If the acne is moderate to severe, oral antibiotics could be added to the mix because bacteria that live on the skin play a role in acne. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.
But, Eichenfield said, "it's important to use antibiotics appropriately." One reason is because acne-causing bacteria have become less sensitive to common antibiotics in the past couple decades, due to widespread use of the drugs.
Another is that antibiotics can have side effects, such as stomach upset, dizziness and, in girls, yeast infections.
When acne is severe and other treatments have failed, the AAP said, doctors and parents might consider the prescription drug isotretinoin -- brand-names including Roaccutane (formerly known as Accutane) and Claravis.
The drug is very effective, but it can cause birth defects, so girls and women have to use birth control and get regular pregnancy tests if they go on the medication. Isotretinoin also has been linked to inflammatory bowel disease, depression and suicidal thoughts in some users -- although it's not clear the drug is to blame, the AAP said. (Severe acne itself can cause depression and suicidal thoughts, for example.)
Dr. David Pariser, a dermatologist not involved in the recommendations, said they are "based on sound evidence" and reflect the "best practices" in battling acne.
When should parents consider taking their child to a doctor for acne treatment? It depends on how severe the problem is, and how bothered the child is, said Pariser, who sits on the board of directors of the American Academy of Dermatology.
Some kids can deal with skin eruptions, but Pariser said he sees others who refuse to leave the house.
Both he and Eichenfield said it's important to dispel kids' (and sometimes parents'
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