Severe Acne is a Heartbreaker

acne3.jpgI saw a polite, soft-spoken boy this week with severe cystic acne.

“How long have you had acne?” I asked.

“For about two years.”

“Have you been treating it?”

“Yeah. Actually I’ve spent so much money on acne medication that my mother made me get a part time job to start paying for it,” he replied.

He had deep red pitted scars on his face, chest and back. It broke my heart.

If you have severe acne, please listen to me —

  • It is not your fault. No amount of pizza (however greasy) or chocolate can cause acne.
  • Stop scrubbing. Apricot scrubs, sugar scrubs, or other abrasive treatments will only serve to make it worse. Your acne is not caused by dirt or by being unclean. Hormones, genetics, and trapped bacteria cause acne.
  • If you have severe acne, like my patient, then topical treatments such as Proactiv®, and even prescription topical medications such as Retin-A® are not enough.
  • Acne can be painful, disfiguring, embarrassing, and permanently scarring. Don’t try to fix it on your own. You need a physician’s help.

There are literally hundreds of companies (many who spam me everyday to get me to mention them here) willing to sell you stuff for your acne. If you have mild acne, most of these products would help. However, if you have severe acne like the patient in the photo, then you need prescription oral medications such as oral antibiotics (doxycycline, tetracycline, or minocycline) or isotretinoin (Accutane® or Sortret®) to treat your acne.

If you are a parent, then please call your child’s pediatrician or dermatologist today for an appointment. Not tomorrow. Today. Adolescence is hard enough; there is absolutely no reason to suffer with severe acne. And no reason to get a second job to pay to fix it.

20 thoughts on “Severe Acne is a Heartbreaker”

  1. My husband tells me he had acne like this as a teenager. Amazingly he doesn’t have many scars from it. Poor kid. It’s tough just dealing with an “ordinary” zit.

  2. I can fully relate to that kid. I had severe acne as a kid (I still suffer from time to time now). It destroys your self confidence and I literally did not dare to talk to women for fear of being rejected!

    I tried all the topical creams, lotions, ointments and face scrubs and none of it worked. I even bought this expensive book from the states which claimed to be able to control acne through diet. It would have meant cutting out literally all the foods I enjoy like tuna fish so that was out.

    I did 2 years of all the different cycline drugs and they didn’t help. Then, finally, I was put on a course of Accutane. It works very well and cured my acne but it is brutal stuff. It damages women’s babies if they are pregnant and I had so many blood tests it’s not even funny. My tryglycerides (whatever they are) were through the roof and I had to stop. Nowadays I use a benzyl peroxide 10% cream to keep it at bay. It’s good but dries out my skin and stains clothes and pillow cases! Oh the joy of bad skin!


  3. It’s so sad that his mom made him get a second job to pay for his treatments… how cruel!

  4. Good post. That picture is definitely severe. Thankfully, my skin has never been that bad.
    When I was younger, I always thought it was me. (Like you said) I thought it was my makeup, diet, face wash, everything. I couldn’t figure it out. I never did get any treatment, because my parents never offered to take me.
    Recently I was looking at pictures of my dad’s side of the family, and guess what? They all had acne. So it really is genetic.
    The only thing that seems to help me, is if I drink a lot of water.

  5. Dr. Val,

    It might not be the mom that is cruel, but the fact of life that the family didn’t have the money to pay for it.


  6. rlbates-
    Thanks for stopping by. You have a wonderful blog at Suture for a Living.

    Acne usually (not always) get better as you get older. Benzoyl peroxide is a good (cheap) way to manage it.

    Dr Val-
    The whole thing really broke my heart.

    Genetics is probably a bigger factor than any of the diet, etc. Glad to hear that yours got much better.

    I don’t actually know if it was a case of an unsympathetic parent or just that they didn’t have the money. It is frustrating that many acne treatments are very expensive and not entirely truthful about the results you can expect. Unfortunatly true about a lot of things in life.

  7. Boy, can I relate. I had severe acne as a teenager, too. Add to that my lack of team sports skills and good grades, and … well… the girls weren’t banging down the doors for a date with me. Thank goodness it got all better (and with that, so did my social life).

    Your post is excellent, and you make a great point — adolescence is hard enough without untreated severe acne.

  8. hi,
    i had the same acne problem once. and i went to the clinic (general family clinic) and took the medicine that the doctor gave (doxycycline) for 2 months, and i asked for another 4months before i thought of stopping the a/b medication. during taking the a/b, i changed my facial cleanser (typical OTC) to DOVE soap (peeling/soft), after read from several reviews over the website of its effectiveness for acne-prone skin. after not taking the a/b, i took topical erythromycin +zinc[zinc helps reduce scarring they say], and after 2 months without i realized, my friends told about the improvemnet of my skin condition, 2months.. well maybe 3 months, and i bought another bottle of the solution as a prophylaxis of further breakout. and now, [once i beleive i cant eat chocholate, nuts, or spicy food, even oily], i just eat anything i want [ mind, i have diabetic type 1], and theres not even a single breakout! OMG!. my target is now, just to reduce the scarring, =)

  9. hi i think acne is very common problem am suffering from it from a long time since school days in beginning it was severe doctor gave benzoyl peroxide and doxycycline it worked,today am 24 but this also not working but now i get acne only on my upper lips n chins ,around mouth m applying benzoyl peroxide 2.5% and cetaphil cleanser with neutorgena toner.

  10. greentara says:

    Thank you for writing this, and your excellent no-BS blog. I am 32 and still controlling adult acne with the help of a dermatologist. When I was sixteen, I took the money from my after school job and made my first appointment. I had already been dealing with acne since age 11. It is money well spent if you can afford it, and indeed cheaper than chasing a cure through countless product lines and misleading advertising that only exacerbate the problem. Thanks again for your sensitivity to this issue.

  11. Charlotte says:

    @Doctor David
    Unrelated-to-this-article side comment: Are you saying that you had a lack of good grades (along with a lack of sports skills), or that “good grades” negatively affected your chances of getting a date?

    I find it incredibly difficult to believe that your good grades scared away potential dates, and honestly, your belief that it did comes off as sexist (or perhaps you were only attracted to airheads).

    Isn’t it altogether possible that you only had good grades because you used the time that would have been spent on dates, studying instead? That makes far more sense.

    Perhaps you should be grateful for your good luck, Doctor. 😉

  12. I am a teenager and I have had really terrible acne since the age of nine. I’ve been to the doctor and been prescribed so many different medication for it, it’s unbelievable. They ALL helped my face but they didn’t help my chest back arms and shoulders. I booked an appointment with the dermatologist and I don’t know what to expect.. If it is anything like the doctors “Here, we don’t care, have another drug” I will be VERY angry. Acne is so depressing and emotionally destroying that I don’t even like to go to work nowadays. Never mind going out to have a good time. When I was younger I didn’t go to school because I was being bullied because of it and I would sit and cry in my room. I just hope there is something they can do.. And maybe fast?

  13. Chi Nguyen says:

    Hello Dr. Benabio,
    I came across your blog through googling about acne treatments and I found this article. I hope you could give me some helpful advices!
    My brother has suffered severe acne since he was 16 (now he’s 24) and seems like it gets worse by time. He has been to dermatologists’ several times, they both gave prescriptions included oral-medication, facial soap for acne skin and acne treatment, but it didn’t work at all if any.
    His skin condition is slightly worse than the picture above (apart from the red scars because his face are covered with depressed scares, swollen acne, and whiteheads (every now and then).
    I really want to help him improve his skin condition since he’s become frustrated with it and kind of give up.

    I predict you may suggest him seeing a dermatologist again, but since we’re from a third-world country and there aren’t professional/ specific dermatologists available here (if any). so I’m afraid that it wouldn’t be any helpful.
    I’ve been searching informations about treating acne and found that isotretinoin is for treating severe acne cases, so I need your advice about whether my brother should get on this medication or not ’cause I’ve read cautions about using this.
    Hopefully I will receive a response from you.
    Thank you for reading my comment!
    Best regards.

  14. Ive been suffering from acne since the 4th grade. After reading this i feel way less guilty and paranoid about the things i do or eat, so i thank you.

  15. hi Dr. Benabio,
    i’ve been suffering acne back few years ago. now that acne’s gone but i’ve acne scars remain on my face. how to “erase” or lighten these acne scars? i’ve tried many products but none worked.

    thank you.

  16. ive been suffering with acne since im 12.i am now 15 and my acne is worse although not as bad as the one in the picture..i used to wear a lot of makeup to cover it but then i started feeling down alot and being depressed because all makeup did was cover up my redness,not the bumps..and i thought it was ugly to wear makeup but yet see 100 bumbs on your face.i stopped wearing make up 2 weeks ago and decided to take care of my skin.its really gard tho.its imbaressin i wont even come out of my house.and when i have visit i dont come out of my father had acne when he was young but by the time he was 18 his face was mom didnt have any at hopefully mine will leave before i reach 18. ive tried everything.i tried using proactive and it didnt even work one bit.i tried clean and clear and many other things but it doesnt work.when they say it works its not always true.everyone has different skin type.
    But there is one thing that works a little for me.Ive started washing my face with Neutrogena power clean srub and right after i was my face i use benzoyl panoxyl.Its the best medication ive used in my life.although it doesnt make miracles.what can i say acne is part of life.but with what i use i do see good results everyweek and it makes me feel better about myself.what i also do is exercise and drink at least 8 glasses of water me it works.i cant promise you anything cuz were all didnt clear my acne but everytime i use benzoyl panoxyl it clears a pimple in like 4 i said i see results i would give it a try if i were you .good luck
    and your not the only brother is 17 and hes got acne too.its worse then mine.but it will leave just give it time

  17. I so understand. I’m 18, and I have annoying acne. Sometimes it’s not so bad. Sometimes it is. Right now it’s icky. >.> I hate it. I hate feeling awkward with it. I sometimes use makeup to hide it. But I find washing does help, and DO NOT PICK. I do that a lot, but trying hard not too.

    Also, even if it’s hard, don’t worry so much about others. Some of my friends have acne too. And even if they didn’t, or mine may be a little worse, they are my friends. They don’t give a shit about my acne. Real friends and caring family don’t care – it’s all in your own head. Yes, it’s annoying, and we don’t like the way it makes our faces look. But do what you can to treat it, but don’t let it get you down. All teens get acne, and some adults do as well.

    It really sucks acne has to exist. It’s annoying.

  18. am 15yrs. l’ve been with acne since the age of 13 but then it was not so complicated as now..though mine isn’t dat serious as dat guy in dat pic above.frnds wat can i do get ride of these pimples in my face?

  19. I’m about to be fifteen in two months and I’ve had acne for two years. It hurts every time i look in the mirror, I see people looking at it all the time, I lose confidence a lot of the times, and I’ve broken down crying a couple of times now. I’m going to a new school tomorrow and I know that it’s gonna suck because I have severe acne. Sometimes, I just want to kill myself.

  20. hello!,I like yourblog so much! share we meet more about your post on MSN? Looking forward to see you.

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