Adolescence is hard. Sometimes adults forget that. It’s hard emotionally and it’s hard physically. Bodies and minds are going through so many changes, some obvious and some not so obvious. And with that grand and awful chemistry experiment going on in their bodies, teens are left confused, stressed and often deeply frustrated with their bodies. Some of those body changes can be somewhat hidden under clothing but there’s one change many kids experience that’s impossible to hide — because it’s all over their faces.

Acne has been a scourge of teenagers for just about forever. As body chemistry changes and oil gland production changes with the coursing hormones, a child who once had the most even and blemish-free skin may feel like he or she is a walking version of connect the dots.

“Acne normally starts in the pubertal or adolescent years when the body increases production of a hormone called androgen,” Gloria Verret, RN, writes for Children’s Hospital of Los Angeles. “This hormone stimulates production of an oily substance called sebum, which mixes with dead skin cells and hair in skin openings known as hair follicles. This buildup of skin cells, oil and hair all clumped together causes pressure, which can burst open and cause skin inflammation.”

As a parent, helping your child learn to deal with their acne can be like walking a mine field. It’s not just an outward skin condition we’re trying to manage, but also a delicate psyche.

Skin care basics

Learning about skin care begins at home. You’ve long since insisted your child wear sunscreen, for example. But skin care needs change as children reach adolescence, and we need to help our kids understand this. Your child may be embarrassed talking about it with you (they absolutely forget that you were a teenager once, too, and had similar experiences!)

You need to find a way to communicate the importance of gentle skin hygiene. Whether it’s by demonstration, shopping together for products, encouraging self research, pointing your child to specific websites with information, or just leaving appropriate products in the bathroom, your child needs your guidance — even if they say they don’t. They may try to use harsh, aggressive products (the ones that you may have memories of using and thinking yourself “it stings, so you know it’s working“) — but these are not your friends. You want a gentle skincare routine that doesn’t involve aggressive rubbing, scrubbing or squeezing — though weekly exfoliation (either chemical or physical) isn’t a bad habit to get into when using the right products.

Your child also needs to understand that picking at his or her acne may make things worse in terms of swelling, redness and scarring. But try not to nag! You probably remember how hard it was not to pick at times; it can be so tempting. Try to walk that line between gentle reminders and concern and nagging.

Dermatologist as partner

If at all possible, an early consultation with a dermatologist may help both of you understand what is happening physiologically and there may be additional effective treatments available to you through the doctor. Particularly if your family has a history of severe acne requiring treatment with very strong oral medications such as Accutane, establishing a relationship early can head of some of the effect of severe acne later, and reduce the need for subsequent treatments (such as dermabrasion that seeks to minimize the appearance of acne scarring).

According to the Cleveland Clinic, the appearance of large, red pimples that look like cysts or cause pain and are resistant to over-the-counter medications is a sign to consider heading to your family doctor or a dermatologist to talk about your teen’s acne.

A partnership with a good dermatologist can offer reassurance and information to both of you over the years that you both will be dealing with this skin condition.

Also — as with other issues — your child may listen to guidelines set forth by the doctor more attentively than he or she listens to you, even if you say the same thing. You’re “just” a mom, after all, and the doctor is an expert.

Reassurance

Along with skin care information and medical support, it’s so important to offer reassurance. Remind your child that they are so much more than what their skin might look like for a short time and that they’re going to get through this and you will help them through it. When they feel so obvious with their inflamed faces, when they are sure they are the only ones going through this much anxiety over their self image, they need you to be there not just for practical assistance, but emotional support — and, again, even if they say they don’t want it. They need to be reminded that this won’t last forever, even when they feel like it will.

According to the American Academy of Dermatology Association (AAD), studies show that “people with acne have said that their skin makes them feel unattractive, embarrassed, or self-conscious. These feelings can cause some teens to avoid trying out for sports, getting a part-time job, or participating in class.” They are also more likely to deal with depression, anxiety, low self-esteem, poor self-image, loneliness and a decreased quality of life because of their skin problems. These affects, per studies, are more likely to affect women.

If your teen is comfortable or interested in wearing make-up, you can help them find skin-friendly noncomedogenic brands that can help cover acne (and that can even give you the chance to talk about ways they can express themselves by playing around with make-up).

Acne is but one of the many perils of adolescence. Helping our kids through it can be tricky at times, but you will both get through it.

A version of this story was originally published in January 2010.

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