Speaker 0 00:00:04 Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, a pharmacist and mom of three. I combine healthcare and practical advice to support you on your parenting journey. This season is all about family skincare and it's proudly sponsored by real life, real life. Believe your skin says how you feel, and this is so, so important as we explore family skincare concerns. Today I'm going to be talking all about tween skincare and teenage acne. I'll be giving some advice about tweens and why it's important to consider their skincare. For the purposes of today, I'm considering a tween to be someone who's between the ages of about nine and 13. I'm gonna explain why it's a good idea to get them in the habit of having good skincare and recommending products that might be helpful in terms of teenage acne, which occurs in children who are going through puberty and beyond. Speaker 0 00:00:57 I'll be talking about what happens and what causes acne because I think that can actually be really, really helpful to understand so that you can make the correct product choices. We all know there's so many different products on the market, which are targeted at teens and parents of teens, and really we just want to cut the nonsense out and try and select products that are going to be really beneficial to their skin. Remember always that the ultimate aim of treatment of acne is to reduce scarring and to clear blemishes. After I explain exactly what causes acne, I'll be talking about how we treat it and then I'll be giving some general advice and of course some product recommendations. All of the information that I give about the treatment of acne, how it happens, and the general advice and treatment options are suitable for any age group from puberty on. Speaker 0 00:01:50 First of all, tweens, I am a parent of tweens, <laugh>. I have two girls and a boy, and the girls are 11 and nine, so they're very much in that era. I have to say I've been a bit lazy about introducing a skincare routine for them. It's something that's been playing on my mind a lot lately, and I've come to the realization which I should have come to a lot earlier, and that's why I'm recording this podcast to advise you to do better than me. That really and truly, you need to capture good habits at an age where your child will still cooperate with you. Your tween has definite hormonal changes coming puberty is around the corner. The first step that I would do to introducing a skincare routine for a child is literally just to give them a face cloth. So they're gonna use this face cloth and water, just water initially to wash their skin every evening as they go to bed. Speaker 0 00:02:44 So you're really just introducing it into the normal routine of brushing your teeth. So every time they're brushing their teeth, they're gonna use the face cloth and water to wash their face morning and night. I have really nice, lovely soft face cloths that actually are really handy and I use them myself as they're quite efficient at taking off makeup, even my stubborn Charlotte till Brie eyeliner. I'll leave a little link to these in the show notes and I'll also pop a little link on my Instagram at Wonder Care underscore I R l. They should be washing their face twice a day, so I've introduced it just alongside the toothbrushing routine. If your child is looking for something a little bit more than just water, then a nice alternative is Rema lipid replenishing cleanser. It's pediatrically tested and it helps to restore the natural barrier of sensitive skin. Speaker 0 00:03:36 It's really easy to use. They just have to press down on the little dispenser pump once or twice and then apply the SR onto wet skin, massage it and gently, and it starts to create a delicate foam. You then just rinse off this foam with water. It's an ideal compromise when you're dealing with tweens. After washing your face, sometimes your face can feel a little bit dry. It's always a good idea to give your child a little bit of a moisturizer. The products that I'm using on my own children, and as a result I'm happy to recommend are the Sera SPF 50 moisturizer, so I get them to put that on every morning after washing their face. That way I know that at least they're getting good sun protection as well. Even on those cloudy days. We were at the zoo recently and I hadn't given it to them, and they came back with very flushed red cheeks. Speaker 0 00:04:24 I was disappointed in myself, so it's definitely a good option, particularly in the summer. At nighttime, they use the Cera v pm moisturizer. This range is good for tween skincare because it's suitable from three years of age, and these two particular products are really simple and effective at helping to replenish the skin barrier on your face. If your child would prefer to use something more than just water with their face cloth, you can actually get the day tonight. Facial routine gift set, I'll put a link in show notes because it's really good value and it includes a cream to foam cleanser as well as the other two products I mentioned. The reason that I think a good skincare routine is important as your child approaches puberty, is that teenagers can be very quick to resist change. It's no harm to get both girls and boys in the habit of washing their face as they enter puberty, as I'm about to explain now, they're gonna have a lot of changes in their skin oil levels, and with acne affecting approximately 85% of all teenagers and young adults to some degree, we can see that it's really important to have these good habits formed early. Speaker 0 00:05:30 Moving on now to a child who is going through puberty, it's at this age that the risk of developing acne occurs. Acne is an inflammatory skin condition, which causes the blockage of pores. This can result in blackheads, whitehead red or pus filled spots, and it can be mild, moderate, or severe. Today I'm going to be talking about the over-the-counter treatments of mild to moderate acne. I will deal with severe acne at another stage. One of the most important things that I want you to take away from today is that it is so, so important that we take acne seriously, whether it's affecting ourselves or our children, acne can often cause significant psychological impact on someone, including a lack of confidence, low self-esteem, and even depression. As I mentioned, usually acne develops at the onset of puberty. If you find that your child who has not yet started puberty is showing symptoms of acne, then it's worthwhile having a little visit with the GP to discuss it. Speaker 0 00:06:29 In general, girls will tend to get acne earlier than boys usually when they're around 14 to 17 years of age, whereas boys usually will get it between 15 to 19 years of age. Like everything that's human <laugh>. This is not an exact science. Remember that even mild acne can cause a profound effect on a teenager as it can actually be seen as stigmatizing. It definitely recommend to have these kind of conversations early so that your child knows that you will take their concerns seriously if they raise them. That alone can relieve a big burden off your child's emotional wellbeing. If you're like me, you like to understand exactly what's going on and understand what's causing the acne, and that way you can understand the products used to treat it better, but the ingredients are doing it means that when you're looking at products on shelves, it'll be much easier for you to pick the correct product that you know is gonna be effective. So what exactly happens? Speaker 0 00:07:22 Puberty causes a cascade of events resulting in the formation of non-inflammatory and inflammatory lesions. The changes in hormones cause an increase in sebum, which makes the skin become oilier and greasier. Normally. Sebum is there to provide a protective coating for your skin, and this is what helps your skin to retain moisture, and so it's really important for healthy skin to have the correct sebum levels. If you get an increase in sebum production, your skin is oilier and greasier, and then dead skin cells, which normally shed quite easily become difficult to shed, and this ultimately blocks the outflow of sebum. Over time, the ducts on the skin become blocked and they trap all that oil in the hair follicle. In this closed environment, bacteria love to grow and multiply and they do so rapidly, and this is what causes the local inflammation also known as a spot. Speaker 0 00:08:18 There's more to it than that though. In response to all of this going on, the white blood cells kick off and they decide that they're gonna sort out the situation and attack the bacteria. This causes the bacteria to die, but this causes pus formm. Eventually the pus gel will burst and the whole thing starts again. So if you're researching acne, you'll see a lot of different terminology being used. You'll see microcom, coone, non-inflammatory lesions, inflammatory lesions, blackhead, white heads, papules, pules nodules, cyst <laugh>. It can be a bit mind boggling, but just to break it down, non-inflammatory lesions are comedones and these can be open, and that's called a black head or closed, and this causes a white head. A white head is when the sebum cannot reach the surface of the skin and the trapped keratin and sebum cause the white head. A black head is when that then starts to darken. Speaker 0 00:09:14 An inflammatory lesion can include a papu, a pudu, or an adu. A papu is just like a red spot, basically an inflamed little red spot. If this is pu filled, then it's known as a pu jewel. Sometimes pues or papules can get a little bit larger and turn into nodules or cysts. Nodules and cysts are really what increase the risk of scarring. The bacteria that grows in the pores is called prop bacterium acnes, and normally it's on everybody's skin and it's healthy and it doesn't cause a problem. But when the sebum is trapped and this bacteria overgrows, it causes an inflammatory reaction. Speaker 0 00:09:55 Okay, so now that I've bored you to death <laugh> with exactly what acne is and what's going on with the skin and what all of the lingo means, it's important to say that there are three different kind of grades of acne. You've got mild acne, which is mainly non-inflammatory, so basically you'll get a few whitehead or blackhead and you might have just a few of the inflammatory lesions and mild acne is generally mainly on the face. In moderate acne, you get many inflammatory lesions and they're not just confined to the face. The lesions can sometimes become painful, and again, here there is a possibility of mild scarring for severe acne. You get all of the symptoms of moderate acne, and you also get the development of nodules and cysts. These are deeper and larger than puls and postes, and they are very likely to scar. They can become widespread affecting the torso and face, et cetera. I just want to pause for a second to tell you a little more about the award-winning real-life products. Real-life understands that your skin reflects how you feel, and if you or anyone in your family live with any skin condition from acne and eczema to dry skin or hyperpigmentation, then you also understand this. The good news is that ReLife is here to help with a range of dermatologically tested and scientifically proven skincare products. Check out the ReLife range on Wonder care.ie, or in your local pharmacy and learn even more by visiting relife.ie. Speaker 0 00:11:27 The treatment for acne is always aimed at clearing the lesions and preventing scarring. I'll name some products at the end that contain some of the ingredients I'm about to discuss, but I think it's important you know what they all are and what they do. A common ingredient in acne products is known as benzo peroxide, and this works by releasing oxygen into the bacterial environment, disperses the concentration of bacteria. It can take a little time to see improvement from this. If your symptoms are no better within four weeks, then you should stop using the product and consult with the doctor. If you are starting to show signs of improvement, then you can continue using the product for up to three months. You can apply it once or twice daily, but usually once is enough and always remember to wash your hands after you apply it. It does have some side effects and it can cause a little bit of skin irritation, burning or peeling. Speaker 0 00:12:18 If you do suffer from any side effects, then stop using it for a couple of days and then try again. Another approach is to apply it for about half an hour for the first week and then wash it off before you go to bed, and then the next week build up to an hour and then the week after maybe try leave it on for a couple of hours or else overnight. It's important to apply this product to all areas where acne occurs, not just to the active lesions at the time. Another ingredient, which is often in acne products is salicylic acid and salicylic acid is thought to increase the hydration of the cells. It's usually used twice a day. Nicotinamide is another useful ingredient. It's thought to have anti-inflammatory properties, so this can help to reduce the swelling and redness associated with acne. It's also thought to have a role in the regulation of sebum production by the glands in your skin. Speaker 0 00:13:12 Again, nicotinamide is generally recommended to be used twice a day. If your skin becomes irritated, do reduce it down to once daily or even on alternate days. Similar to the benzo peroxide, you should use it everywhere that you normally suffer from acne, not just on current inflammatory lesions. It's important to avoid getting it near your eyes or mouth and do remember to wash your hands after using it. Both benzo peroxide and salicylic acid are known as keratolytics. This is because they promote shedding of the keratinized cells on the skin surface. So do you remember earlier I was discussing how acne happens and that the cells start to find it hard to shed and that adds to the fact that they get blocked and makes it impossible for the sebum to escape? Will these ingredients basically help to remove any of the old keratinized cells that are sitting on the surface and this stops the sebum from getting blocked in? Speaker 0 00:14:08 Okay, so just before I move on to product recommendations, I'm gonna highlight a little bit of advice and also bust some myths. <laugh>, in terms of advice, good hygiene is really important, and this is because it helps to reduce the severity of acne. You're decreasing the skin and you're also removing bacteria. So this is why I am saying that preteens should get used to this routine before they hit puberty. Washing the face twice a day with water until they reach puberty, and then with an acne specific cleanser or product if they get symptoms of acne, is really helpful. It's also a good idea to make sure that if your teenager is sweating at all, that they wash sweat off straight away when possible. Sweat acts as an irritant to acne symptoms. Another simple tip is to avoid hairstyles that have hair touching the face constantly, and also to shampoo hair regularly. Speaker 0 00:15:03 Try and tell your kids not to be squeezing pimples or blackheads, and that goes to the adults as well. <laugh>, avoid heavy greasy cosmetics and try and use more water-based moisturizers. A healthy balanced diet and regular exercise with good water intake is always helpful, but I do want to be clear that there is no actual evidence to say that there is a definite link between the consumption of chocolate or fatty foods and acne. Another myth I want to bust is that being in a hot country or in the sunshine helps acne. There's no actual evidence to say that it definitely helps either and always remember to stay sun safe and wear an SPF in relation to using scrubs and makeup. So for face scrubs, they always have to be used really gently. There's no evidence to say that it helps with acne. Aggressive skincare can really irritate the skin. Speaker 0 00:15:58 It's really important that we don't damage the skin cells and make it harder for them to recover. The whole goal of acne treatment is about rebalancing the sebum production and outflow. In terms of products, the first product that I'm gonna discuss is benzo peroxide. So benzo peroxide is available over the counter in Ireland in a 5% topical gel. This is known as aide. I'll put a link to it in my show notes cuz I just want to make sure that it is still available from the wholesalers because as we all know, we're having a lot of drug shortages at the moment, and I didn't want to recommend this one without being sure that you can get it. But yeah, we have it in stock on our online shop for treatment with benzo peroxide alone. That is probably the only product really that contains it. Other Carly that are on the market include pex, which is a new range. Speaker 0 00:16:52 They do three products. They have a cleanser, they have a product called PEX Long and PEX High. I like this because they have a Carly in it, but also ingredients that are going to help moisturize and rehydrate the skin. The PEX range has evidence of efficacy in 90% of cases, and that's after 30 days use, so it is definitely worth the try With the PEX range, you're going to use the cleanser by just massaging it into the skin twice a day. What I like about it is it's gentle, but it also has some really effective ingredients in it, but has the salicylic acid that I was talking about earlier, which is a paralytic. So that's gonna help to stop the skin pours from getting clogged, and it's also gonna help to regulate the sebum outflow. It also doesn't contain any vegetable or mineral oils or petroleum jelly, which could increase sebum production. Speaker 0 00:17:46 After using the pop cleanser, you can then apply PEX High in the morning and evening. This is basically a breakout treatment, so you apply it to the active areas of your acne, so your spots twice a day for at least four weeks. If your skin tends to be a little bit drier, then I'd recommend just using it morning and night for the first 10 days and then just use it in the evening. In the morning, you're going to use PEX Long instead. This is a more moisturizing product and it will compliment your treatment with Pex High. When your breakout has cleared up, you can continue to use the PEX long as a regular maintenance moisturizer. This product won't clog up your pores and so is good to keep acne symptoms at bay. This range has all been dermatologically tested and another good positive about it is that it doesn't cause photosensitization and that's actually really good because a lot of acne products will cause your skin to become sensitive, and that's true for the prescription ones as well. Speaker 0 00:18:47 And when your skin is sun sensitive, you're much more likely to suffer from skin burn and skin damage. So using the PEX range isn't going to put you more at risk of that. Generally if you leave the moisturizer on for about half an hour or so so that it can fully absorb into your skin, you can then place an SPF on over it. For acne sufferers, I recommend the LAROCHE poe and Teleos fluid because it is really, really light and it contains a very, very good spf, but it's not gonna clog up your pores because it's a fluid. So I know earlier for the preteens I was saying use the Sera cream, but for acne sufferers, you would actually be better to stick with your PEX range and potentially the acne side gel. And then in the morning after you've applied your PEX high or PEX long leave a little while and then pop the and teleo 50 fluid over it. Speaker 0 00:19:47 I don't actually think you'll get any better treatment than that combination. The one thing I want to say is that patients is really, really important. People tend to give up on acne treatments because, well, first of all, you're dealing with teenagers in a lot of cases. Obviously adults are still affected, especially up to kind of 30 years of age, but adults tend to be a little bit more compliant because they're more disciplined and more driven to solve the problem. There are many teenagers who just <laugh> either don't care or give up because they don't see instant results. So it's important to emphasize that you need to give a product up to four weeks to really see the benefit. These products are really, really effective at treating mild to moderate acne. Encourage your child to engage with their treatment and by all means, let them listen to this podcast so that they understand how it works. Speaker 0 00:20:39 Children are smart. If they understand the science they will get behind it. There are some circumstances where a GP visit is required, and that's if the acne is moderate to severe. If your child has nodule cysts or is covered in inflammatory pules on their face and their chest and torso, then it's best to go and see the doctor. Also, if after about four weeks you haven't had any improvement from the over-the-counter treatments, I'd also go and see the doctor. However, I do wanna say that if it's improving, it's not fully better, but it is improving, then do stick with it. If improvements are happening, generally they'll continue to develop. As I said earlier, if you have a child who has not yet gone through puberty and they have acne symptoms, that's quite uncommon. So if in doubt, do bring them to the gp. There's another condition or two that can be confused with acne. Speaker 0 00:21:34 One of them is rosacea, which can cause a lot of flushing and blushing of the cheeks, and sometimes this can include spots. So if it's more a general redness with just a few spots, then I would see the GP about that. And again, if you or your child are suffering from serious psychological upset as a result of acne symptoms, it's definitely an important thing to reach out to the doctor for support. We tend to brush off acne sometimes in conversation as a few spots, but it's not. And in a very, very superficial world, people can be really cruel, and that is what can have a really significant impact on our emotional wellbeing. Add to the fact that we have social media platforms and amazing internet access, but all we do is see perfect people with perfect skin and perfect bodies. And so I actually feel it's much harder for the teens of today than it was even at my age. Speaker 0 00:22:28 And I remember having teenage acne and I remember it did upset me at the time. I hated it. So I can only imagine now what it's like being surrounded in a world where normal humans just don't seem to exist. Anyway, I'll stop reminiscing about the pre smartphone times now. <laugh>, I've shown my age. <laugh>, thank you so much for listening. I will put links in to every product that I mentioned in this podcast into show notes and also on my social media so you can find me at Wonder Care underscore il on Insta. And do get in touch. I'd love to hear from you. Another great way to get in touch is to leave a review on Apple Podcasts. I'm not gonna lie, it brightens up my day if I see your review on there. So if you find my podcast helpful, I would really love if you could leave a review. Speaker 0 00:23:17 And obviously if you wanna say something bad too, I'll, I'll take the bad with the good <laugh>. As always, it's been a complete pleasure chatting here in my room to myself, but knowing that I'm going out to all of my amazing Wonder Care podcast listeners. So thank you so much for joining me. Do tune in next week where I will be taking on the very exciting topic. Well exciting in my life cuz we all suffer from it of eczema and dermatitis. It's a big one and a very important one. So I really look forward to delving into that. Thanks for listening. Bye.