Being a teenager is not much fun at times. Even adults that escaped high school fairly unscathed by other teens’ harsh judgments and petty schemes will remember it as a tumultuous time. When you add acne to problems like school, friends, work and family, everything can start to seem like ‘too much’ very quickly. While school and friends can be complicated problems, fortunately acne treatments for teenagers have come a long way, and are now much more straightforward than they used to be. Today we check out a valuable five-step acne treatment solution for teen skin. The plan can be cut short at any time, if you find that a particular step has cleared up your acne effectively.

Step 1: Oral antibiotics

If there aren’t any contra-indications to oral antibiotics, they are a very suitable first step for many acne treatment seekers. They help tone down breakouts to a level where chemical peels, microdermabrasion, laser acne treatment etc can be undertaken with minimal discomfort.

Optional Step: Oral contraceptives

Obviously they’ll cause more problems than they solve in boys; however oral contraceptives may help acne in some girls, with relatively few side effects. One interaction of note, though – when these are also used as the sole method of contraception there will be a 14-day window in which they are ineffective when starting a course of antibiotics.

Step 2: Laser acne treatment

Laser acne treatment offers a widely effective, very safe way to get rid of all the lesions associated with acne. It works by subtly altering the sebaceous glands in your skin so they produce less oil, as well as killing off the populations of P. acnes in your skin (which take time to build up).

Step 3: Microdermabrasion, dermabrasion and chemical peels

All of the above procedures can help smooth out acne-roughened skin. We recommend they are undertaken after the oral antibiotics are established and laser acne treatment has been completed because they’ll have a better chance to act curatively on your skin. If you end up having the more severe dermabrasion, also, you should do it at a time when you are getting relatively few new lesions, as new pimples can cause scars.

Step 4: Benzoyl peroxide

Benzoyl peroxide increases the turnover rate of the skin and helps kill acne bacteria.It is a fairly common acne treatment, but we haven’t placed it earlier in the program because it does have side effects, sometimes causing cystic acne and flaking, and also making your skin build up a tolerance to it, so constant use is required.  It shouldn’t be used before laser therapy, as it increases sun sensitivity.

Step 5: Oral isotretinoin

Oral isotretinoin is also known as Accutane, or Roaccutane, and is one of the last resort treatments for acne. Usually people that complete a course of oral isotretinoin find that they have permanently improved skin. The fact that it increases turnover rate of the skin means that fine lines and wrinkles are improved as well. It has quite a range of serious side effects though, including flaking and peeling of the skin, exacerbation of sun sensitivity and sometimes mood changes and depression; this is why it is included as the last step.

Remember:

Acne treatments for teens are often a joint decision between the patient and their parents. When they disagree about what sort of treatment will be best, it’s wise to have these ‘discussions’ (or perhaps occasionally, arguments!) in the presence of a doctor. They’ll at least be able to give a professional evaluation of risks and benefits in a particular case.

People with acne are often told to just wait – “You’ll grow out of it”. This is certainly true eventually, although sometimes it only happens after many years of heartache and shattered confidence. Yet, one thing that you never grow out of is acne scars.  Fortunately there is now an enormous range of cosmetic treatments for acne scars, with a process to suit every type of scar and every skin type. Today we go through the full range of acne scar treatments, their suitability for different people and different marks. We’re looking at the range of acne scar treatments in order from the least effective (and usually cheapest and least risky), up to the more effective treatments with greater risks and side effects.

Microdermabrasion (Effectiveness: * )
Microdermabrasion is best used in conjunction with other therapies. It can be useful for acne, but is not particularly effective as an acne scar treatment.

At-home chemical peels (Effectiveness: ** )
Chemical peels, like microdermabrasion, are more effective against acne in its active stages than for remedying scarring. It is low cost but will need to be repeated often.

Medical-grade chemical peels (Effectiveness: *** )
Medical grade chemical peels can be very effective for low grade scarring. They may only need to be repeated once or twice, but they do carry some risk of scarring and the recovery time is far longer than at-home peels.

Dermal fillers (Effectiveness: *** )
Dermal fillers are a mid-range cost, very low risk treatment for deep acne scars. They will also substantially improve the look of an acne scar. However, they are temporary only – you’ll need to keep up the treatments every 6-9 months for the rest of your life.

Subcision (Effectiveness: *** )
Subcision is a great option for single deep scars, but cannot be performed across the whole face. You may need several treatments, but it has a low cost, mid-range recovery time and fairly low risk. 

Diode laser (Effectiveness: **** )
There is minimal downtime from this acne scar treatment, but multiple sessions will be needed to help fill in deep scars. The procedure carries very little risk, especially if you are treated in a professional clinic, as the scarred areas are targeted and surrounding skin is spared. Compared to other single-time procedures, diode lasers have a good chance to fill in acne scars with very little associated risk.

Fractional carbon dioxide lasers (Effectiveness: **** )
Fractional carbon dioxide lasers both ablate the surface of the skin (removing the top layers), as well as causing a mild heat injury to the tissue, which stimulates the formation of new collagen which fills in scras.

Skin needling (Effectiveness: *****)
This very effective acne scar treatment has a fairly substantial recovery time, but will show effective improvements for quite some time. The overall risk is quite low compared to the effectiveness of results. 

Fully ablative laser resurfacing (Effectiveness: ***** )
This is quite an effective treatment, but don’t let those 5 stars blind you to the major risks that are associated with fully abrading the top layers of your skin. It can also result in permanent scarring or loss of pigmentation in the skin that may look worse than the original scars. Only one acne scar treatment is needed, but it is expensive and you’ll need a fair bit of time off work to recover.

For most of us that endure the ravages of acne, you don’t really care much about scientifically classifying your lesions or scars. You just wish they would go away! That is completely understandable – however, understanding the type of acne scarring that you have could actually be the first step in figuring out how you can get rid of it. Laser acne therapy and dermal fillers for acne scars are now very popular, very long-lasting and very effective treatments for acne scarring, with laser therapy also having some benefits for active acne. The treatment types will vary depending on what type of scarring you have, though – so today we help you take that initial step of classifying your scars to help prepare you for acne scar treatments. 

Grading levels of acne scarring

The first four ways of classifying your acne scars relate to their severity, generalizing about the individual differences between scars. You might have Grade 1, 2, 3 or 4 acne scarring, with different laser acne treatment or pigmentation treatment options for each level.

Grade 1 scarring: Is mostly pigment-based. Ordinary scars from cuts to your skin appear white – in grade 1 acne scarring the lesions are also white or hypo-pigmented.

Grade 2 scarring:  Grade 2 scarring is defined as being visible at distances of less than 50cm, and able to be covered by makeup. Of course, not everyone is happy with needing lifelong cosmetics to ‘look normal’, and for many people cosmetic use causes breakouts – so laser acne treatment is a real possibility at this stage.

Grade 3 scarring: Grade 3 scarring is not easily covered by cosmetics, and is visible from more than 50cm away. When we talk about rolling scars, shallow boxcar scars and hypertrophic scars later on, remember that those scars will often fit into grade 3.

Grade 4 scarring: Is also difficult to cover and seen at distances greater than 50cm away, but cannot be flattened by stretching the skin. Icepick scars, deep divots, keloid scarring and sever boxcar scars fit into this category – more on those names in a second. These may need a combination of laser acne scar treatment and dermal fillers to improve their appearance.

Specific types of acne scarring

When you are looking at a particular acne scar, or a confined area or type of acne scarring, there are also other ways to classify them. These include:

Macular scarring: This type of scarring is the only one counted in grade 1 acne scarring. Laser acne scar treatment isn’t effective for macular scarring, and it usually isn’t feasible to remove the rest of the pigmentation in the face to match the lightened area. The most usual treatment is with lightening creams to help even out skin tone.

Boxcar scars: These acne scars look as if they have been punched out with a hole punch. If you cross sectioned them, they would have sharp vertical edges. They might be treated by either dermal filler or laser acne scar treatment, depending on their severity.

Rolling scars: Where acne scars have been deep and the overlying skin tethered to structures beneath, these are known as rolling scars. Large uneven patches can be treated with lasers or skin needling.

Deep divots and ice-pick scars: Deep scars that have involved the loss of subcutaneous tissue are either deep divots (larger surface area) or ice pick scars (small holes). Chemical peels, microdermabrasion, laser acne scar treatment and skin needling can do a lot to improve the look of these scars.

Hypertrophic scarring: These are often pigmented scars. The pigment can be removed by laser, and the surrounding area treated with either fillers or laser to stimulate collagen production.

Keloid scarring: These scars are big, red-purple and nasty – skin needling and skin resurfacing by laser is the treatment of choice, but doesn’t completely eradicate the scars.