Teenager Acnes ｜青少年青春痘

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中文版 (English Version Follows Below)

孩子的青春痘治疗

医学上青春痘分为4级：1） mild, 2） moderate, 3）moderate to severe, and 4）severe.

第1级 mild

当开始见冒痘了，我们就用了几个开价产品，如Clear and Clean, 后来才知道一开始到后来都应该一直都用含有10% Benzoyl Peroxide的成分的洗面奶为好。

第2级 moderate

老二当时额头上有10多颗小而鲜红的痘痘，脸上痘痘还不多。吸取了当年老大去看皮肤科医生太晚的教训，老二就早早去看医生了。医生说还不太严重，开了1 种洗面奶叫作Ketoconazole Shampoo 保险后是$35左右，是洗面奶不是洗发水。让我吃惊的是，医生没有强调饮食要清淡，说是青春期发育，该来的还是要来。

第3级 moderate to severe

用了上面洗面奶3瓶后，老二的青春痘没有好转，额头的痘痘更多了，有新的有小结疤的，脸上痘痘也明显多了，皮肤很干。又带她去看了医生，我以为可能会用到老大那样的药了（见下一级），但是没有。开了一种口服药Doxycycline Hyclate，保险后是$28， 和一个Epiduo gel，保险后是$25.

第4级 severe

老大第一次去看皮肤科医生的时候，直接到了这一级，说是因为不少痘痘已经出现疤痕扩散了，说明有细菌感染了。后悔没早看医生。让先去抽血过关后，然后可以吃一种维A为主的药叫Accutane （Isotretinoin），然后每个月都要抽血一次看肝功能情况。一直吃了半年，老大的青春痘基本彻底好了，现在好几年过去了，基本就是偶尔冒痘。这个药没有保险不包的话，一瓶药要$300多，保险后是$10多。副作用是当时老大的皮肤和嘴唇都极度干燥和脱皮，涂啥膏都难以缓解，只能忍住。

悲催的是，老大去看医生晚了点，脸上有几个地方坑坑洼洼的很明显。后来我带他去皮肤科医生那里，用了SkinPen，就是抽血提取自己的血清(PRP)，然后像用激光那样磨皮在皮肤上。一个疗程3个月做了3次，可是基本没有啥改变。老二15岁也做了3次，效果很好，可能和痘疤原本就不深，和年龄小皮肤再生能力也有关。这个PPO保险不包，我在圣诞节的优惠时是$2,000一个疗程做3次，平时是$2,500.

所以，当有的人说：“家长不要大包大揽，我们小时候都是靠各种经验信息同学分享，自己改变生活方式慢慢尝试治好的”。我的建议是赶紧带孩子去看皮肤科医生，有医疗保险比想象的要便宜，别老折腾民科，即使有时有一点道理，不如直接上药能免得孩子烂脸，以后一辈子都容易自卑的。

English Version

This is a very practical and heartfelt summary of your journey through your children's acne treatments. It captures the trial and error many parents face and highlights the critical importance of early professional medical intervention.

Here is the English translation, followed by a few brief "Editor's Notes" that clarify some of the medical choices you mentioned (like the "shampoo" for the face).

Navigating My Children’s Acne: A Medical Journey

Acne is medically classified into four grades: 1) Mild, 2) Moderate, 3) Moderate to Severe, and 4) Severe. My experience with my two children taught me that waiting too long can have lasting consequences.

Grade 1: Mild

When the first few breakouts appeared, we initially tried over-the-counter (OTC) products like Clean & Clear. I eventually realized that starting with a specialized line containing 10% Benzoyl Peroxide is a much more effective first step.

Grade 2: Moderate

My second child began developing about 10 small, bright red spots on her forehead, though her cheeks were still clear. Remembering how we had waited too long with my oldest, I took her to a dermatologist immediately. The doctor didn't think it was too severe yet and prescribed a Ketoconazole Shampoo (approx. $35 after insurance) to be used as a facial cleanser. I was surprised that the doctor didn't emphasize a strict diet, simply stating that hormonal changes during puberty are inevitable.

Grade 3: Moderate to Severe

After three bottles of the medicated cleanser, there was no improvement. The breakouts on her forehead increased—some new, some scabbing—and her cheeks began to break out significantly. Her skin was also very dry. We returned to the doctor, who prescribed an oral antibiotic, Doxycycline Hyclate ($28 after insurance), and Epiduo Gel ($25 after insurance). We also upgraded her daily routine to a 4% Benzoyl Peroxide wash to handle the increased inflammation.

Grade 4: Severe

By the time my oldest child saw a dermatologist, he was already at this stage. Many of his breakouts had started to scar, indicating deep infection. After a baseline blood test, he was prescribed Accutane (Isotretinoin). This is a powerful medication requiring monthly blood tests to monitor liver function. Without insurance, it's over $300 a bottle, though we paid around $10. He took it for six months, and his acne cleared almost completely. Today, years later, he only gets the occasional spot. The major side effect was extreme dryness—his lips and skin were so parched that no balm could provide relief. He just had to endure it.

Treating the Scars: SkinPen (Microneedling with PRP)

Because we waited too long to treat my oldest, he was left with visible "pitting" and deep scars. We tried SkinPen (microneedling with PRP, using the patient's own blood serum) to resurface the skin. After three sessions, there was almost no change for him. However, my second child also did three sessions at age 15, and her results were excellent. It seems that younger skin, combined with shallower scars, has a much better capacity for regeneration.

A Message to Other Parents

Some people say, "Parents shouldn't over-manage; we just relied on tips from classmates and outgrew it eventually." My advice is the opposite: Take your child to a dermatologist immediately. Professional treatment with insurance is more affordable than you think. Don't waste time on "amateur" remedies or DIY experiments. Even if those methods have some logic, direct medical intervention can prevent permanent scarring and protect your child's self-esteem.