When Nick Robins was only 11 years old, he started battling serious acne.
"My acne was pretty much mostly on my face," said Nick.
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Nick's mom could tell he was upset, so she took him to the dermatologist.
"He would always be spending a lot more time in the bathroom, you know, just wanting to cover up somehow," said Lexie Robins.
Nick, who is now 15, isn't alone. According to a recent medical review, acne is increasingly common in 7 to 12-year-olds, with dermatologists treating more signficant acne at younger ages than ever before.
While the reasons why aren't 100% clear, "There appears to be a trend that children are going through puberty at an earlier age, and acne can be the first sign of puberty," said Dr. Amy Derick with the American Academy of Dermatology.
Doctors say parents, like Lexie, are also more sensitive to the symptoms.
"We live in a culture of sort of digital perfection," said Dr. Lawrence Eichenfield with the American Acne and Rosacea Society.
And worried about psychological effects.
"Pre-teens with acne are more likely to have depression, lower self esteem, feelings of uselessness," added Derick.
Eichenfield is part of a team that recently developed the first guidelines for pediatric acne. He says over-the-counter options can be effective in mild cases.
"For more moderate to severe acne we really have to move to prescription products," he said.
Most are prescribed off-label, which in this case, means clinical studies haven't been done in patients under 12.
"Most of the medicines we end up using based upon our experience with using them in teenagers, and they're perfectly reasonable to be used in younger children, as well," explained Eichenfield.
"There needs to be additional studies with this age group since it is such a common problem," said Derick.
Experts advise early intervention is key to prevent things like permanent scarring and dark spots, but doctors and parents need to weigh the benefits against any risks.
As for nick, a one-two punch of topical and oral medications did the trick.
"His skin is completely cleared up now, and he's got such confidence," said Nick's mom.
Experts say if your child is younger than seven and has significant acne, it could signal a more serious medical problem, like a hormonal imbalance. As always, if you have any questions or concerns, talk to your pediatrician or dermatologist.