Pediatricians Endorse New Acne Treatment Guidelines

Experts note many medications now available for range of cases

By Amy Norton

HealthDay Reporter

MONDAY, May 6 (HealthDay News) -- Pimples have long been the bane of teenage existence, but pediatricians say there is now enough evidence on effective treatments to put out the first guidelines on battling acne in children.

There is a range of medications that can clear up even severe cases of acne, according to the American Academy of Pediatrics (AAP). Writing in the May issue of its journal Pediatrics, the group throws its support behind new guidelines from the American Acne and Rosacea Society that detail how to treat acne in children and teens of all ages.

That "all ages" part is important because acne is becoming more and more common in pre-teens, too, said Dr. Lawrence Eichenfield, the lead author of the AAP report. One study of 9- and 10-year-old girls found that more than three-quarters had pimples.

It's thought that it may be because boys and girls are, on average, starting puberty earlier compared with past generations, said Eichenfield, a pediatric dermatologist at Rady Children's Hospital in San Diego.

According to the AAP, mild acne often can be tackled with over-the-counter fixes. Washes, lotions and other products containing benzoyl peroxide are the best studied, and the best place to start, the group said.

"It's a pretty effective agent, especially for mild acne," Eichenfield said. Benzoyl peroxide is also the most common ingredient in over-the-counter acne fighters. Another common one is salicylic acid, but there has not been much research on it. When it has been tested head-to-head against benzoyl peroxide, Eichenfield said, the latter has won out.

If over-the-counter products do not do the job, the next step could be topical retinoids -- prescription medications like Retin-A, Avita and Differin. They are vitamin A derivatives and work by speeding up skin cell turnover, which helps unclog pores.

The main side effects of all the topical treatments are skin irritation and dryness, the AAP said.

If the acne is moderate to severe, oral antibiotics could be added to the mix because bacteria that live on the skin play a role in acne. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.

But, Eichenfield said, "it's important to use antibiotics appropriately." One reason is because acne-causing bacteria have become less sensitive to common antibiotics in the past couple decades, due to widespread use of the drugs.

Another is that antibiotics can have side effects, such as stomach upset, dizziness and, in girls, yeast infections.

When acne is severe and other treatments have failed, the AAP said, doctors and parents might consider the prescription drug isotretinoin -- brand-names including Roaccutane (formerly known as Accutane) and Claravis.

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