Acne in adolescence and puberty

Spec. Dr. Svetlana Djurisic, dermatologist - Dermatological clinic DERMATIM, Belgrade, Serbia

Puberty is a part of one’s life when the development of secondary sexual characteristics in both
sexes takes place under the influence of hormones. One of the characteristics is the enhanced
activation of the glands with external and internal secretion. The result of that process is that the
skin is getting oilier and with the persons that are genetically predisposed the secretion of
sebaceous glands is followed by the appearance of blackheads. The blackheads fill the canals in the
skin forming cysts and then pustules.

Depending on the type and severity of acne, they can be divided into those that are characterized as
blackheads and one that next to blackheads form cysts and pustules. The most severe form of acne
comes in form of nodules, pustules, painful changes that can affect the entire surface of the face
and the back.
The appearance of acne on boys is specifically genetically conditioned, even though they are most
frequent in the period of puberty and adolescence when the testosterone level is the highest. The
testosterone is a hormone that makes the skin and hair oilier when enhanced, but it is at a normal
level in boys and a large percentage of girls with acne. Next to the genetic predisposition, the
misbalanced hormonal status with girls can be the cause of the appearance of acne. Getting period
properly and regularly with most of the girls leads up to the withdrawal of acne.

Acne and nutrition

Improper diet, fast food and consumption of too much candy can make acne more severe, but it
cannot be their cause. This type of food enhances the level of insulin in our blood that has the same
effect as the male hormone and it makes the skin oily and prone to pustules. Fruits and other
natural sugars do not cause the appearance of acne. According to certain research, large amounts of
milk and yoghurt can cause the worsening of the acne. It is said that there is a high level of
hormones in dairy products so not more than three glasses of milk are recommended to the people
prone to acne.

Acne and stress

Most of the adolescents notice that acne appear in stressful situations. The reasons for that are the
adrenal hormones that are increased when the body is exposed to stress and they have the
androgen effect (the effect of testosterone).

The treatment of acne

The treatment of acne is necessary because in most cases they leave scars that are hard to remove.
There is no therapy that can be universal. The therapy depends on the type and sensitivity of the
skin and also on the type of acne. If the condition is caused by hormonal misbalance the hormonal
status should be treated next to the treatment of the changes on the skin.
During the therapy, creams and lotions with antiseptic effect can be used, such as salicylic acid,
benzoilperoxid, azelaic acid, retinoids, or local antibiotics. The significant improvement and speed of
the effect of the therapy can be brought by peels with alpha acid, beta acid, salicylic and azelaic
acid. Also, treating acne by laser therapy can be very successful but has a short-term effect.
After finishing any kind of local therapy, regardless of it being by laser, cream or peel, patients
should get medicine to maintain the proper condition of the face and which role is to control the
further activation of the glands. With the case of severe form of acne antibiotics or isotretinoin pills
are used for 4 to 6 months.

Treatment of acne scars

If the scars of acne remain even after the therapy, there are various treatments by which they can
be significantly reduced. The methods of choice are chemical peels with trichloroacetic acid (TCA)
which should be implemented by an experienced dermatologist, laser treatments, abrasion or filling
scars by hyaluronic acid.