When Nick Robins was only 11 years old, he started battling serious breakouts.
"My acne was pretty much mostly on my face," said Nick.
Nick's mom, Lexie Robins, 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.
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 significant acne at younger ages than ever before.
The reasons why aren't 100 percent 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, American Academy of Dermatology.
Doctors say parents like Lexie are also more sensitive to the symptoms and worried about psychological effects.
"We live in a culture of sort of digital perfection," said Dr. Lawrence Eichenfield, American Acne and Rosacea Society.
"Pre-teens with acne are more likely to have depression, lower self-esteem, feelings of uselessness," said Dr. Derick.
Dr. 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," said Eichenfield.
Most are prescribed off-label, but since they're used in teenagers, Eichenfield deems many of them safe in younger children.
Doctors and parents need to weigh the benefits against any risks.
As for Nick Robins, 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 Lexie Robins.
Experts say if your child is younger than 7 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.