Managing Moderate Acne in a 13-Year-Old Male: Combination Therapy with Cabtreo and Light-Based Treatment
Case Overview
A 13-year-old male presented to our dermatology clinic in Houston, Texas, for evaluation and management of moderate acne affecting the face. The acne consisted of comedonal lesions (blackheads and whiteheads) and inflammatory papules and pustules, persisting for the past 1–2 years.
The patient had previously used oral doxycycline 100 mg and topical dapsone with only minimal improvement. He reported both oily and intermittently dry skin and had been using over-the-counter products inconsistently. His mother accompanied him for the visit.
Clinical Findings
A thorough facial skin examination revealed:
Multiple inflammatory papules and pustules concentrated on the forehead, cheeks, and chin
Open and closed comedones throughout the T-zone
No cystic lesions or scarring at this stage
The patient appeared well-developed and in no acute distress. Dermatoscopic examination confirmed comedonal and inflammatory acne without signs of secondary infection.
Diagnosis
Acne Vulgaris (L70.0) – moderate severity, mixed comedonal and inflammatory type
Treatment Plan
1. Topical Prescription: Cabtreo Gel
The patient was prescribed Cabtreo 0.15%-3.1%-1.2% topical gel, a combination of tretinoin, clindamycin phosphate, and benzoyl peroxide.
This once-daily nighttime treatment provides comprehensive action against acne by:
Reducing inflammation and bacteria (clindamycin, benzoyl peroxide)
Normalizing skin cell turnover (tretinoin)
Preventing new clogged pores and breakouts
Patients were advised on proper application:
Apply a pea-sized amount to the entire face at bedtime.
Wait 30 minutes after washing to ensure skin is dry before applying.
Moisturize afterward to reduce dryness or irritation.
Counseling:
We discussed that benzoyl peroxide can bleach fabrics and may cause mild irritation. In such cases, frequency or amount can be adjusted.
2. Discontinuation of Oral Doxycycline
Given the patient’s age and the potential gut flora disruption associated with long-term antibiotic use, oral doxycycline was discontinued. The focus shifted to topical combination therapy and light-based modalities.
3. Adjunctive Light Therapy
The patient elected to begin LightStim red light therapy, a non-invasive, FDA-cleared device that helps reduce inflammation and promote skin healing.
Light-based treatments are especially beneficial for teen acne by decreasing redness, minimizing breakouts, and improving skin tone over time.
4. Gentle Skin Care Regimen
A simplified regimen was provided to maintain the skin barrier and prevent irritation.
Morning (AM):
Cleanse with CeraVe, Cetaphil, or La Roche-Posay gentle cleanser.
Apply non-comedogenic moisturizer with SPF 30+ (reapply every 2 hours if exposed to sunlight).
Evening (PM):
Cleanse with a gentle cleanser.
Apply Cabtreo gel (pea-sized) to the entire face.
Follow with a hydrating moisturizer such as CeraVe, Vanicream, or Neutrogena.
5. Moisturizers and Sunscreen
Daily use of a broad-spectrum SPF 30+ sunscreen was strongly emphasized to prevent photosensitivity from tretinoin and minimize post-inflammatory hyperpigmentation.
Patient Counseling and Expectations
The patient and parent were counseled that acne treatment requires consistent daily use and patience:
Noticeable improvement expected after 8–12 weeks.
Maximum results within 3–6 months.
Early worsening (“purging”) may occur before improvement.
They were advised to contact the office if acne worsened, failed to improve after several months, or if any side effects occurred.
Follow-Up
A follow-up visit was scheduled in 3 months to assess progress and determine whether escalation to isotretinoin (Accutane) is appropriate if persistent inflammatory lesions remain.
Discussion
This case underscores the effectiveness of combination topical therapy in managing moderate adolescent acne.
Cabtreo, containing tretinoin, clindamycin, and benzoyl peroxide, targets all major acne mechanisms — inflammation, clogged pores, and bacterial growth — while reducing the need for long-term oral antibiotics.
In adolescent patients, pairing Cabtreo with light therapy provides an excellent non-systemic option for achieving clear, healthy skin and preventing scarring. Early education on gentle skincare and sun protection supports long-term success and confidence during the teenage years.
Key Takeaways
Cabtreo Gel offers all-in-one topical acne control.
LightStim therapy provides additional anti-inflammatory benefit.
Avoiding long-term antibiotics reduces resistance and side effects.
Consistent routine and patience yield the best results.
About Our Clinic
At Reena Jogi MD Dermatology, we specialize in teen and adult acne treatment using evidence-based, individualized plans. Serving Houston and Katy, Texas, our dermatology clinic provides Cabtreo therapy, light treatments, isotretinoin management, and acne scar prevention with expert guidance and family-centered care.
