My son just turned in a paper for his AP English class in which he wrote about how his severe acre in seventh and eighth grade and how it affected him. A number of members of the group of friends that he had poked fun at him, and without going into great detail it changed his world view. I might add that sometimes his teachers would laugh when another student would make a little “joke.”
We did delay taking him to a dermatologist because of insurance issues and the belief that it might just clear up. It didn’t, and as soon as he saw a dermatologist he was immediately put on Accutane. I knew his problem wasn’t fun, but I wasn’t aware of just how bad it was. Essentially my son completely ditched one group of friends and replaced them with kids who aren’t the most popular, but who are quite smart.
My only point in posting this is that if you have a child with acne problems, don’t delay getting them to a dermatologist. And be aware of how bad things just might be at school.
My oldest brother had extremely severe acne, back in the days when there was no Accutane. He was already an odd duck (probably would be diagnosed on the autism spectrum today - Asperberger’s). The acne really sent him into a tailspin.
I have 2 younger brothers who also had very bad acne. They had self-esteem issues as a result. When they were adults, Accutane became available. Both took it, with one having to do 2 courses before it truly worked.
When my son was a teen, his acne flared up. The dermatologist tried a number of different things before moving to Accutane, since it is not a medication to be used as the treatment of first choice. My brothers encouraged the Accutane, because they felt it had given them their lives back. S’s face cleared up beautifully, just in time for his first semester in college. Before the Accutane magic kicked in, he did struggle with a period of time during which his acne was so bad I sometimes allowed him to stay home (cysts can be horrible - and painful).
My son has struggled with his self-esteem, and I was surprised to find that he does not view his acne issues as contributing to his self-esteem issues. He says that because we were always working toward a solution, and because his family had been through it, it wasn’t as awful for him as it might have been.
My daughter, on the other hand, has also struggled with acne - but hers is hormone related and therefore Accutane is not the solution. She had to pursue other routes, and it took years to get her system in balance enough that the acne can be controlled topically (she is allergic to 2 types of antibiotics so could not go that route). She was very embarrassed when she had bad breakouts, and it did affect her social interactions.
People who get a few pimples just do not understand how bad it can be to have acne (not talking about mild breakouts here). It can be bad for self-esteem, it can affect interpersonal relationships, it can prompt teasing, it can affect young peoples’ lives. Some of the new acne treatments are really expensive, but you can often find coupons for topicals that greatly reduce the cost. Dermatologists can be expensive, and Accutane is a fortune (we have a high-deductible plan, and that $700/month was a bear). I feel so bad for kids whose families are unable to afford treatment.
Ask your daughter’s dermatologist about spiranolactone for hormone-related monthly breakouts (and topical dapsone) if current treatment loses effectiveness.
The only thing that cleared up my severe acne was zinc oxide cream. I’ve recommended it to many people in the years since–no prescription needed, very inexpensive–and it has worked for all of them as well.
If you notice your teen is developing scarring, treatment is critical. In addition, laser treatment (Vtouch) can stimulate collagen to fill in the pits. It is best to do this sooner rather than later. In can also be used in conjunction with a different laser treatment that tones down the redness that takes so long to go away.
My son started to have cystic acne in about seventh grade. He grew to six feet at about the same time. We briefly tried Proactive and it made it worse! I made an appointment with a dermatologist and he went on Accutane for a short period. It cured it! He has no scars to his skin or ego. He now washes his face with Cetaphil soft soap and sometimes uses a topical cream that contains benzoyl peroxide. He hasn’t had a cyst in years. His unretouched senior portraits look great. I urge anyone who notices their child breaking out to make an appointment. It takes a while to get new patient appointments.
Another one here who sings the praises of Accutane for those who need it. Nothing else worked. (We did try the zinc oxide after seeing the recommendation here but nope - didn’t help a whit.)
Daughter was hesitant to start Accutane but the dermatologist was great. Explained why she needed Accutane rather than antibiotics, topicals, etc. The dermatologist asked her to trust him - he could help. We caught her acne quickly; I honestly believe she was on her way to much worse.
Both our kids had moderate (not severe) acne and did Accutane. We wanted to nip the problem in the bud before it lead to scarring. Extreme skin dryness while taking the Accutane is really, really hard on the lips-- severe chapping, cracking, bleeding.
An adult friend w severe acne scarring did Accutane . It made a SIGNIFICANT improvement in the smoothness of her face.
My S developed severe acne in 9th grade, a year after our move to a new city. Largely because of his good looks and athletic prowess, and despite his shyness and social awkwardness, he was welcomed into a group of “popular” kids. Like OP’s S, when his acne became severe he suffered socially and reevaluated some of his new friends.
S’s doctor insisted that he try different courses of treatment (topicals, antibiotics, etc.) and “give them a chance to work.” His acne got progressively worse. After more than a year, I wised up and took S to a new doctor who immediately put him on accutane. I’ve always regretted not getting him on accutane sooner. It wasn’t until later that I found out how much he suffered, and he still has some scars. He probably should’ve done a second course of accutane, but he was a soccer goalie and had problems with his fingers (area around nails) cracking and bleeding.
When D’s face began to break out in middle school I got her on accutane right away. She now takes spironolactone for medical reasons. It also helps her skin (which is lovely).
My son, who is now 29, did a single three-month course of Accutane 11 years ago. It really is a wonder drug. The improvement in his skin was remarkable and lasting.
But Accutane gave him a permanent case of chapped lips. He is constantly using lip balm on them and perhaps he always will. He’s not upset by this; he feels it’s a very small price to pay. Others (particularly serious players of wind instruments) might disagree.
I know parents who are always perfectly turned out with obviously expensive hair cuts and clothes who don’t seem to do anything about their children’s acne. Kudos to you who have helped your children.
For mild/ moderate acne, I highly recommend old fashioned sulfur soap. My sons have very few skin issues, but I sure do at times. Sulfur soap is inexpensive and effective for me.
Please don’t judge the parents because of the kids. I have a dd with crooked teeth because after paying for braces, she refused to wear the retainer. Other dd has acne scars because she had to do everything natural and didn’t want to use Accutane. Parents can only do so much.
Onward, You are right. I shouldn’t judge. In the instances I’m talking about I actually know the parents quite well and feel frustrated. They can afford a trip to the dermatologist and Accutane if needed. One of them talks a lot about making appointments for the dermatologist as well as the orthodontist, but this never seems to happen. She sent me a link to a trip she is going on…$4500. That is how much my second son’s braces cost. No trip for me.
You have done all you can do as a parent. I’ve lectured my DS about wearing his retainer and I think he does, but what can you do?
Agree with Onward: my daughter (age 20) needed Accutane but didn’t want it. I turned into someone I didn’t like - nagging about her skin. When she saw her dermatologist (after a few months where her skin got progressively worse) he took his time talking over her concerns and explaining exactly why she needed Accutane. He told her that he loved his daughters and would never ever give them something that could hurt them and both had been on Accutane - one more than once. She listened and agreed. Funny thing: she was in a wedding shortly after finishing Accutane and the photographer came over and told her she had the most beautiful complexion - peaches and cream. We both just smiled. Still I remember those months of trying to get her to the dermatologist and her reluctance to go. Parents can only do so much. (I sometimes wonder if the dermatologist had been less patient or not known exactly how to handle the situation if she’d have agreed.) Fortunately all’s well that ends well.
We were lucky enough to nip bad skin in the bud. Over Xmas break sophomore year, S2’s face broke out like crazy. Lots of whiteheads, on its way to cysts. It was sudden. He had had a few pimples before, but nothing like this. I had a brother who needed Accutane, so I was prepared to act. The poor kid suffered while we were on vacation in an exotic location, normally the kind of trip he would have loved. Instead he was so self conscious he couldn’t think about anything but his skin. We went to the doctor as soon as we got back home. By the time school started he wasn’t healed, but was past the worst.
@EarlVanDorn: Speaking of the essay: Did you only find out the impact of his acne and his feelings about socialization and self-esteem by reading the essay?
I read your opening and thought, “Yeah, I know what it is to find your kid reveals something that was a real source of internal strife. Even if the child has processed things and speaks in the essay from a point of having moved on, as a parent one reels from that discovery, or hurts all over again though you had known about the issue but thought it had been a minor blip.”
I wish I had acted earlier, but my son never seemed to care about his acne. I just recently got him to a dermatologist but my son is only half interested (he keeps “forgetting”) in doing what is prescribed. And I can’t remind him everyday now that he’s away at school.
The good news is that his acne hasn’t hindered his self esteem or social life. All through high school he has had a wonderful group of friends, plenty of self confidence and he even has a beautiful (and while beauty is subjective, trust me, I don’t think anyone would disagree), smart and sweet girlfriend he’s been with for almost a year. Hasn’t seem to slow him down. Hopefully, he will find the same kind of friendships at college.
My S has more minor acne (not cystic, not disfiguring). I’ve gotten him Proactiv, suggested strategies, offered a derm consult and he’s not interested. He’s made it clear that it’s hurtful when I try to be helpful and our relationship is far more important than my nagging him about his skin. Again though his is more general occasional breakouts, not the kind that is Accutane-appropriate.