How To Treat Preteens

By Author: Steven Johnson
Total Articles: 494
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There's been a slow but steady change in the age at which acne appears. If we go back into the last century, the observational evidence showed the first signs during puberty, i.e. in most cases, this would mean children had a clear run until their teen years. Now, it's beginning to affect more children before their teen years. The current observational research evidence shows three-quarters of girls in the range 9 to 10 years are suffering attacks of acne. The reason for this is the earlier onset of adrenarche. Previously this was delayed until nearer the time of menarche. Now the sebaceous glands are being triggered into higher levels of production younger and younger. Indeed, there are the first real signs of it affecting both boys and girls as early as 6 to 7 years which is a dramatic shift. Under normal circumstances, doctors would have at least one drug readily available for prescription no matter what the age of the patient. However, none of the standard drugs for the treatment of acne have been approved for use with children by the FDA. This has produced a difficult ethical problem. Should doctors offer prescriptions ...
... knowing the FDA has not approved the drugs?

Given the trend to early-onset acne, there are an increasing number of research projects testing the safety of remedies for younger children. The most recent comes from a team at the University of California. The trial was to test a topical retinoid. This is a cream or lotion using chemicals derived from Vitamin A, the basis of many of the standard treatments for acne. At present, all these creams are only licensed for use in children who are at least twelve years old. This trial recruited 40 participants aged between 8 and 12. All were suffering mild to moderate acne outbursts that had begun around their ninth birthdays. They were all given pump dispensers containing a gel.

The results show about the same level of performance expected in older children and young adults. Over a period of about three months, the count of zits was reduced by just under 40% in slightly more than three-quarters the participants. Despite using a moisturizing cream, just over a third found their skin drying out and growing irritated during the initial stages of use. No one quit the trial and everyone found the adverse symptoms disappeared after about one week.

Although this is a very small sample and so not statistically significant, these results would suggest the FDA should revise its license to permit the prescription of this treatment to younger patients. For those more seriously affected, adding an antibiotic will usually improve physical appearance. As it stands, Accutane is not available for use with such young children. So for these children, we must look for more research evidence to convince the FDA. As it stands, the evidence seems to suggest that untreated acne in the young leads to more severe outbreaks during adolescence. If these creams, lotions and gels are safe and effective, they should be used as early as possible. Should the acne reappear in later years, Accutane may then be tried.