Updated 24 July 2013

Dealing with spots

It’s in your teen years, the time you really don’t want to have to deal with spots, that they appear.


It’s in your teen years, the time you really don’t want to have to deal with spots, that they appear.

Contrary to popular belief the amount of chocolate, biscuits, fatty foods, tomatoes – in fact any sweet or savoury stuff you eat – is not the cause of your spots. Acne has everything to do with hormone levels. In teenage boys and girls spots are directly linked to an increase in male hormone levels. In boys everyone knows when these levels rise – they grow facial hair and their voices break.

But in girls the increase is invisible because it’s overshadowed by the even greater rise in female hormone levels.

If all you get is one spot now and again it’s not necessary to try to magic it away with hundreds of creams and pills – but if spots start disfiguring your face and worry you, help is at hand. Remember, not all remedies work equally well for everyone.

Some teens will see a change in the first week while others may have to wait for up to eight weeks before the effect of the treatment becomes visible.

Here’s a guide to help you care for your skin and keep acne under control.

Stage 1 : You don’t have spots but you’re worried you may get some.

  • Wash your face with a gentle soap twice a day. Washing more often could dry and irritate your skin. Avoid very hot water as this can aggravate acne.
  • Don’t use exfoliators, astringents and masks unless suggested by your doctor as these can also irritate the skin and aggravate acne.
  • Don’t rub, scratch or prod your skin. Popping spots can worsen acne.
  • Relax. Stress doesn’t cause acne but can aggravate it.

Stage 2: You get small spots or blackheads now and then.

Find an ointment that contains benzoyl peroxide, alpha hydroxy acid or salicylic acid. Make sure you don’t use creams or ointments that are oily or fatty or contain alcohol or fragrances. Dermatologists advise teens use Cetaphil as a face wash.

Stage 3: You have a problem with spots but it isn’t too bad and the spots aren’t inflamed.

Using salicylic acid or benzoyl peroxide 5% (Panoxyl) cream at night is a good idea.

A dermatologist may prescribe a cream containing tretinoin (Retin A, retinoic acid), a vitamin A derivative, or adapalene (Differin), or both. Both Retin A and Panoxyl can cause skin irritation and make your skin hot and red. It can also make you burn more easily in the sun. If this happens use the cream only every second night until the redness fades.

Other treatments are tazarotene and local antibiotics but a dermatologist must prescribe these.

Stage 4: You have a problem with spots that are inflamed and nasty-looking.

You could use over-the-counter creams but it would be better to see a dermatologist before the problem gets out of hand.

Your specialist will probably prescribe an antibiotic cream such as Eryderm or give you an antibiotic capsule such as tetracycline. It’s usually also necessary to keep on using the tretinoin cream while taking the antibiotic. (The capsules could make women more susceptible to thrush and shouldn’t be taken by pregnant women as they could turn the unborn baby’s teeth yellow.)

Stage 5: You have severe acne.

At this stage things are bad. Your acne consists of deep, chronic, inflamed cysts. If you haven’t seen a dermatologist yet do so now because help is available. The specialist will probably prescribe isotretinoin (Roaccutane).

It has potentially serious side-effects and your doctor will do a blood test and monitor your liver function while you’re on it. It must not be used by pregnant women as it can harm the foetus.

It can also cause depression and parents should keep a close eye on teenagers taking the drug. It is however extremely effective and can clear up between 70 and 80 per cent of severe acne within five months.

The anti-androgen contraceptive pill Diane-35 can help many teenage girls and women keep their acne under control but it has side-effects: users could gain weight, become moody and develop facial pigmentation. Other treatments include chemical peels, laser treatments and scar-tissue removal.

(This is an edited version of a story that originally appeared in YOU Pulse / Huisgenoot-POLS magazine, Autumn 2008)

(Picture: teen with problem skin from Shutterstock)


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