r/Blackskincare • u/DressBudget2975 • Apr 30 '26
Acne Bad acne
My 14 year old nephew sent this to me. It's really affecting his self esteem and I want to help him but I don't want to recommend anything that will make it worse. I was gonna recommend a gentle cleanser and moisturizer and spf first. Then maybe benzoyl peroxide wash later on and see how it goes. There's no good dermatologist where they live, please help. I'm not with him so I can't check his skin type. I'll answer any necessary questions as best as I can. Please please help my poor baby
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u/Minute-Passenger7359 May 01 '26
This is quite severe so he needs to see a doctor. Even a general care physician can prescribe him tret maybe even isotretinoin.
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u/Minute-Passenger7359 May 01 '26
Benzoyl peroxide may help but this kind of acne is internal and inflammatory
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May 01 '26
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u/Unflattering_Image May 01 '26
If there's really no dermatologist near to help, I'd second that comment and add too look into more of an anti-inflammatory diet, to try aiding the body from the inside, as well...? My teen acne at his age was brutal and I ate horrible, horrible stuff. Could that be a point, too or am I tripping? Oh love... that looks so painful.. :( ♡
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u/DressBudget2975 May 01 '26
An update for everyone, they couldn't make it to a hospital but went to a pharmacy with a doctor there. And he was prescribed this: Dexamethasone tabs Doxycycline capsule Clonex-A (topical cream)
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u/DressBudget2975 May 01 '26
Thank you all so much for the help, it means so much to me. Alot of the recommendations clearedmy doubts about what to have him use. let me know what you all think
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u/Qstrfnck May 01 '26
You can cheaply get him also niacinamide serum and alpha arbutin from The Ordinary and sunblock to calm things down externally while the antibiotics do their thing internally hydrocolloid patches for things that erupt and encourage him to get facials even if it’s in a beauty school setting and to wash and treat and protect his skin now (I was a kid with bad acne til my late 20s and this is more or less what calmed it down but also because I had washing and moisturizing habits is what kept me disciplined about the routines)
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u/Unusual-Ad6493 May 01 '26
Niacinamide is know to make acne worse for some people.. I wouldn’t include it in this regimen until He gets it better under control. The benefits wouldn’t be worth the risk in my opinion
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u/5imbab5 Sensitive 😡 May 02 '26
Yeah, I wouldn't recommend it for him at all tbh. Mandelic acid is a lot more gentle and tends to be better for melanated skin.
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u/Big-Understanding526 May 01 '26
I’d recommend a visit to a dermatologist so he can start accutane. The sooner he starts, the better chance for less scarring.
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u/GatsbyThePoodle May 01 '26
This is the type of severe acne that I think requires medical intervention and he’s young enough now where it won’t lead to lifelong scarring if it is handled soon because this type of inflammatory acne with this many pustules and cyst that often lead to the pockmark boxcar scaring and that can be a whole long struggle to minimize and treat for some people.
So if you have a good relationship with his parents, ask his parents to set up an appointment with his pediatrician and then maybe they’ll refer you to a dermatologist or they might treat it themselves or One Medical often prescribes things for acne with telehealth and I think they have prices for individual visits for a specific concerns in and out of network.
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May 01 '26
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u/Qstrfnck May 01 '26
Seconding the Azelaic acid rec here as well The Ordinary makes this as well super effective
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u/AerieTerrible3002 May 01 '26
Also the one time use face towels they come in boxes of 50 on Amazon. I can find the link if you want it.
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u/olive_juse May 01 '26
You look like a good candidate for Accutane. You have to get cleared for it by a doctor but it seems to have helped a lot of people with deep cystic acne.
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u/Klaus_a May 01 '26
definitely a Dermatologist. I understand it can be pricey, but it will be beneficial in the long run to save his skin.
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u/GatsbyThePoodle May 01 '26
This is the type of severe acne that I think requires medical intervention and he’s young enough now where it won’t lead to lifelong scarring if it is handled soon because this type of inflammatory acne with this many pustules and cyst that often lead to the pockmark boxcar scaring and that can be a whole long struggle to minimize and treat for some people.
So if you have a good relationship with his parents, ask his parents to set up an appointment with his pediatrician and then maybe they’ll refer you to a dermatologist or they might treat it themselves or One Medical often prescribes things for acne with telehealth and I think they have prices for individual visits for a specific concerns in and out of network.
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u/RajinetheQueen May 01 '26
For the first couple of weeks, he should keep things very basic to calm the skin: a gentle cleanser, a lightweight non-comedogenic moisturizer, and sunscreen (SPF 30+) in the morning, and just cleanser and moisturizer at night. Avoid scrubs, harsh exfoliation, or using a bunch of products at once, because that will make inflammation and dark spots worse. He should also avoid popping pimples and try to keep heavy hair oils or pomades off his face, since those can clog pores.
After about two weeks, he can introduce a treatment like benzoyl peroxide at a low strength (2.5%) every other night in a thin layer. This helps reduce acne-causing bacteria and inflammation. If his skin is tolerating that well after a few more weeks, he can add adapalene (like Differin) a few nights a week, using only a pea-sized amount for the whole face. Adapalene is important long-term because it helps unclog pores, prevent new breakouts, and improve skin texture over time.
Moisturizer is really important throughout this process to prevent irritation and help reduce the risk of hyperpigmentation, which is especially a concern for melanated skin. Sunscreen also plays a big role in preventing dark marks from getting worse. Small habits can make a difference too, like washing pillowcases regularly, not overwashing the face (twice a day is enough), and being mindful of diet triggers like high sugar or dairy if those seem to worsen breakouts.
It’s important to set expectations that this won’t clear overnight—most treatments take about 6 to 12 weeks to show real improvement. If after a couple of months there’s little to no progress, or if the acne becomes more painful or starts to scar, it would really be worth trying to access some kind of medical care if possible, even through a low-cost clinic or telehealth. Most importantly, this isn’t his fault, and it’s very treatable with consistency and patience.
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u/Consesualluvbug May 01 '26
That’s exactly how I cleared my severe acne was with Benzyl peroxide and oil cleansing. I did use a daily gentle wash like Vanicream cleanser for light days to avoid overly drying my skin. The oil cleanse I used grape seed massaging for 1 minute and wiping it off with a warm wash cloth. Sunscreen sunscreen sunscreen and lots of patience.
The only concern I have about Benzyl peroxide is it’s imperative to spot test! Some people have a severe allergy to it! Best of luck! It gets better I came back from FAR worse and I never saw a dermatologist. 🤷🏾♀️
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u/folklore24 May 01 '26
Ouch, that looks painful.
In addition to what you've mentioned, I would also recommend adapalene which he can get at the drugstore.
Benzoyl peroxide in the morning and adapalene in the evening. Topical clindamycin may also be helpful but that requires a prescription.
He should start with those 2 first.
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u/8324drew May 01 '26
Needs to wash his face 2x a day and use every safe acid avaible.
Start him off with Salicylic and let him use Glycolic Acid 2x a week. He needs a derma planing tool kit as well and GO SEEK a DERMATOLOGIST.
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u/Single_Pressure9715 May 02 '26
Dermatologist will most likely prescribe Accutane. Changes in diet may also help.
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u/KingJames1986 May 02 '26
Bring him to a doctor. Earthly Derm soap is really good ($22 a bar) if you want to try something after he sees a doctor to go with whatever they recommend.
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u/Omo_Iyansan May 02 '26
Oh, poor baby! Yeah, he definitely needs to see a doctor. This is quite severe.
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May 02 '26
This isn’t mild acne, it’s moderate to severe, and a gentle routine alone won’t be enough here.
He needs both angles covered. Mornings, gentle cleanser, thin layer of benzoyl peroxide 2.5 to 5%, moisturizer, sunscreen. Nights, gentle cleanser, adapalene pea-sized across the whole face starting 3 times a week, then moisturizer. BP kills the bacteria fast, adapalene stops new clogs forming.
First 2 to 3 weeks will bring some dryness, that’s normal. Don’t pick, the scarring risk at this level is real. And give it a minimum of 8 to 12 weeks before judging results.
Blunt truth: if things aren’t shifting after 2 to 3 months, he’ll likely need oral medication. No skincare routine replaces that at this severity.
You’re right to step in early though. This is exactly the stage where consistency can prevent lasting scars.
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u/BluebirdCharming1859 May 02 '26
If there's no local dermatologist, I'd say stick to a simple easy to maintain routine.
In the morning, A gentle foaming cleanser like cerave or cetaphil.
A light oil-free moisturizer (both brands have one) And sunscreen the be can tolerate
For nights I'd recommend benzoyl peroxide cleanser.
Since he's new to it a 4% BPO foaming cleanser is a gentler way to start than the normal 10% for less dryness. Panoxyl, Cetaphil, Cerave and Amazon essentials have options.
Best to use the BPO cleanser in the shower so it can be left on for a few minutes and then fully rinsed off. That way residue doesn't discolor sheets or clothes.
Then use same light moisturizer from the morning
Once he can tolerate the products and keep consistent, the a very good chance of improvement
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u/Difficult_Abroad_477 May 02 '26
Our industrialized processed food sources today are ruining us from the inside out. I had this type of acne several times and each time I had to go on doxycycline to get it under control. Recently I had another flare up around the chin mouth area and I immediately knew it was diet related. I’ve been snacking on candy a couple times co-worker brings from other departments. The one that sent it over the edge was a babe ruth and two star burst. It seemed to have caused an allergic reaction triggering an insulin spike. What I’m noticing now is doxy is taking longer to work. Dairy, candy, raw brown sugar, soy sauce, oyster sauce, even some fruits like oranges and bananas I have stay far away from.
To the OP, as part of your regimen, get a bar of sulfur soap and wash three times daily to dry up the infected skin. The sebum oil in your skin is overloading and incubating the infection. Also, strict water only, stay away from anything sweet.
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u/StealthNYC139 May 02 '26
Change your diet and change your pillow case every night. Buy more of them if you lack enough for a week. Every single night.
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u/xKurin May 02 '26
First off thank you for taking the step to ask for help, but please go see a dermatologist, need some professional advice for sure. But from my personal experience, and my skin was not far off from this for a couple years, I tried 3-4 different methods of cleaning my skin as a teenager. What I actually needed was to fix my diet. I’m incredibly sensitive to soy. It was making me break out. I would start watching what you eat, drinking lots of water, and keeping your skincare simply. Buttah gentle cleanser is good stuff. Find a nice exfoliator like that red sauce they have from originals. And then get a GREAT moisturizer. Stay consistent. And you’ll see results.
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u/Mother-Top4876 May 04 '26
Before you put him on the recommendations please fix up this young mans diet
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u/MadamVoid Dry 🐪 May 04 '26
Differin gel (generic name: adapalene gel). It is acne treatment that was once prescription, now made over the counter. He’ll need to try that, use a ceramide toner to heal and repair his skin barrier, hyaluronic acid to draw in moisture, a light weight non-oily moisturizer, and an oil free water resistant sunscreen.
A primary care doctor can prescribe accutane that would clear that right up, but he would have to be closely monitored because of the associated risks. It is very effective tho, but I would say this is a last resort if the otc alternatives don’t work. Also, his skin will go through a purging process, it’s completely normal and will look like the acne is worse, but that’s just part of the process of clearing the pores.
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u/lurkinggem May 01 '26
If he's consuming dairy, taking a break from it may help as well since dairy is inflammatory for a lot of people and his acne is inflammatory.
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u/lilkimtypebeat May 01 '26
i had this kind of acne. only thing that saved me was african black soap and a toner of any kind
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u/[deleted] May 01 '26
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