Last Updated on November 8th, 2019
Everybody knows that teens get acne. Nearly everyone now an adult remembers getting blackheads, whiteheads, pimples, and other kinds of zits as a teenager. But there is a disturbing recent trend of acne in children as young as 7 up to the age of 12.
Dermatologist Latanya Benjamin of the Lucille Packard Children’s Hospital at Stanford University in California told a New York Times reporter that, in her practice, it is not uncommon to see blackheads and whiteheads on the faces of children aged from 7 to 9. Dr. Benjamin attributes this new trend to a change in the average age of adrenarche, the maturation of the adrenal glands.
In the modern world, children’s adrenal glands, perhaps due to the overstimulation posed by video games, television, and pressures to succeed at an early age in school, start producing stress hormones in adult quantities earlier and earlier. Exposure to xenobiotics, artificial hormones from the environment, and high-fat diets are also inducing precocious puberty. Children begin to have functioning sex organs as early as 8 or 9. The earlier onset of sex hormones also causes earlier onset of acne.
A study published in the medical journal Annals of Dermatology two years ago stated that the average age of a non-adult patient brought to the dermatologist for acne care had declined from 15.8 to years to 15.0 years. In other words, the average age of children and teens affected by acne has fallen about 10 months.
But the proportion of children taken to the doctor to get treatment for acne has risen dramatically. At one time, dermatologists almost never provided acne care to children who were not at least in the sixth grade. Now, most dermatologists routinely treat acne in children who are in the third grade. And 1.5% of all acne care visits are for seven-year-olds.
It’s typically your family practitioner who will offer antibiotics for acne in childhood. The dermatologist is far more likely to recommend a combination of benzoyl peroxide and one of the vitamin A derivatives known as retinoids, especially Roaccutane, Retin-A, or Differin. Your family practitioner is more likely to prescribe a pill—the form of acne medication that is most likely to have side effects—while your dermatologist is more likely to prescribe a skin cream or gel—which costs more.
Health insurance in the USA doesn’t cover a lot of the medications doctors like to prescribe for children who have acne. Roaccutane, Retin-A, and Differin, for example, are “off-label” for use in treating children under the age of 12. Your health insurance may balk at paying for them. However, all insurance plans will pay for the relatively new anti-acne product called Epiduo, which is a combination of Retin-A and benzoyl peroxide.
Epiduo has been clinically tested on children as young as 9, so the US Food and Drug Administration has approved its use on children. The downside to using the product is that it can make growing skin itchy and even actually hurt. When this happens, the doctor is likely to suggest a milder product that the FDA has not approved, but which has fewer side effects on rapidly growing skin.
Some natural products are not a good idea for kids, either. Tea tree oil, the Australian herbal extract, is a great product for treating acne in adults. It gets rid of acne bacteria faster than the most commonly prescribed medication for acne, benzoyl peroxide, and it relieves inflammation and itching, too.
Unfortunately, tea tree oil also interferes with hormonal balance in the bodies of children who have not yet passed puberty, especially the bodies of prepubescent boys. It interferes, in some cases, with the body’s use of estrogen, encouraging the growth of breast tissue.
When this happens to elementary school-aged girls, it’s a social concern. When this happens to elementary school-aged boys, it’s a social disaster. The effects are reversible when tea tree oil products are discontinued, but the “breastiness” of the chest diminishes as other tissues grow normally around the breasts. It can take several months to undo the effects of tea tree oil compresses and tea tree oil soaps. This is not by any means a common complication of the use of tea tree oil in pre-adolescent children, but it’s common enough that no parent should ever use a tea tree oil acne care product on any child who has not yet passed through puberty.
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