Managing Moderate Acne in Adolescents: A Case Study
By Dr. Ashley Baldree, Village Dermatology
Acne is a common concern for many teenagers, and while it’s a typical part of adolescence, it can significantly impact self-esteem and quality of life. Today, I’d like to share insights from a recent visit with a 14-year-old patient who is battling moderate acne on her cheeks. This case sheds light on the treatment plan we developed, along with the education provided to her and her family regarding care expectations, safety measures, and the journey ahead with isotretinoin.
Case Overview
Our patient, an established young teenager, came to us with moderate acne on both cheeks, featuring pimples and areas of early scarring. After careful evaluation, we discussed a multifaceted approach to target the active acne and reduce the potential for further scarring.
Skin Care Essentials
The foundation of any acne regimen is a consistent and suitable skincare routine. We emphasized using non-comedogenic cleansers, moisturizers, and cosmetics. Non-comedogenic products are less likely to clog pores, which is essential for anyone prone to acne. Consistency in these basics will help create an environment that’s less likely to aggravate acne.
For more information on acne-specific skincare, visit our Acne Care page.
Setting Realistic Expectations
It’s important to remember that acne treatments do not work overnight. I explained that she could expect to see a 60-80% improvement over the next 2-3 months if she follows the regimen closely. Patience is key, as acne treatments often need time to show results.
Treatment Plan: Isotretinoin
Due to the scarring and severity of her acne, we decided to initiate isotretinoin therapy. This powerful medication can dramatically reduce acne by decreasing oil production, but it requires careful monitoring and adherence to specific guidelines.
For a deeper look at how isotretinoin works, see our Acne Treatment page.
Dosing and Safety Protocols
Her starting dose will be 1 mg/kg until a cumulative dose of 120-150 mg/kg is reached, which is standard for maximizing efficacy. Given isotretinoin’s potency, we discussed in detail the importance of regular blood tests to monitor liver enzymes and lipid levels, and we reviewed monthly urine pregnancy tests for safety, as isotretinoin has known risks of severe birth defects.
Counseling on Side Effects and Preventive Measures
I thoroughly discussed potential side effects, including dryness, sensitivity to sunlight, joint aches, and rare but serious mood changes. Other important instructions included:
Sun Protection: She should apply a broad-spectrum sunscreen with SPF 30+ daily.
Hydration and Moisturization: Regular use of moisturizers is crucial to counter the skin’s tendency to dry out on isotretinoin.
Our Hormones and Acne page further explores how hormonal changes can impact skin and influence treatment results.
Birth Control and Abstinence Counseling
While the patient has chosen abstinence as her method of birth control, we reviewed the need to remain vigilant and fully understand the commitment to avoid pregnancy during and after treatment. We also reiterated the need for dual forms of birth control should her situation change.
Additional Counseling Points and Support Resources
We covered several essential safety points:
Avoiding Blood Donation: Due to isotretinoin’s teratogenic potential, blood donation is prohibited during and shortly after therapy.
Driving Precautions: If she notices any night vision issues, she should avoid driving at night.
Emotional Monitoring: We discussed the possibility of mood changes, emphasizing that any signs of depression should be promptly reported.
For more insights into potential causes of acne and how lifestyle factors can influence treatment, visit our Causes of Acne page.
Follow-Up and Ongoing Support
We’ll see her back in one month to assess progress, review blood test results, and provide additional guidance as needed. The patient has clear instructions to contact us if she notices any severe side effects, including headaches, vision changes, mood changes, or abdominal pain. Regular follow-ups are vital to ensure safe, effective treatment.
By working closely together and following this structured plan, we aim to help our young patient achieve significant improvement in her acne and prevent further scarring. We’re here to support her through each step of her journey to clearer skin.
For more information on how we treat acne and support our patients at Village Dermatology, please visit our comprehensive Acne Care page.