Daughter’s skin, what can I do? How do I discuss it without looking like I’m criticising?

[Watermelon222]

Dd16 has pretty bad acne on face and neck and some on back and chest.

We have tried most of the cream treatments, which helped initially, but less so now. She is currently on antibiotic tablets, which I would say are not doing much.

She always seems to get large ones on her face and neck which are very red and inflamed looking. Obviously this is not pleasant for a teen girl.

I am treading on egg shells trying to discuss this with her as I understand it’s a tricky topic. She doesn’t like to speak about it and gets defensive if I bring it up. It must bother her, hence the reaction to me mentioning it, but I can’t do anything about it on my own.

A few months ago the gp mentioned trying the contraceptive pill if 5he antibiotics don’t work but dd is dead against this because of “side effects “.

I feel for her that all of her friends have clear complexions, and if dd tries to put makeup on it gets clogged up around the spots, or looks too heavy or just slides off. I imagine this really bothers her, but I really struggle to address this as she gets very defensive. She tends to not bother with any makeup most of the time, but her face looks very blotchy and inflamed.

It is really starting to become a blight, especially wanting to wear summery clothes but not being able to. And also affecting her self esteem and confidence.

Does anyone have any ideas or suggestions?

Reading your post is a bit uncomfortable as it does sound as if you are a bit obsessed with how she looks.

You assume she must want to wear make up and certain clothes and compare her skin to her friends and you seem to feel her concerns about side effects from the pill (maybe weight gain worries her) are not justified.

I had bad acne right into my 20s. Nothing except roaccutane worked for me and that worked a treat very quickly and I wished I'd done it sooner. One of the reasons I didn't get help sooner though was because I felt if it's just a cosmetic vanity issue then it's not legitimate for me to bother people about. If I had been helped to see it as a medical condition like eczema then I think I would have felt better about seeking treatment. I definitely would encourage you away from framing about looks.

Would she consider trying to cut out dairy? It can work for some people with acne and even asthma and hayfever, though obviously not everyone. Might be worth a try if her diet is otherwise healthy.

I actually think this is bothering you more than it is her, and no doubt she's finding it annoying that you're pointing out her acne. She's very young, her hormones are balancing out. My dr put me on the pill for 10 years for bad skin as a teenager and it took me years to detox the estrogen that built up in my liver.

Dianette was a life changer for me & my PCOS.
I know everyone is different but I had no weight gain, the body hair reduced & my skin was fantastic.
You say your daughter is against it - could she just give it a try for 6 months maybe?

Tons of people will be giving you skin care routine advice here but you can ignore it, hormonal acne isn't going to respond to over the counter treatments. All you can do is use the gentlest cleansers and lots of occlusive moisturiser to help control the irritation and flaking. Accutane is the only thing that reliably works, however, she would HAVE to take it with birth control and there are well-known and sometimes horrific psychological side effects that you have to monitor for extremely closely. The good thing is that once it's worked, you can stop taking it and usually things never go back as bad as they were before.

Please go straight to a dermatologist to talk about serious options eg Roaccutane aka Isotretinoin. Scarring from bad acne is no joke and it can ruin self esteem if not tackled robustly.

Review the skincare products she’s using. Buy her Caroline Hirons Skincare book.

Private dermatology appt (I would especially recommend you take a look at Dr Anjali Mahto on Instagram - consultant dermatologist who also struggles with acne herself).

I had terrible teen skin, I’m 40 this year and still get spots.
I was on the pill, antibiotics, medicated wash etc etc. I gave up dairy, wheat, added sugar.........Nothing helped.
The pill made me emotional and gave me shocking thrush.
I had a good diet full of fresh fruit, veg, little processed food.
You can’t always improve it.

Have you tried niacinamide or salycilic acid serums? This has been a game changer for my red inflamed acne skin which is hormone related? Antibiotics etc just didn't do a thing but these serums which cost £6.99 in boots have given me almost normal skin.
Sorry not advice on broaching the subject delicately for her but maybe buy them and leave for her to try?

”Please go straight to a dermatologist to talk about serious options eg Roaccutane aka Isotretinoin. Scarring from bad acne is no joke and it can ruin self esteem if not tackled robustly”
100% agree with this ^
Ask the doctor for a referral to a dermatologist.
If it’s cystic acne it’s unlikely to go away by itself and could cause lifelong scarring.
The fact that she is so defensive and doesn’t like talking about it suggests that it does indeed bother her.

Another one here saying to please ask for roacutane.

My sister had awful acne for years, and had tried everything. She was prescribed roaccutane and her acne disappeared so quickly, and it's never ever come back.

My partner had the same issue as a teen, was also prescribed it and it also totally sorted the issue out

There can be bad side effects, but tbh, the course is so short, it's far better than being on the pill for months.

my 13 year old gets bad acne that antibiotics and the cream didnt do much for. Shes now gone on microgynon for periods, and her skin has really improved too.
Most people dont really get significant side effects from the pill, but if she did, then its not like she couldnt just stop taking it

Have you tried pimple patches? They might help, even if she just used them on the worst painful ones. There are loads online so it may be worth trying a few different ones to find what suits her skin best. There are even ones that go underneath make up!

She’s not unreasonable to be worried about side effects from the pill. I had a horrendous reaction to it which caused a permanent serious health condition. (I was very unlucky to react this badly, but it’s not completely uncommon for women to react negatively to the pill.)
OTOH I’ve been fine with roaccutane. Whereas I know some people can’t tolerate that either.
FWIW, when I was on roaccutane previously I wasn’t on birth control as I can’t tolerate any. I’m married & we cited condoms & abstinence as our 2 methods, it was accepted.

I also second the advice re a decent cleansing routine, pillowcases & also to use a clean separate towel for her face which should be changed every couple of days. We have about 10 hand towels & they all go in the wash with the bath towels regularly weekly.
Also, try different laundry detergent. It could be an allergy.
Also, does she have long hair & use conditioner? Is she thoroughly rinsing it off her back etc before getting out of the shower? It’s dreadful for clogging the pores.

I’m 40 & still struggling with it. It doesn’t necessarily just go away.

Yes, please encourage her to see a private dermatologist. It transformed my skin. When the worst of the acne was under control, I found that using products for dry skin and not oily skin helped me too.

Sometimes bad acne is diet-triggered. One of the most common causes of bad acne is a diet which includes dairy products.
I do know many teenagers (not an understatement!) who improved the condition of their skin just by cutting out dairy.

@Watermelon222 I’m not sure if it would be suitable for her skin because she’s only fifteen, but you can get special creams from a brand called skin & me and another one called dermalogica (I think). It’s prescription cream that contains a mix of Tret, azaelic acid and something else. It’s really good for treating acne and I think is about £20 pound a month for a supply (one treatment a night). Definitely worth looking into, although it does usually take up to 3 months for it to kick in.

My friend had this and took Roacutane which completely irradicated it forever. It was presented to her as a real last case option after everything else had been exhausted though because the side effects were so intense so if she isn't willing to try the pill then she might not want this. My friend had tried everything including several different types of pill and even a chemical peel. She was a bit older than your dd, maybe 17 or 18 I think. The roaccutane completely changed her life so its definitely worth exploring.

Thanks for all of your useful suggestions.

For those asking who is more bothered, me or her, the answer is I don’t know how she feels as I find it tricky to broach the conversation. My gut feeling is that she is bothered by it massively, but I don’t want to draw attention to it by mentioning it too much. Of course it bothers me, as would anything which could affect their wellbeing or self esteem.

I suffered myself with bad acne, so I still remember being affected badly with self confidence and having limitations on what I was happy to wear. My life was changed by dianette, but that was 30 years ago!

It’s tricky I find being a parent, you want to help but not draw attention to things which may or may not be seen as a big deal.

As far as skincare regime goes, I’m not sure she has one. She uses clearasil wipes daily. Diet is not bad, but could be better. She hasn’t got a sweet tooth like her sister and typically her sister who eats loads of crap and barely washes her face has completely clear skin!

For those who gave up dairy, where did you get your calcium from?

I would also look carefully at her makeup, as an adult I started getting cystic acne. It was caused by changing to an oil based makeup base and moisturiser. I changed back to clinique and it went....

I used to get really annoyed at my mum for bringing up my skin, it probably does embarrass your DD but it’s not nice to feel like it’s a constant topic of conversation.

What skincare products is she using? In my experience, the stuff aimed at teenage acne made mine much worse because it’s so drying (clearasil and the like). I really suffered until my late 20’s from cystic acne. I second a PP who suggested la Roche posay effaclar, it’s been really good for my skin and really helps clear up spots and keep them from coming. I also use coconut oil to take makeup off because those wipes make me break out massively.

Secondly, sounds like a cliche but lots of water and keeping away from food that spikes your blood sugar helps me. If I go crazy with the sugar I’m guaranteed a break out. I agree with your DD about the pill btw, I had terrible mood swings and anxiety from taking the mini pill and it definitely didn’t help my acne either!

Oh nonono clerasil wipes she needs to stop using them

Lots of good advice here. Also look carefully at the products she's using - in many cases so-called teen products are simply too harsh and make the problem worse. And the more fruit and veg she eats, the better.

It's worth looking at the product range Elizabeth's Daughter.

@littleredberries

Sometimes bad acne is diet-triggered. One of the most common causes of bad acne is a diet which includes dairy products. I do know many teenagers (not an understatement!) who improved the condition of their skin just by cutting out dairy.

I had adult acne and was on antibiotics, I eventually realised it was caused by dairy. It surprises me that doctors seldom talk about causes.