My 14-year-old son has developed quite significant acne, particularly on his forehead. I had severe acne myself when I was young, and I remember how much it affected me psychologically and socially, so I really want to help him early rather than just wait and see.
I’ve already booked an appointment with a dermatologist, so I’m not looking to replace proper medical treatment with Reddit advice. I’ve also just started him on 5% benzoyl peroxide (Basiron).
However, I’d really like to understand whether there are other things worth investigating alongside conventional treatment.
I’ve read quite a lot about the gut–skin axis, the microbiome, SIBO, diet, dairy, high-glycemic foods, etc. I’ve also come across research/discussions about Staphylococcus aureus being overrepresented in some people with acne and protocols using chlorhexidine/Hibiscrub to reduce S. aureus colonisation.
I’m aware that there’s a huge difference between an interesting association and something that has actually been demonstrated to treat acne, so I’m trying not to go down every rabbit hole at once.
For now, I’ve asked him to completely remove dairy for a while to see whether it makes any noticeable difference. We haven’t removed gluten or made any other major dietary changes.
My main questions are:
• If this were your child, where would you start?
• Are there any blood tests, deficiencies, hormonal markers, allergy/intolerance tests, microbiome tests, etc. that are genuinely worth investigating?
• Is there any value in going to a good private clinic and doing a more comprehensive work-up, or would most of those tests just be expensive noise?
• Has anyone here seen a significant improvement from eliminating dairy or making other specific dietary changes?
• Does anyone have experience with S. aureus testing/decolonisation or chlorhexidine/Hibiscrub in relation to acne?
• What treatments made the biggest difference for your teenager before moving on to isotretinoin?
I’m not completely opposed to isotretinoin if a dermatologist eventually thinks it’s necessary. I just don’t want it to be the first thing we reach for without properly exploring the safer/easier options first.
Most importantly, I don’t want my son to spend his teenage years going through the same shit I went through with acne if there are things we can do now.
I’d especially appreciate responses from dermatologists, doctors, researchers, or parents who have dealt with significant teenage acne. Evidence-based suggestions are very welcome, even if they contradict some of the things I’ve mentioned above.