A Key to Successful Teen Acne Treatment

The problem of acne is one of the most common among adolescents, as this condition not only affects physical appearance but also significantly disrupts psycho-emotional balance. For many, adolescence is marked by complex physical and emotional changes, and the appearance of acne can become a significant challenge.

Acne is a chronic skin condition that occurs due to dysfunction of sebaceous glands and hair follicles. The main pathogenic feature of acne is the hypersecretion of sebum, which leads to the blockage of hair follicles and pores. This disrupts the normal exfoliation process, creating conditions for the colonization of pathogenic microorganisms, particularly Cutibacterium acnes. The rapid multiplication of these bacteria stimulates the development of inflammatory reactions, which, in turn, leads to the clinical manifestations of acne, such as breakouts. The disease is most commonly localized in areas with high sebaceous gland activity, such as the face, back, chest, and shoulders. The clinical picture can vary from the presence of open and closed comedones (blackheads, white bumps) to papules, pustules, nodules, or cysts, depending on the severity and the intensity of the inflammatory process.

Acne has a significant psychological aspect that affects the quality of life of adolescents.¹ The appearance of acne often causes feelings of shame, reduced self-esteem, anxiety, and even depression in young people. In some cases, it can lead to difficulties in social adaptation and social isolation, with adolescents avoiding contact with peers due to the fear of judgment. Therefore, acne requires a comprehensive treatment approach, not just the application of standard dermatological methods, as the psycho-emotional state of the patient plays a crucial role in how they perceive therapy. Many young people begin standard treatment—which includes the use of medications that may vary depending on the severity of the disease—with great enthusiasm. However, the individual psychological needs of the patient can complicate the treatment process. Patients often encounter side effects such as skin irritation, peeling, and dryness, leading to frustration with the therapy. Furthermore, a need to manage stress can complicate the implementation of recommendations and adherence to the treatment plan.²

Collaboration between a dermatologist and psychologist, when possible can be an essential component in some cases. Even just in the dermatologist’s office, a staged implementation of methods can ultimately enhance the effectiveness of treatment and ensure better results.³

A mini-study was conducted in which two groups of adolescents suffering from moderate and severe acne participated. In the first group, only standard treatment protocols were applied: consultation, examination, and the prescription of drug therapy in the form of oral or topical retinoids, azelaic acid, salicylic acid, or benzoyl peroxide, depending on the severity of acne.⁴ In the second group, a comprehensive treatment approach was used. In the first stage of treatment, the adolescent underwent a consultation with a dermatologist, who conducted a precise diagnosis, determined the severity of the disease, and developed an individual treatment plan based on clinical indicators. The second stage involved the adolescent seeing a psychologist, who assessed the emotional triggers that could influence the skin condition, such as stress, anxiety, or low self-esteem. The psychologist’s task was to increase the patient’s stress resistance, support the process of accepting their condition, and foster a positive attitude toward treatment. The third stage was the implementation of a dermatologist-developed individualized skincare plan into the patient’s daily routine, including recommendations for home care products to cleanse, moisturize, and protect the skin. This is an important preparatory step for long-term medical treatment. The dermatologist also can develops a plan for procedures such as regular facials, peels, or specialized masks, depending on the chosen dermatological treatment. These procedures help reduce the symptoms of acne, improve the overall condition of the skin, and correct aesthetic defects. They also can increase the patient’s self-esteem, contributing to the restoration of self-confidence.

The study demonstrated that a comprehensive approach to treating acne has a significant impact not only on the physical state of the patient’s skin but also on their psychological and emotional well-being.² This approach involves a combination of properly selected skincare products and an individually developed dermatological treatment plan, which promotes gradual skin clearing and reduces inflammatory processes and the consequences of breakouts. This not only improves the patient's appearance but also positively affects their self-esteem and confidence.

A key aspect of this approach is psychological support, aimed at helping the patient accept their condition, which helps prevent the development of depressive states and anxiety. This process starts during the consultation and continues throughout the treatment. Psychological support fosters an understanding of the temporary nature of the problem and the realization that acne is a controllable condition. This approach helps reduce negative perceptions of one’s appearance, decrease self-criticism, and significantly lower the stress level that often accompanies the disease, as stress is a well-known trigger for acne flare-ups. Therefore, comprehensive therapy, which includes both medical and psychological interventions, is the most effective approach to treating this disease.^5,6 Studies have shown that adolescents who receive psychological support are less likely to experience anxiety during acne flare-ups. Properly selected skincare contributes to improving the patient's appearance, which is crucial even during prolonged medical treatment. Positive changes in the appearance and emotional state of adolescents promote their openness in communication, reduce social discomfort, and prevent isolation. It also facilitates interaction with medical professionals and improves treatment effectiveness, as patients become more motivated and willing to follow doctors' recommendations.

The primary goal of the proposed approach to treating acne is to introduce medication therapy in stages after completing psychological preparation and the incorporation of skincare products selected by the dermatologist into the routine. This gradual approach minimizes the risk of severe adverse reactions to treatment and ensures the stability of the therapeutic effect. It is important for the patient to clearly understand what happens at each stage of the treatment process, as this increases trust in the therapy and motivates continued treatment.

An interdisciplinary approach is highly effective in treating adolescents with acne. The comprehensive interaction of a dermatologist and psychologist leads to long-term results and reduces the risk of relapses. It is recommended to implement this approach into clinical practice for treating acne, especially among adolescents, as it creates conditions for restoring health at all levels and improving patients' quality of life.

1. Zaenglein AL, Thiboutot DM. Expert committee recommendations for acne management. Pediatrics. 2006;118(3):1188-99. doi: 10.1542/peds.2005-2022.
2. Purvis D, Robinson E, Merry S, Watson P. Acne, anxiety, depression and suicide in teenagers: A cross-sectional survey of New Zealand secondary school students. J Paediatr Child Health. 2006;42:793–6. doi: 10.1111/j.1440-1754.2006.00979.x.
3. Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055-2067. doi: 10.1001/jama.2021.17633.
4. Khan MZ, Naeem A, Mufti KA. Prevalence of mental health problems in acne patients. J Ayub Med Coll Abbottabad. 2001;13:7–8.
5. Magin P, Adams J, Heading G, Pond D, Smith W. Psychological sequelae of acne vulgaris: Results of a qualitative study. Can Fam Physician. 2006;52:978–9.
6.  Misery L. Consequences of psychological distress in adolescents with acne. J Invest Dermatol. 2011;131:290–2. doi: 10.1038/jid.2010.375.

Hanna Kibitska, MD

• Dermatologist and esthetician, Denville, NJ.