Acne & Teens: Dr Yadav in HuffPost

Dr Sonam Yadav (Medical Director) was recently featured in Huffington Post for an article about acne in teens and how best to manage it. 

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What are the links to depression?

There is plenty research evidence that acne causes decline in quality of life and may lead to stress, anxiety and depression. This is attributed to the impact of acne on a young person's appearance and its relation with self esteem. However emerging evidence also shows that acne and underlying causes themselves (such as Polycystic Ovarian Disease in young girls) could have a strong and complex correlation with depression. Complicating matters further is the side effect profile of some medication used for acne: specifically Isotretinoin (commonly known as Accutane) which is a potent and very helpful drug for severe acne, but has an established risk of causing/worsening depression and/or suicidal thoughts. It is unfortunate because the patients with most severe acne benefit the most from this treatment but may already be struggling with self esteem. However dermatologists are well versed with this side effect risk and do screen/counsel patients and family for the same.

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What are the side effects of some acne
medications? There are several effective topical and oral medications for acne, each with a distinct side effect profile. Isotretinoin for example can cause skin dryness, dry eyes and chapped lips; poor night vision and can affect liver enzymes and platelet counts (which are monitored through periodic blood tests). Most importantly though it can harm an unborn foetus thus strict birth control is an important part of counseling before treatment, especially in young people who may be poorly informed & at risk.
Topical medication containing vitamin A can cause skin dryness or rarely allergy (retinoid dermatitis), while prolonged use of antibiotics commonly causes resistance. Benzoyl peroxide is a drug that escapes the resistance problem but is a common cause of allergy and contact dermatitis. Oral antibiotics such as minocycline can cause sometimes staining of gums and teeth as well as skin.
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How is it best treated or prevented in this age
group?
Treating acne before it occurs, is my mantra. Prevention of infected zits and scarring is vital. Using the correct home care products (even over the counter ones) is important to counteract oily skin, dandruff and minor acne (whiteheads and blackheads) in order to prevent serious outbreaks. Over cleansing and avoiding moisturizers are two common problems, both of which cause skin dryness and thus, paradoxically, rebound acne. Ideally young kids must see a dermatologist at the earliest hint of acne, when it is easiest to combat. This would reduce risk of scars and low self esteem.

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When do you know acne requires expert help?
All acne needs an expert diagnosis and direction at least once. This is because causes and kinds of acne vary - treating the root cause would go a long way in treating and managing acne. Thus acne must be treated early and aggressively. Home remedies and picking at skin worsen the problem and cause scarring which is tedious and expensive to treat.