Teenage Acne: As a Parent, What You Need to Know – Part II

In my last post I discussed the pathophysiology of acne and how a pimple is formed. From the initial plugging of the duct going from the small gland in the skin to the outside to the colonization of the thick material stuck in the duct with bacteria. The growth of bacteria and the eventual formation of a pimple was the final common pathway to the process.

All of the forms of treatment are aimed at relieving one of the above factors. The simplest form of treatment is the use of keratolytic agents which cause the top layers of skin to peal faster than they ordinarily do. You must remember that our skin is constantly pealing and replacing itself. In an effort to prevent plugging of the ducts an effort is made to try to keep the skin pealing frequently.

The two most common keratolytic agents are benzoyl peroxide, and retinoic acid. When used too rapidly these can cause flushing and irritation of the skin, so we usually start using it less frequently than we use it eventually. The other process involves bacteria getting into the pores from the skin (we all have bacteria on our skin) and growing to produce a painful pimple. For this there are a variety of antibiotics that can be used both topically (placed right on the skin) or systemically (taken by mouth). The problem is that the process of formation of a pimple takes quite a long time, and the stimulus for teenage acne (hormones) does not stop while treatment begins. So, it is usually a prolonged process to clear the acne (months versus weeks or days).

There are all types of combinations of medications to use for acne and if one does not work it is reasonable to change products. A few of these are found over the counter such as proactive, but most are prescription medications.

Of course, regular soap and water washes help also and avoidance of picking or squeezing the pimple is very important because it can change simple acne in the skin to a much larger cyst or abscess under the skin that can then scar the skin.

Most kids get some degree of acne at one point or another, but keep reminding your children that there are ways to deal with acne, because is can be an emotionally upsetting time for adolescents.

Baby Silk

Hi, we’re Dr. Diane Truong and Dr. JJ Levenstein, pediatricians and founders of MD Moms, makers of Baby Silk, the first personal care line for babies developed by pediatrician-moms. As pediatricians and moms, we’ve cared for thousands of children for nearly a quarter of a century. It’s no surprise that during this time we’ve fielded hundreds of questions from concerned parents about common skin conditions and the safety and efficacy of the products available to treat them. One of the most common questions asked in our practices was, “How do I treat my baby’s cradle cap?” Cradle cap, for those unfamiliar, is a greasy, flaky rash that develops on the scalps of many newborns in the first few months of life. As parents ourselves, we couldn’t find any baby products on the market for our own children with ingredients that made sense (i.e., there were plenty of oily emulsions out there, but none with specific keratolytic or exfoliating ingredients). Our solution? To make one ourselves. But we didn’t stop at cradle cap. Because parents also asked about how to treat skin conditions such as diaper rash and dry skin, we created a full line of skincare solutions for babies.

Building MD Moms from the ground up meant we’d need to make sacrifices, but we believed strongly enough in our vision that it was more than worth the investment. With the help of a consultant, feedback from our own patients and a veteran cosmetics formulator from a respected research and development laboratory, our Baby Silk line—inspired by our Gentle Scalp Rub—was born in 2006. In our early stages, we borrowed against all of our assets (college fund, savings, and our home and retirement accounts) so that we could fund the first couple of years of MD Moms until we started to see an increase in sales. Personal time was spent traveling, arranging promotional events and taking part in weekend meetings and special projects. And when we weren’t treating our patients, we spent many late nights rebottling, repacking and shipping thousands of promos.

Because safety is our top priority, each of our products undergoes strict clinical testing and exceeds industry guidelines for safety. We use the latest medical data to ensure that each is effective, gentle and safe for infants. We further validate our products’ gentleness and safety by performing RIPT (repeat insult patch testing on sensitive subjects) to assure that our products are least likely to irritate baby’s skin. All of our products rated “0” on a 1-5 scale (perfect, hypoallergenic, non-irritating score) in the first round of testing. Additionally, we enlist a chemist and Pharm D Safety Assessor to review the chemical specifications and toxicological profiles of our ingredients to ensure that they are safe and fulfill the needs of our young consumers. And with the needs of our little patients in mind, we’re continually working to enhance and improve upon our line.

We know we’ve accomplished our mission when we hear from parents who were elated to find us after unsuccessfully searching for solutions to their little ones’ skin conditions. Also, our company has made it possible for us to raise awareness of the Oscar Litwak Foundation, our children’s Charity of the Year, which brings Mobile Playrooms to hospitalized children who are unable to leave their beds. We’re fortunate to be able to address children’s needs—whether it’s through charity or our Baby Silk line—and will continue to look for ways to improve the health and lives of children.

HEALTHFUL HINTS

Q: Aside from using Gentle Scalp Rub, what else can I do to treat my baby’s cradle cap?

A: Cradle cap is best treated by removing the crusts and flakes on baby’s scalp with an oil-based shampoo. Shampoos with an oily base essentially soften the greasy scales, and separate the scales from the baby’s hair. When combined with a gentle exfoliator, like salicylic acid (a derivative of aspirin), the flakes will be easier to rub or comb off the baby’s scalp.

Q: Are there different types of sunscreen?

A: Yes. A variety of sunscreens exist to provide protection from sun exposure: chemical sunscreens, physical sunscreens, or a combination of both.

Chemical sunscreens absorb UV radiation on the skin, then disperse this energy into harmless rays. They are made from active ingredients like octyl methoxycinnamate, octyl salicylate, octocrylene, and oxybenzone (which provide UVB protection) or avobenzone (which provides UVA protection). Chemical sunscreens require 20 minutes to activate, and ideally should be applied in 2 coats 20-30 minutes apart, before going outside.

Physical sunscreens (containing titanium dioxide and/or zinc oxide) are not absorbed into the skin, but rather sit on its surface and reflect, scatter and block UVA and UVB rays. These ingredients are less irritating, in general, and are immediately active upon application. In fact, the American Academy of Pediatrics and the American College of Dermatology advocate their use in children, and even in infants under the age of 6 months if direct sun exposure cannot be avoided.

Some sunscreens combine both chemical and physical agents in order to provide broad spectrum protection. Our sunscreen uses only physical agents to provide both UVA and UVB protection.

Q: How can I prevent diaper rash on my baby?

A: The best way to prevent diaper rash is to keep your baby’s bottom clean and dry at all times. Since this is not always possible, using a barrier cream to keep baby’s skin from coming into direct contact with irritants in a dirty diaper will help.

Q: Why is my baby’s skin dry?

A: A newborn’s skin dries out almost immediately after birth, as baby transitions from the moist environment of the womb to his or her new environment in the outside world. Within the first 2-3 weeks of life, a newborn’s skin will typically flake and shed, regardless of what a parent does. After that point, if your baby’s skin continues to feel dry, regular application of a moisturizer can make a difference.