It usually begins at the age of ten or eleven: blackheads and small bumps suddenly grow on the thin, smooth skin of children. They often not only hurt, but also look stupid. It’s great when you’re already struggling with your body, which is changing so much. There are different ways to do something about it: effective medicines, but also alternative methods. We ask two people who know.
that’s what the dermatologist says
Dermatologist Dr. Markus Reinholz runs the acne clinic at the Munich University Hospital and treats around 300 young people struggling with pimples every year.
What causes pimples problem?
Juvenile (adolescent) acne depends on testosterone. Therefore, children are usually more severely affected. In this transition phase from childhood to adult metabolism, the sebaceous glands first have to get used to the higher levels of sex hormones. This may initially lead to increased sebum production. Inflammation develops, the sebaceous glands become clogged, and unloved pimples appear.
How many suffer from it?
Dermatologists speak of juvenile acne when comedones or blackheads appear. By this definition, up to 95 percent of today’s youth suffer from this skin problem at some point. So almost everyone. 30 percent of them struggle with moderate to severe acne.
When does acne usually start?
During puberty: In some cases, it can appear as early as eight or nine years old. Typically, the classic peak is between the ages of twelve and 17. I advise everyone to go to the dermatologist as soon as the first blackheads, nodules and pus blisters appear. My motto is: “Hit hard and early”: it is better to do strong therapy right away than to wait too long and then risk ugly scarring in the worst case.
What medications are you taking?
Basic therapy is a twice-daily cleansing facial with an anti-inflammatory acne syndet. Please, no soap! In addition, the adolescent should start pharmacological treatment as soon as possible. Mild “acne comedonica” can be treated with mild local retinoids in cream form. These are derivatives (derivatives) of vitamin A. If they don’t help, switch to fixed combinations, drugs that contain two or more active ingredients. For the most severe form of acne, oral systemic retinoids in pill form work very well. However, many patients and their parents fear side effects such as liver dysfunction, increased blood lipid levels, dry mucous membranes, mood swings, or depression. There is also a risk of fetal harm. Therefore, girls should also use birth control during therapy. However, all of these side effects are rare. And if the treatment is carried out under good medical supervision, the positive effects far outweigh the negative ones. It also prevents scarring. After that, the acne should be completely gone, and maintenance therapy can follow from time to time.
Do cosmetic treatments make sense?
Yes. For mild to moderate acne, I always have my therapies accompanied by fruit acid peels or microdermabrasion, a skin peel that is performed with special grinding attachments. However, in the case of severe forms, I would postpone cosmetic treatment for the time being, because otherwise acute inflammation may be promoted. For daily care at home I use special soap-free anti-acne cleansers with non-comedogenic cosmetics and a pH value of 5.5. Exfoliating ingredients like fruit, glycolic, lactic or salicylic acid are good. In addition, care products should also contain anti-inflammatory ingredients.
What foods are better to reduce?
White sugar and fast food: I know from my own research that foods with a high glycemic index that cause blood sugar to rise rapidly, such as table sugar, white bread, or fast food, trigger and increase the inflammatory process . Foods that release sugar slowly, on the other hand, are not a problem. This includes eggs, fish, oatmeal, spelt, legumes, nuts, fruit, lettuce, and vegetables. Cutting down on pizza, fries, or ice cream is often enough. Or at least skip one or the other as a test. A complete resignation is certainly not sensible. A balanced Mediterranean diet, on the other hand, yes.
And the milk?
My colleague, Professor Bodo Melnik, a dermatologist at the University of Osnabrück, blames increased milk consumption for acne. I feel the same. A study conducted in Italy in 2012 with 205 acne patients between the ages of 10 and 24 reached the same conclusion. Milk is actually a fattening food with growth hormones and an incredible amount of nutrients. In any case, the human being is the only mammal that continues to consume baby food, that is, milk, in adulthood. It’s the crowd that counts here. Half a glass a day is probably not a problem. But when young men supplement their diet with shakes made from pure cow protein and highly fortified vitamins to build muscle, blackheads and impure skin are often unavoidable.
What doesn’t work?
Pinch the pimples and keep touching your face. Cigarettes and alcohol are also counterproductive. While the sun improves acne, as a dermatologist I cannot recommend excessive tanning as it leads to skin aging and skin cancer.
What if there are scars?
There are also therapies for this, such as peelings with fruit acids, laser sessions or dermabrasion. But they are expensive: the price ranges from a few hundred euros to several thousand euros per session for combined treatments. Health insurance usually doesn’t pay. But even with this, the skin cannot be restored to its original state. It can only alleviate the symptoms and refine the complexion.
Social media as a pimple killer?
TikTok is currently touting chlorophyll, the substance that turns plants green, as a silver bullet against acne. Pssst: Instead of buying expensive supplements, you can drink a cup of green tea every day or eat lots of lettuce, parsley, and spinach.
Stress breeds bad bacteria on the skin
In 2007, researchers at the University of California, San Francisco discovered in an experiment with mice why skin tends to swell and pimple when stressed: If the animals were under too much electricity, the protective proteins in the mice’s skin significantly degraded. At the same time, skin infections caused by the bacteria Streptococcus pyogenes multiplied faster and were more resistant than in refrigerated rodents.
That’s what the naturopath says.
Ulrike Töpperwien from Friedrichsdorf, near Frankfurt am Main (toepperwien-heilpraktiker.de) has been working as a naturopath for 27 years. Her attention is focused on acne treatment, which is carried out in several steps.
“I’ll take a look first in a two hour period initial medical history diet and lifestyle of my patients. Are you getting enough sleep, are you under a lot of stress, are all the drainage pathways in the body clear? Because in Chinese medicine, what the intestines, liver, kidneys and lungs cannot detoxify, in the end the skin has to do it. And since, as I understand it, healing always happens from the inside out, the skin only becomes healthy in the end.
At the same time, I recommend one colon cleansing. The prerequisite for this is a stool test in the laboratory to find out how the intestinal flora is composed, whether there is colonization by fungi, parasites or inflammation. Because gut and skin influence each other a lot. The more varied and rich in vital substances the food is and the more different dietary fibers are ingested, the more vital the microbiome, i.e. the intestinal flora, will be. At first, girls and boys do a colon cleansing regimen for one to two weeks with an alkaline diet: This includes fruits and vegetables, water, tea, ideally sugar free, low gluten, preferably wheat free and dairy free. . Among other things, flea or flaxseed, as well as walnut leaves. I also advise people with acne to cut back on fluoride, iodine, and chlorine. These halogens are excreted through the skin and are often found in salts. Good alternatives are, for example, sea salt or the old one.
In external treatment I have good experiences with Healing clay masks made. And with gentle washing lotions, acne water or gentle washing pastes from natural cosmetics manufacturers that regulate the pH value of the skin. If the pimples are inflamed, I prescribe Calendula tincture. Also cream with propolis – a bee resin, which in the naturopathic sense is considered antibacterial and anti-inflammatory, is a good idea.
If I have acne, I prefer to leave the makeup for special occasions and also use natural cosmetics here. In everyday life, pimples can be hidden with a good concealer. always worth a try meditation or mindfulness practice. Because good stress management can have a positive effect on the metabolism, the hormonal system and therefore also on the skin. So why not try cool, often free, meditation apps on your cell phone when you were a teenager?!” *
Ask the document online
Don’t have time to go to the dermatologist? The teledermatology platform onlinedoctor.de Save a visit to the practice. How are you? Upload a photo of your skin problem with a short description and select a dermatologist. You will receive a recommendation for action within two days. Techniker Krankenkasse, HEK and private health insurance companies already cover the costs.
*e.g. B. Balloon, Calm or Headspace