Acne Tips I Wish I'd Known As A Teen

A classmate from grade school recently DM'd me, asking if I’d write a MediumBlonde post on how to create an effective anti-acne skincare routine for teens. And while MB is not a parenting blog, I figure most of us probably do (or will soon) have a teen or two in our lives (son, daughter, niece, nephew, grandchild, even a friend) who could use help combating acne without wrecking his or her skin.

But, first a quick disclaimer: I’m not a dermatologist. Or an esthetician. I have, however, been researching and writing about skincare for more than twenty years, I've created a regimen for my own almost-fourteen-year-old son (and so far, so clear), and I myself battled acne the wrong way for so many years, I know, at the very least, what not to do.

So, based on the above, this is how I’d treat my skin if I was 16 again:

Be proactive, not reactive I believe that fighting acne is similar to most anti-aging strategies: It’s much easier to prevent breakouts (or, to continue the analogy, sunspots or fine lines) than it is to get rid of them.  Thus, my strategy with Heath was to start him on a salicylic acid product at the age of 12, the second I saw tiny whiteheads on his nose.

Salicylic acid is an oil-soluble, beta-hydroxy acid that travels down into pores, dissolving the excess oil that causes skin cells to stick together and create clogs. You can find salicylic acid in lots of cleansers, but I believe, for real results, you need to up the ante to a salicylic acid product that stays on the skin overnight, like a toner, peel pads or a serum. My choice: Juice Beauty’s Blemish Clearing Serum, which contains salicylic acid but is free of potentially-irritating ingredients like parabens, sodium lauryl sulfates and artificial dyes or synthetic fragrances. While I don’t actively seek out “natural” options for my own skin, for Heath, I'm admittedly more cautious. He applies this serum every night before bed.

Cleanse but don’t strip This is a big mistake I made as a teen. In a desperate attempt to ensure my skin was super clean, I washed up to four times a day with St Ives Apricot Scrub. Problem was, doing this removed so much oil that my skin got tricked into thinking it was seriously dehydrated—and began gushing sebum and clogging pores faster than I could strip the oil away. 

So, I have Heath wash just once a day, at night in the shower, with Juice Beauty’s Blemish Clearing Cleanser. (In the morning, he just splashes his face with water or takes another shower and rinses his face. I do not have him use a cleanser again in the morning because I feel strongly about not overdoing it). Anyway, the Juice Beauty formula cleans thoroughly (and it will take off makeup), but it’s surprisingly gentle. There are other cleansers that work well too, such as Yes to Tomatoes Detoxifying Charcoal Cleanser, Shiseido Ibuki Gentle Cleanser and La Roche Posay Effaclar Purifying Cleanser. One cleanser I‘d avoid, however (even though lots of dermatologists like it), is Cetaphil. I just don’t think it cleans teen skin thoroughly enough.

Use a second acne-fighting acid in the a.m. Dennis Gross, MD, a New York City dermatologist, once told me that his Alpha Beta Peel Pads contain a variety of acids (salicylic, glycolic and malic acids) because each acid deep cleans and exfoliates in a different way and putting them all together provides a better result. This makes sense to me. So, in the morning, Heath wipes a glycolic acid pad over his face, focusing primarily on the T-zone and along his hairline where he's most prone to pimples. Glycolic acid helps inhibit the growth of p. acnes, the bacteria that causes acne, and it helps remove excess dead skin cells which can accumulate and clog pores. Heath uses Beauty Rx Peel Pads because they contain only glycolic acid; again, I’m conscious of not overdoing it. However, as Heath gets older and puberty has its way with his hormones, we may upgrade to  Dr. Gross’ multi-acid pads.

Note: If your teen has relatively clear skin, and using a salicylic product at night is doing the trick, you can skip this morning step. Remember, overdoing it just as bad as doing nothing at all. But Heath has two parents who were on Accutane in their late teens, so we opt for the extra acne ammunition.

Moisturize, at least some of the time It seems counter-intuitive at a time when skin is at its oiliest to insist on moisturizer. But acne products, as they remove oil, dead skin cells and bacteria, can also inadvertently break down the skin’s barrier function (that’s the part of your skin’s outermost layer that keeps moisture in), so it’s important to, at least two to three times a week, apply some oil-free moisture. That said, Heath hates moisturizer, and I usually have to chase him down and slather it on while he protests. Hopefully your teen is more cooperative. But it’s imperative that it gets done (even under duress), as it’s the best way to prevent inflammation and sensitization, both of which can make acne look worse and last longer. On Heath, I use Elta MD Clear SPF 46. I also like Neutrogena Oil-Free, Ultra-Gentle Moisturizer and Juice Beauty Oil-free Moisturizer.

Be strategic with shampoo Most of Heath’s breakouts are along his hairline, where his hockey and lacrosse helmets are tightest and trap bacteria. So, about two months ago, I had him start using Yes to Tea Tree and Sage Oil Shampoo and Conditioner because tea tree oil has anti-bacterial and anti-fungal properties and gives those breakout-prone spots an extra-deep cleaning. This has already made a noticeable difference.

Dial down the dairy When I was at Shape magazine in 2008, I was writing a piece on acne and came across a study in Journal of the American Academy of Dermatology that suggested there might be a link between dairy consumption (skim milk was specifically cited) and the incidence of acne in teen boys. The study concluded that the hormones in cow’s milk impacted the endogenous hormone levels in teens, exacerbating acne flare-ups. This made sense to me. I drank a lot of (Strawberry Quik-spiked) milk as a teen, as did my husband and my younger brother. We all ended up on Accutane. Now, this is not to say all teens who drink milk will end up on Accutane—or even that all milk-drinking teens will suffer from acne. But if your teen has a genetic propensity to breakouts, steering clear of large glasses of milk with every meal may be a good idea. Because of his family history, Heath does not drink milk at meals (he drinks water), and in his cereal, he has almond or coconut milk. He does eat pizza and cheese on his burgers (we're not fanatics), but whenever possible, we opt for nondairy.

Consider sulfur instead of benzoyl peroxide My parents probably spent a small fortune on Clearasil in the 1980s trying to help me heal my pimples. Then they spent even more money replacing all the pillowcases it bleached. I’m not a fan of benzoyl peroxide. In fact, I think BP may have made many of my pimples last longer because I’d slather it on so diligently that it dried and hardened the skin above and around the bumps, making it difficult for clogged pores to open and drain (gross, but true). I believe a much better spot treatment is a powder that contains sulfur to gently dry—plus zinc to calm inflammation, reducing redness and swelling. My favorite is tinted Bare Minerals Blemish Therapy powder, but it’s being discontinued (!!)  so buy it up while you can. I just bought four here. Juice Beauty makes something similar and Mario Badescu makes a non-tined version: Special Healing Powder.

Final note: if your teen’s acne is well beyond the prevention stage, and he or she is plagued by cysts and nonstop flareups, please see a dermatologist. There are lots of good in-office options that weren't available when we were teens, like professional-strength peels, blue-light therapy, and a variety of Rx retinoids that are far easier to tolerate than the aggressive, full-strength Retin-A we endured in the '80s. As I stated above, getting a head start on acne is key; beyond that, the goal is to keep it under control. Accutane is a last resort, and one I think I could have avoided had I followed an approach like the one I've outlined here. Good luck!