Help! My Teenager is asking to start on roaccutane!

I get this message all the time from concerned parents. Their pre-teen or teenager has started to breakout. They've already tried a variety of different products to try and fix the problem, and they're still struggling with their skin.

The below is adapted from an email I sent to a concerned mother just yesterday, advising her on the best way to approach this problem.

Firstly I’ve been in your child’s position with medication and I think you’re right to keep her off it, based on how you’ve described her condition. It doesn’t sound severe enough to me to require the medication and if they just makes some simple changes to her routine I’m sure the acne can be bought under control.

Further their acne is partly hormonal, but based on what you’ve described it sounds like it’s been made much worse by using of too many of the wrong kinds of products. Bear in mind that healthy skin will heal itself, so the fact that it’s not healing shows there’s something she’s doing to her skin which is preventing that healing from occuring. My advice to anyone who gets into this position is to stop everything and start over, with the simplest routine possible. 

You’ve probably seen or read me say that the skin has a protective barrier which prevents dirt and bacteria from causing acne and blackheads. This barrier becomes damaged through the use of the wrong types of skincare, and then dirt and bacteria have free access to the unprotected skin cells beneath the barrier, which is when acne forms. If your teenager is doing lots of face washes, exfoliation, using “active” ingredients or masks to try and pull out the oils, or derma planing these will all be contributing to the damage to her barrier. Also if she’s touching her face a lot or wearing makeup she’s introducing more dirt and bacteria to that unprotected skin.

If the environment is correct that barrier can reform, but if she’s continuing to use products that re-damage the barrier it’s not given the opportunity and the acne continues and can become worse.

I recommend they start with just the one product and if they can restrict themselves to that one product for even a week I think they will see an improvement in their skin. Our moisturising serums can be used to oil cleanse, and then reapplied and left on to hydrate. The oil cleansing removes the dirt and accumulated environmental toxins from her skin, without stripping her barrier, giving it the opportunity to heal. Additionally using a Guasha to stimulate lymphatic drainage and circulation, which will also help improve the healing around the acne. 

The biggest challenge will be ensuring that they sticks to the routine. It takes skin cells 30 days to form and travel from the base of the dermal layer to the top of the epidermis. This means it will take at least 30 days for that barrier to reform. Within that time they can still get acne and breakouts because her skin is still unprotected, so even breakouts that occur after they’ve started the new routine doesn’t mean it’s not working. However you should see an improvement in their overall skin texture and a reduction in inflammation. That is a sign you’ve created the right environment for the healing to occur and all that remains is to stay consistent and stay patient.

I recommend you take a before photo so that if they doubt the process you can refer back to it. I’ve found that many of my clients misremember what their skin looked like when it’s not perfect after two weeks. Having the photo to refer to is a great way to remind yourself when you’re on the right track.

Please reach out to me if you have any questions or wish to discuss this any further.