About 85% of teenagers are affected by acne at some point; Up to 20% may have facial scarring, which can be severe and permanent. Acne can also lead to psychological distress, low self-esteem, anxiety, and even depression.

For these reasons, milia should be treated promptly; In this article, we will discuss the condition in patients aged 13 to 19 years.

1. What causes acne?

This inflammatory skin condition, which occurs most commonly on the face (but can also affect the chest, shoulders, and upper back), usually occurs due to blockage of the sebaceous unit, increased sebum production, changes in keratinization and increased penetration of Cutibacterium acnes.

2. Are there common triggers and risk factors for acne?

Changes in hormones often cause teenage acne. Testosterone typically increases during puberty and is one of the main causes of teenage acne. Many patients may believe that this hormone is only stimulating in boys, but testosterone levels also peak in girls during puberty. In most patients, acne resolves in adulthood.

Some common risk factors for acne include genetic predisposition, anxiety, stress, menstrual cycle, temperature, and humidity. Using cosmetic products, poor skin hygiene, and pregnancy can also cause acne. Steroid use is another common cause and can be found in both male and female athletes who want more muscle to improve their performance.

3. What are the different types of acne? How is it graded?

Acne can be comedones, papules, mixed or nodules. In terms of severity, there are different classification methods. It is important to recognize the type of acne because the clinical type and severity can influence treatment. The US Food and Drug Administration recommends classifying acne using the Investigator’s Global Rating scale (Table).

4. How are milia treated?

Common topical and oral treatments include salicylic acid, benzoyl peroxide, antibiotics, and retinoids. Oral isotretinoin (a retinoid) is by far the most effective, but it has the potential for many side effects, including birth defects, liver abnormalities, and inflammatory bowel disease. Most clinicians will determine treatment based on both the clinical type and severity of acne.

5. What conditions contribute to severe teenage acne?

Polycystic ovary syndrome, Cushing’s syndrome, and congenital adrenal hyperplasia can lead to the development of acne in adolescents and will be accompanied by other symptoms. For example, with polycystic ovary syndrome, the patient may have irregular periods, excessive body hair, and thinning hair.

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