can handle - that's the job of her doctor. All you have to do is find her a good one.
posted by pretentious illiterate at 10:53 AM on January 9, 2014 [5 favorites]

Eleven is still too young, but birth control is the magic thing that finally cleared me up when I was in my late teens. We'd done over the counter everything, tons of lectures about washing/toning/moisturing (which I did, despite my parents' disbelief), and even multiple prescription medications from a dermatologist, and nothing really completely worked.

Now that I'm an adult, I *stay away* from all the salicylic acids and harsh acne cleansers and just use mild cleansers, clean pillowcases, and the aforementioned birth control. It doesn't even seem to matter which type of pill or patch, as long as I have something hormone regulating. Apparently for me acne is 80% hormonal, and that's why so many other things failed. Had I known this earlier, I would have put teenage me on whatever pill I could tolerate, rather than the multiple useless dermatologist visits, harsh medicines/cleansers, and years of embarrassment.

So, for now, I'd go the mild cleanser and moisturizer with a clean pillowcase route, but keep the hormonal thing in mind when you consult with a dermatologist. I cannot emphasize enough how many things we tried that didn't work before finding that out.
posted by wending my way at 10:55 AM on January 9, 2014 [3 favorites]

Please don't jump into putting an 11-year-old child on an intense drug like Accutane because she's had one breakout.

I would urge you to try simple over-the-counter remedies first, and go to a dermatologist if needed. Perhaps later she will want Accutane, but she doesn't seem to care that much about her appearance yet, and that's a really lovely thing.

Please also be aware that teens and pre-teens pick up on their parents' anxieties. So if you make her breakout into a big thing and become anxious about it, she'll pick up on that and likely become anxious about any future breakouts. I'm not trying to diminish how difficult acne can be...but but best gift you can give your daughter would be confidence in herself that has nothing to do with her looks or the clearness of her skin in a given week. Sorry that sounds kind of preachy - I just felt like this thread could send your family down a rabbit hole of a million different treatments to try - when what is really required right now is a bit of patience and perspective.
posted by leitmotif at 10:55 AM on January 9, 2014 [4 favorites]

Amen to what @pretentious illiterate said. People of means waste no time messing around. They head straight to the dermatologist, and that's why their kids' faces are not permanently acne-scarred.
posted by hush at 11:36 AM on January 9, 2014

Why don't you try an elimination routine. Like start by washing the face 2 or 3 times a day with only water. Is he skin oily? They try a little bit of oil cleansing or a pinpoint drop of gentle cleanser. IS it dry and flaky? Then moisturize it (i'd use a regular moisturizer with oil) and wipe a wet facecloth over it a few times a week to exfoliate. Try to establish a very simple baseline hygiene (and diet!) regimen before whipping out PRODUCTS!
posted by WeekendJen at 12:08 PM on January 9, 2014

A few years ago, when I was already in my 30's, I decided it was finally time to stop having acne. AskMe lead me to Paula Begoun's book, but I understand that it is out of print, and her website is where she publishes her current information.

I learned that I was treating my skin too harshly, by having facials, using professional grade acne-cleansers, and the like. I stopped using harsh products, and instead began using Cetaphil. My acne cleared up within a week. After a while, I even stopped using Cetaphil every day, and usually just wash my face with warm water.

As someone else mentioned above, I later figured out that I have a couple of food allergies that will cause me to break out - milk, as someone mentioned above (I drank a sh*t-ton of milk as a teenager, as well as ate tons of cheese), and almonds.

Also as mentioned above, if I have a blemish now I usually put bacitracin on it (the generic form of neosporin), it is usually gone by the next morning.

So, my advice is to start with diet and mild cleansing techniques, before going to heavy-duty, expensive drugs. Just, if you are going to limit her milk intake, be sure she is getting calcium from another source, as this is the time that her bones are growing, and you don't want her bone density to be compromised.
posted by vignettist at 12:49 PM on January 9, 2014

When I was about that age, I had horrible skin as well. Neither of my parents had dealt with this, so it was all a mystery. The dermatologist eventually put me on Accutane, and it almost all has gone away.

I used the acne.org regimen to get things back into shape about 5 years ago (when I was in my early 30s), but other than that, I haven't had any real problems with my skin since Accutane. (IANAD, etc)
posted by getawaysticks at 5:32 PM on January 9, 2014

Wow. Lots to take in here.

My husband's brother took Accutane, and he has really nice skin now. But he was in his late teens and I cannot imagine doing an Accutane and BC pill combo with her at this point, especially since she already takes an inhaled steroid. The breakouts are very isolated and mild.

The dairy stuff is disheartening, since she's a picky eater who basically lives on cheese and huge glasses of milk.

The clean pillowcase and towel is a good reminder - one I need to get better about heeding myself.

Proactiv did not work for me. I found it very hard on my skin and found that things actually got worse with it. Hormonal contraception was also not a help to me. I could probably benefit from going to a dermatologist myself, now that I'm thinking about it.
posted by jeoc at 8:18 PM on January 9, 2014

Keep your child well clear of 98% of the teen skin care aisle at the drugstore.

Benzoyl peroxide (with a low %, like 2%, and just the treatment lotion, not the wash) and salicylic acid (same %, same rule) have a long track record and work well for many. Anything other than those two things should be regarded with caution.

Stay away from anything minty, tingly, or burny. Manufacturers make these concoctions to satisfy to self-loathing teenagers that they are destroying their pimples (the tingling is I think supposed to function as evidence). But the ingredients that do that are either useless or actively harmful. Neutrogena is one of the worst offenders - they have one product that's decent, the rest amount to dermo-terrorism. Too many others to list. Definitely refer to makeupalley, they know their stuff. I wish that site existed when I was a teen determined to remove the first two layers of my face.)

I personally like Cerave cleanser (gentle, effective), but of course everyone's mileage varies with this kind of thing. Otherwise, a dermatologist greatly helped me. (But others definitely didn't. Research, get opinions, for sure.)
posted by cotton dress sock at 11:17 PM on January 9, 2014

Jeoc, not to go too far off track, but the unsweetened almond milks and even unsweetened vanilla almond milks are pretty darn good. I think switching to a non-dairy milk may not be as bad as you think. Mine put up a big dramatic fuss but I call it Almond Juice so they aren't thinking exactly dairy milk and they drink it. There could also be a transition period of half almond mixed with half dairy. I remember as a teen switching from whole to 2% to skim (before it was called fat free) and the trauma and then a couple days later forgetting the whole thing. The sweetened Almond Milks taste like milkshakes to me though bring in another issue of sugar. This switch would be easier now at 11 since you are buying all the milk unless she is buying it for lunch at school.

Again, good for you to take care of this. I agree with finding a good dermatologist but I don't think the derms talk much about diet similar to some regular doctors prescribing cholesterol or blood pressure meds before even suggesting that one exercise for example. The acne is an indication of inflammation that if reduced is a benefit to the entire body not just the skin. Though the topical acne meds are great. I initially even went on a low-dose oral antibiotic in my 20s. I am in my 40s now and am still working on this issue too.
posted by RoadScholar at 6:11 AM on January 10, 2014

I'm kind of concerned by all the comments recommending that you eliminate dairy from your 11-year-old daughter's diet. Some commenters may have noticed a link between their own dairy intake and the condition of their own skin, but this isn't really evidence that that dairy causes acne or that avoiding dairy can prevent it. Any concious change in diet can seem to "cause" subjective improvements to health, particularly at first, simply because paying more attention to what we eat means we're less likely to absentmindedly eat junk. But if you're going to do something potentially risky, you need a lot more evidence than "oh, it seemed to work for me". And eliminating a whole food group during adolescence is risky. Doing this without good reason and ongoing professional supervision could set your daughter up for a life of poor bone density and potentially osteoporosis in old age. I'm not saying eliminating dairy is never helpful (I'm lactose intolerant myself and have made doctor-approved dietary changes as a result), but please don't make any major changes to your daughter's diet unless both a dietician and a dermatologist agree that they are necessary. Try the low-risk stuff first.
posted by embrangled at 11:22 AM on January 10, 2014 [6 favorites]

nthing dermatologist visit, and also acne.org. i've been using their benzoyl peroxide since 2008 and it's the only thing in my life that's cleared up my skin.

When I was a kid with terrible acne (all through middle school/high school and beyond) the thing that scared me most in the world was the idea that with some new regimen "it has to get worse before it gets better." I remember that phrase from when my mom took me to the dermatologist at around 12 and they suggested Retin-A for me (or maybe it was Differin?) -- anyway, I resolutely didn't use the stuff because I was SO HORRIFIED about the idea of my skin getting worse than it already was.

So... maybe keep that in mind in terms of her reaction to potential solutions the dr offers.
posted by eleutheria at 11:58 AM on January 11, 2014

Nthing moisturizer and food sensitivities, and possibly soap/sodium lauryl/laureth sulfate sensitivity. I never got bad all-over acne, but instead would have one or two epic, painful cysts. I also have epically sensitive skin. Other ideas:
- If pimples itch or hurt, you will touch them, which will make them worse. OTC topical anaesthetic (I found the polysporin cream with benzocaine or whatever) worked, not for the antibiotic so much as the mild numbing. Get the cream, not the oily ointment. This also makes it easier to forget it's there and be less self conscious, which is impossible when you can literally feel it.
- There are different strengths of salicylic acid, and face washes or toners with even milder concentrations. It works, but you do have to calibrate it to your skin's sensitivity. Ditto tea tree oil.
- If her acne gets really bad, make sure her doctor checks her hormones are all where they should be, as acne can be a symptom of some imbalances.
- I found taking essential fatty acids makes a huge difference to my skin, although now that I'm older I tend to break out in hive-y rashes where it used to be zits. This can be addressed by diet rather than supplements, I'm just lazy. Also: hydration.
- Being very careful about makeup. On the one hand, less is more, and on the other, having recourse to concealer in an emergency is a nice safety net. I would recommend Cover FX, which was developed starting, IIRC, in conjunction with a dermatology clinic at a Toronto hospital to cover scars.
- Sunlight! She'll need to invest in a good, hypo-allergenic non-clogging sunscreen for the rest of her life, and again, a little bit goes a looooong way, but a moderate amount of sunlight makes a huge difference.
posted by sarahkeebs at 5:16 AM on January 13, 2014

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