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Teenage Acne and Facewashing
Q: My 14-year-old daughter has recently developed significant acne on her face. She has tried the over-the-counter benzoyl peroxide treatments, but that just made her skin red and dry. She is trying a new cleanser that a friend recommended, and washes her face three or four times a day. I told her that I don't think it's good to wash her face so much, but whenever I offer advice, she gets upset and says that I'm being too critical. What do you suggest?
There are really two issues in your question. The first relates to the science of acne. It flares in the adolescent age group because of the hormonal changes that occur in that time. It is not caused by dirty skin, though there is a type of bacteria that likely plays a role in the severity of acne, and that is why some teenagers are helped by antibiotics. The first step in treatment usually is benzoyl peroxide and /or retinoic acid cream.
Washing the face frequently is generally not helpful as you suggest, and this leads us to the second issue. Teenagers can be very self conscious, and advice from parents (who they are struggling to be independent from) can be interpreted as criticism. To address both issues, I would recommend making an appointment for your daughter to see her primary physician. Her physician can assess how severe her acne is, explain the cause and treatment of acne directly to your daughter, and set up a management plan that they can jointly agree on. You can be supportive by taking her to the appointment and helping her to get whatever medications are needed.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.