Here is my column in today’s Sunday Times Style:
Q. My daughter is 16 and has started to get acne. She hasn’t mentioned it to me; however, I have seen her picking at it in the mirror, and she panics if she has to go somewhere without wearing foundation. I want to speak to her about it so that I can help her get the right advice, but I don’t want to make her feel like she should be self-conscious about it. How should I approach this?
Alexandra, 47
A. Acne during teenage years is extremely common — studies show that 90 per cent of teenagers will be affected at some point. There are two main influences: genes and hormones. We start to produce sex hormones at a rapid rate during puberty, which increases oil production in the skin, leading to congestion, enlarged pores and spots. Add in stress, exams, relationships, not-so-great nutrition and the lack of a skincare routine, and you have a recipe for breakouts.
How you approach this with your daughter is important; acne is a sensitive issue, particularly because there is a spectrum of severity. We assume that someone who has blackheads and the odd pimple is less distressed by their skin than someone with more obvious cysts and swellings. But it has been proven that the amount of distress doesn’t correlate with the severity of the acne, so it’s important not to assume anything. We don’t want to medicalise it, or make it a problem if she doesn’t see it as one, but also we don’t want to ignore it.
I’d start with a really simple, straightforward routine. Shopping for products and building a routine creates shared ground, and this is something you can do together. She should cleanse twice a day, for example with a salicylic acid-based face wash, and follow with a non-comedogenic moisturiser.
Get her into the habit of applying sunscreen each morning. There are some great oil control options that will keep shine at bay. She should stick to her routine for a few weeks and if it doesn’t seem to be working, consider introducing targeted active ingredients e.g. niacinamide. You want to do this in a manageable way so as not to overwhelm her.
Teenagers go from not requiring anything besides shampoo and body wash to suddenly having to think about a whole skincare routine, so expect some trial and error. Keep an eye on their interest in TikTok trends and the “skincare hacks” on there. Some of these can be dangerous and, as a dermatologist, I wouldn’t recommend trying them; however, when someone in a position of trust with a big following tells a young person to try something, they may sign up to that way of thinking. Don’t be too strict or bossy about it, just show an interest so that you know what they’re looking at.
Encourage good habits when it comes to nutrition too. Do this as a family, rather than targeting your daughter individually. Acne is not necessarily a direct result of diet, so it’s important not to put this idea in her head. There’s a lot of misinformation out there. I’ve seen many teenagers in my clinic who have eliminated carbohydrates and dairy from their diet unnecessarily.
Picking at spots can cause further damage and scarring, but try not to criticise her for it, as this will only make her feel worse. Instead, introduce pimple patches: these act as a physical barrier to the spots, reducing the likelihood of picking.
Let her wear make-up if she wants to as well; when you’re dealing with acne, having the option of foundation and concealer can make a real difference to self-confidence. Suggest a non-comedogenic foundation such as L’Oréal Paris True Match Super-Blendable Liquid Foundation (£10; boots.com) to prevent pore-clogging, and make sure she knows how to remove make-up thoroughly.
It’s important to acknowledge that not everyone who has spots needs to see a doctor, but if the spots are stubborn and don’t respond to products and if there are scars or marks appearing, do consider seeing your GP or a consultant dermatologist, especially if her emotional wellbeing is affected. Doctors are used to making judgments about when medical treatment is appropriate, so it’s worth having that conversation. Sometimes knowing a bit more about the options gives you more agency, so you can decide what is right for your child.
The consultant dermatologist Dr Justine Kluk is an acne specialist with her own clinic on Harley Street drjustinekluk.com
Find the article at thetimes.co.uk/article/how-to-deal-with-teen-acne-0d7327gmc, or come see us in clinic for Dermatologist led skincare advice.
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