12 year old with mild acne

[Maisy37]

Hi just looking to see if anyone has any advice ? 12 year old DD has gone mild acne on forehead ,face and back . This has been since 2020 . GP has been very helpful and has so far prescribed following
Duac - worked brilliantly for a year then stopped
Epiduo- made acne much worse so after persevering for a month stopped use
oral antibiotic erythromycin- she’s currently on month 2 of a 3 month course , has made it slightly better but not much .

the GP has said next step would be a stronger tetracycline antibiotic

shes got very oily skin and prone to greasy hair so she keeps hair clean and off face . She also uses la Roche Posay effaclar Duo face wash and cream ( the cream seems to really help )

she would likely benefit from the combined pill however she hasn’t started her period yet so it’s not an option yet .

we are persevering with medical advice and will get the new antibiotic but anyone got any pearls of wisdom ?

thanks in advance

Isn’t acne just part and parcel of being a teenager? Not that she should just put up with it, but strong antibiotics seem like a bit of an overkill for something that is entirely physiologically normal?

I would try a mild retinol product of an evening - make sure she wears sunscreen. Niacinamide has also made a huge difference to my skin.

Spironolactone is also used for hormonal acne but I don’t know whether it’s allowed for that age.

There are also topical antibiotics- I recall one called Zineryt.

I would probably try both of these before strong oral antibiotics personally

I was going to say try X, Y and Z.
But you've tried them all.
If your doctor has already gone down the heavy medication route then probably the only thing left is the pill in due course.
I'd go back to the doctor and try the antibiotic.
Good luck!

Thanks for the replies and suggestions ! We will keep following the medical advice and I hope with time that the treatments help . The positive thing is that there are options and the GP’s that have seen her have been really helpful and not dismissive at all of something that these days can be treated .

Acnecide products are very good. You can get them in Boots. Personally, I wouldn’t give my child long term antibiotics or the pill. I was on the pill for acne for years and it worked really well but I put on so much weight and got brown stains on my skin. I don’t like the long term antibiotics for health reasons but also I found that they worked well but as soon as I’d stop taking them, my acne would come back even worse. I first went to the doctor with acne aged 11 and I’ve only recently got to the point where I don’t put on a dab of acnecide cream and I’m 51. The thing which cured my skin was pregnancy (but probably a bit drastic!)

Niacinamide is a good shout thanks 😊

You might be making a terrible mistake with long term antibiotics.

Acne is often a symptom of dysfunctional gut bacteria. Antibiotics kill off the good gut bacteria (hence why they appear to work) but they also kill the good gut bacteria. 70% of the immune system is in the gut. If you don't focus on repairing her gut health rather than just eliminating it she could end up with serious long term bowel issues and autoimmune disease.

I'd start with diet. No sugar, in particular.

Acnecide is just a starting point OTC product for acne. Teenagers with ongoing problems usually start on an OTC product then if it doesn't work move on to Duac. Niacinamide may help with redness and the prevention of scarring but it won't get rid of the acne.

Ok thanks I think I will talk to GP again . They were very reassuring about the use of oral antibiotics otherwise I would not have agreed ! I’m going to look again at topical treatments

I agree about long term antibiotics - they really messed up my gut and I ended up with various yeast/fungal infections. Took years to sort. I would avoid if you possibly can. Especially as her teeth will still be developing.

Do ask about Spironolactone though, its main use is as a diuretic so many GPs are not aware that it can also be used for hormonal acne. Very few side effects as far as I am aware.

Yes she started with acnecide to no avail . I’m happy that there are different options out there. It’s something that bothers her so we will keep researching.

I will do thanks for advice !

Oh and finally - I would recommend La Roche Posay Effaclar tinted moisturiser and NARS creamy concealer - they don’t seem to make acne worse at all. Makeup is a godsend for a teen with acne!

@minipie I will do thanks for advice !

My 14 year old has been dealing with acne since he was 12 as well. We've been through the cycle of topical treatments, etc and have maxxed out at the tetracycline tablets. The tablets help calm down his skin but don't completely clear it up. If he is a bit sloppy with hygiene there's also a bit more of a breakout.

Currently on a wait list to see dermatologist (which we have been told could take well over a year) It is frustrating but we've been assured that he will outgrow it as his hormones eventually settle down. He is on the advanced side of the puberty spectrum compared to his peers, so hopefully soon.

I struggled with acne as a teen, went on the pill at 16 which helped. I’ve also used Dermatica prescription skin care online which has helped so much.

I had acne from the age of about 10 and so did DH so no surprise our DC has it. I remember mine clearing up around 14-15 ish, my mum did take me to the dr's but nothing really worked and just made me more self conscious of it as she was making such a big deal of it.

With DC we've made sure they have a good face wash and let them get on with it. If it was really upsetting them we would look into other options but it's just really part of being a teen and puberty, they'll likely grow out of it.

Oh yes forgot to say! Cerave face wash also helps!

My DD nearly 13 is the same. She was prescribed the oral antibiotics but couldn't take them as she's not good with tablets and refused to swallow them. 🙈

It's interesting you said the epiduo made it worse. DD was prescribed this and I thought it was OK but we ran out and I've noticed since stopping it her spots are much less red and inflamed. It's calmed down a lot!

We use now micellar water and a face wash. And every other night we use REN glow tonic. This seems to be keeping it at bay. Not perfect but better than it was.

If you can I'd see a private derm .

I rate Dr Natalia Spierings or Dr Emma Wedgeworth

Perhaps try a prescription of Dalacin T - it's a strong topical antibiotic solution and it works.