Why is my daughter starting to suffer from acne?

Few things cause more stress and embarrassment for adolescent girls than pimples and blemishes on their faces. Acne affects almost 90% of teenagers and is brought on by the rise in androgens, or male-like hormones, that occurs with puberty. There are many misconceptions about acne and what causes it. Contrary to popular belief, foods like French fries, soda, pizza, and chocolate do not cause acne. And while it is obviously a good idea for your daughter to wash her face, over-zealous, frequent scrubbing with strong soap will do more harm than good. The irritation caused to the skin may actually encourage the formation of acne.

As a mother of a daughter entering puberty, what skin care advice can I give her?

Your daughter should wash her face with a gentle cleanser no more than twice a day. She should use non-alcohol based cleansers that contain alpha-hydroxy acid or beta-hydroxy acid (salicylic acid) because these will gently exfoliate the skin. After washing, an over-the-counter product containing benzoyl peroxide should be used to kill the bacteria causing the acne. "Popping" pimples is a very bad idea because it can force bacteria deeper into the skin and cause scarring. Minimizing makeup and using only oil-free, water-based products will be helpful too.

If these measures don't clear up the acne, the next step is to have your daughter see a doctor and be evaluated for the need to use a stronger medicine or antibiotic. (Interestingly, the birth control pill can be very helpful in controlling acne. The pills cause a decrease in the circulating androgen levels and thus reduce the primary cause of acne.)

Acne affects almost 90% of teenagers and is brought on by the rise in androgens, or male-like hormones, that occurs with puberty.

Brett says:

Before going to extreme measures with acne medication, it is really important to just wash your face and apply lotion and sunscreen. Find good face washes, lotions, and sunscreens for sale that are designed for sensitive skin. I began to see a dermatologist in seventh grade and used a combination of products until I found ones that worked the best. I alternate between Tazorac® and EpiduoTM, and I use Keflex as an oral medicine. It is really important to find products that wont dry out your skin and will give you the best results.

What causes dermatitis in the genital area?

In my medical practice, I see more than my fair share of irritated bottoms. (That's part of the glamorous life of a gynecologist.) A significant portion of these cases is caused by one of two types of contact dermatitis. Unfortunately, this problem affects the genital^[1] region just like any other part of the body.

Liquids that are inserted in the vagina for the purpose of cleansing the vagina. These commonly contain vinegar and can be bought over-the-counter or made at home. Douching is not generally recommended by the medical community.

Irritant contact dermatitis^[2] is caused by repeated exposure to a caustic or physically irritating substance such as urine, feces, or soap residue. The primary causes include over-washing, use of creams with drying bases, the persistent wetness that can occur from menstruation, urine, or feces, and incomplete rinsing of clothing so that soap residue on underwear interacts on the skin when the woman perspires. Panty liners and douches^[3] are other causes of irritation.

Allergic contact dermatitis is an allergic reaction to something that touches your skin. The more common substances include neomycin, benzacaine, preservatives (parabens and propylene glycol), latex (condoms), chlorhexidine, nail polish, lanolin, and perfume. You will be surprised to find these ingredients in very commonly used over-the-counter products.

While there are so many wonderful-smelling bath salts, soaps, and body washes out there these days,

I advise my patients to stick to mild soaps that have no perfumes or additives. A good rule of thumb for you and your daughter to keep in mind is, "The better they smell, the worse they irritate."

I have seen young girls who need to urinate frequently and are evaluated for bladder infections. And yet, these symptoms completely cleared up when they simply stopped using fruity shampoos and yummy-smelling bubble baths. This was most likely because these soaps and shampoos had an irritant effect on their urinary areas. Therefore, I recommend to patients who are prone to skin irritation that they use hypoallergenic^[4] soaps available in most stores.

Although we live in a largely shower-oriented society, a soak in the bathtub with just warm water and mild soap is often just what the female genital area needs for cleansing and soothing. The soak seems to do a better job at rinsing away the bad bacteria in the vaginal area, and at calming irritated skin. Though everyone is in a rush today and showers are quick, a 10- or 15-minute bath on a periodic basis could do your daughter a lot of good.

Should my daughter be shaving and waxing?

One final hygiene topic involves shaving and waxing. (I'll cover this topic in greater depth in the chapter on body art.) Many adolescents feel the need to shave their legs, even before they hit middle school. Those with darker hair in particular tend to feel that their leg hair or underarm hair is very noticeable and, therefore, a source of embarrassment. As long as your daughter is instructed in how to shave and the use of a safety razor, there shouldn't be a problem.

A soak in the bathtub with just warm water and mild soap is often just what the female genital area needs for cleansing and soothing.

Shaving and waxing of the pubic region is a little different. I see many young women with irritation and itchiness in the pubic area caused by shaving. An exam often shows that they have ingrown hairs and red bumps caused by the inflammation of their hair follicles. Therefore, you may want to recommend to your daughter that if she really wants to reduce the amount of her pubic hair, she should keep it limited to simple trimming with an appropriate pair of scissors.

Kama says:

If you will read the directions on the back of your cream hair remover, you may find a caution statement that reads, in part "Do not use on recently tweezed or shaved areas." There may be no mention of recently waxed areas. Recently waxed areas are hypersensitive and the skin contains tiny pockets where the hair shafts used to reside. Learn from others' mistakes is a wonderful adage. Therefore, allow me. Do NOT use cream hair remover on recently waxed skin or you will achieve a chemical burn like.. . you read about.

• [1] A term that refers to a person's internal and external sexual organs.
• [2] An irritation of the skin that can be caused by an infection or the use of a product such as a soap, lotion, or powder. The symptoms can include itching, burning, and general discomfort.
• [3] Liquids that are inserted in the vagina for the purpose of cleansing the vagina. These commonly contain vinegar and can be bought over-the-counter or made at home. Douching is not generally recommended by the medical community.
• [4] A product that has a low likelihood of causing an allergic reaction.