Navigating the teen years is tough for both teenagers and their parents and caregivers. Amongst these challenges, teenage acne often stands out. Despite being extremely common, it is surprisingly misunderstood. At the hear of this is that teen acne is not just a physical or cosmetic problem. There are a number of hormonal, physiological and psychological factors that drive acne during a period of major changes. Furthermore, teenage acne can significantly impact self-esteem and social interactions both in the present and long-term. All of this makes early intervention and effective treatments vital. In this guide we’ve put together a guide for parents and caregivers on the causes, prevention and best treatments for teenage acne. We believe that parental support and guidance is a core part of how to treat teenage acne.
What is Teenage Acne?
This is a common skin condition that usually arises during adolescence, a period marked by significant hormonal changes and physical development. The main driver of teenage acne is an increase in androgens, such as testosterone, which occurs in both males and females during puberty. These hormonal fluctuations lead to an increase in sebum production. This is the oily substance that sebaceous glands in the skin secrete. When excess sebum mixes with dead skin cells, it can clog pores. This then creates an ideal environment for a bacteria called Propionibacterium acnes to thrive. As a result you get inflammation and the appearance of spots and blemishes.
Teenage acne commonly appears on the face and neck but it can also affect the chest, back and shoulders. In addition to the physical effects, teenage acne can have a major emotional and psychological impact. It can affect self-esteem and social interactions during these important years. Therefore, understanding and addressing this condition holistically, considering both the physical and emotional well-being of the teenager, is essential in acne treatment.
How It looks
The types of acne in teens can vary significantly in both severity and form. It can range from mild comedones (blackheads and whiteheads) to more severe inflammatory lesions like papules, pustules, nodules and cysts.
Teenage acne often begins as small, non-inflamed blackheads and whiteheads. These appear due to blocking of pores with excess sebum and dead skin cells. As these comedones become colonised by bacteria, they can evolve into more visible and sometimes painful forms of acne. This includes papules, which are small, red, raised bumps and pustules, which are similar but contain pus, often with a white or yellow centre. In more severe cases, teenagers may develop nodules and cysts. These are deep, painful and inflamed lumps under the skin that can lead to scars if not treated properly. In addition to the pimples and scars, acne can also leave behind hyperpigmentation (dark marks) or post acne erythema (red spots).
What Causes Acne in Teens?
Teenage acne isn’t just a series of random breakouts. It’s a chronic condition predominantly causes by hormonal changes during puberty. These hormonal shifts lead to more oil production, which, combined with dead skin cells, can clog pores and become the perfect breeding ground for bacteria. This results in acne. Understanding this process is the first step in learning how to treat acne.
Whilst critical, hormonal changes are not the only drivers of teenage acne though. There are a number of other factors involved. Firstly, genetic predisposition plays a significant role in the skin’s sensitivity to hormones and its tendency to produce excessive sebum. If a teen’s parents experienced severe acne, the likelihood of them getting it increases.
Lifestyle factors can also drive teenage acne. The role of diet in acne is still an ongoing area of research but there are some signs that it plays a part acne severity. For example, foods with a high glycemic index, such as sugary snacks and refined carbohydrates, can spike blood sugar levels. This in turn can stimulate sebum production and promote skin inflammation. Dairy has also been linked in some studies to making acne worse. There’s also evidence that stress levels can worsen teenage acne. It increases the production of hormones such as cortisol which increase oil production in the skin. Finally, certain medications can also trigger acne breakouts. Drugs like corticosteroids, testosterone and lithium are known to tigger or worsen acne in some people.
Why It Is Important to Understand Teenage Acne
Understanding the causes, triggers and exacerbating factors of teenage acne is vital for a number reasons. They give you a path for how to effectively treat teenage acne as well as support your child throughout this journey. Below is an overview of how this can help you:
- Effective Treatment: Acne is not just a cosmetic issue; it’s a medical condition. Proper understanding of teenage acne enables parents, caregivers and the teenagers themselves to find the best treatments. A huge part of understanding this point means recognising when over-the-counter skincare is sufficient and when to consult a dermatologist for medical treatments.
- Preventing Long-term Effects: Without proper treatment, acne can lead to acne scars and hyperpigmentation, which can be permanent. Early and effective treatment can prevent this.
- Debunking Misinformation: There are a lot of myths surrounding acne which often lead to ineffective or harmful treatment practices. Understanding the causes of acne will help you make informed decisions about the right skincare and treatments.
- Promoting Healthy Habits: Understanding drivers of acne can encourage the adoption of healthier skincare and lifestyle choices including stress management. These can all improve overall skin, physical and mental health.
- Empathy and Support: The teenage years are formative in developing self-esteem and social skills. Acne, particularly when severe, can negatively impact a teenager’s self-image and confidence. It can lead to social withdrawal, anxiety, and even depression. Understanding the psychological burden of acne is vital in providing the right emotional support your child will need during this period.
Myths About Teenage Acne That Should Be Debunked
There is a lot of misinformation and disinformation around acne. These can lead to stigma and drive teens to useless or even harmful treatments. Debunking these myths is a vital part of treating acne and helping your teenager during this journey. Below are the most common acne myths that should be retired:
- Acne Is Caused by Poor Hygiene: Acne is mainly caused by hormonal changes, not poor hygiene. Over-washing or too much scrubbing can actually irritate the skin and worsen acne.
- Eating Greasy Food and Chocolate Causes Acne: Although a balanced diet is important for overall health, there is no direct link between greasy foods or chocolate and acne. This sort of disinformation can cause shame or guilt around eating.
- Acne Is Just a Cosmetic Issue: Acne is a medical condition. It can have significant psychological effects and, in severe cases, can cause long term scars and skin discolouration.
- Only Teenagers Get Acne: Whilst acne is most common in teenagers due to hormonal changes during puberty, it can affect people of all ages, including adults.
- Popping Pimples Will Make Them Go Away Faster: This can push bacteria deeper into the skin, increase inflammation and lead to scars. It’s best to treat acne with appropriate skincare products and resist the urge to squeeze or pop spots!
- Sunshine Clears Up Acne: While short-term sun exposure may dry out pimples, it can also damage the skin and increase the risk of skin cancer. Additionally, some acne treatments can make the skin more sensitive to sunlight.
- Acne Will Just Go Away on Its Own: Although acne may improve over time, there is no guarantee it will just go away by itself. It’s important to treat it early to prevent worsening of the condition and potential scars.
Best Treatments for Teenage Acne
There are a large number of acne treatment ranging from over-the-counter skincare to prescription medicines and professional treatments. The best way to treat teenage acne depends on the causes and severity. Also how well the skin responds and time to see results will vary from person to person. For mild or moderate acne, its best to start with a combination of proper skincare and lifestyle improvements. In teenagers where the acne is not responding to this, getting worse or is severe (for example widespread acne, nodules and cysts or scars), it maybe best to seek medical help early.
A good skincare routine should form the backbone of any teenage acne treatment. It doesn’t have to be complicated or expensive. The trick is to select effective skincare ingredients that will tackle the underlying problems that cause acne. Look for products that contain:
- Benzoyl Peroxide: This helps kill acne causing bacteria and reduces inflammation. The best way to use benzoyl peroxide is in gel or cream form as a spot treatment for new pimples. It works best for papules or pustules.
- Salicylic Acid: Beta hydroxy acids (BHAs) like salicylic acid exfoliate the skin and unclogging pores. It’s is especially good for blackheads and whiteheads but will also help with other acne lesions. The best way to use BHAs is in a toner and swipe all over the face at least 2-3 times a week.
- Retinoids: This includes retinol and retinal increase cell turnover and boost collagen production. They help to unclog pores, control oil and brighten the skin. They can help with all forms of acne as well as to fade hyperpigmentation and smooth skin texture.
Medications & Prescription Skincare
Sometimes, skincare alone isn’t enough to completely clear acne. This is especially likely in more severe forms like cystic or nodular acne. In cases like this, medical treatments can be invaluable in teenage acne. You will need to see your family doctor who may either start treatment or refer your child to a dermatologist depending on the severity of the acne. In general, these are the most common prescription medicines used to treat teenage acne:
- Oral Antibiotics: Examples of these include doxycyline and limocycline which are normally prescribed as tablets for periods of 3 months at a time for moderate to severe acne. They help reduce inflammation and bacteria.
- Prescription Retinoids: Adapalene, Tretinoin or Tazarotene gels or creams are effective for severe acne, hyperpigmentation and scars. They maybe used alone or mixed with antibiotics like clindamycin or benzoyl peroxide.
- Hormonal Treatments: For girls, the combined oral contraceptive pill or anti-androgens like Spironolactone to balance hormones that cause acne. These are given as daily tablet and often reserved for more severe acne due to potential side effects and long treatment duration.
- Isotretinoin: Commonly known as Accutane or Roaccutane, this the most powerful medication for severe acne or acne that hasn’t responded to other treatments. This is a tablet medicine that is often used for 6-12 months and can completely clear acne, scars and hyperpigmentation. It does however have potential risks so needs montoring and can only be given by a dermatologist.
- Corticosteroid Injections: These are used for large, painful acne cysts or nodules. Corticosteroid injections significantly reduce oil production and inflammation. They are however reserved for isolated severe lesions and are not a long term treatment option.
Professional Skin Treatments
These aren’t usually effective for treating acne by themselves but can manage severe acne as part of a comprehensive skincare routine. Again, in most cases, its best to try medical treatments before adding professional skin treatments. These treatment should be performed by a medical professional with experience in treating teenage acne. They will also ensure that the correct protocols are deployed and minimise the risk of skin irritation or injury:
- Chemical Peels: Remove the top layers of skin, opening pores and improving skin texture. Often a course of chemical peels is needed and then maintenance with skincare. These are best for mild to moderate acne.
- Laser Therapy: Reduces oil production and bacteria. Laser therapy can also help with scars, texture and hyperpigmentation. The number of sessions needed depend on the type of laser and desired outcomes. This is usually reserved for severe acne.
- Extraction Procedures: These are done by dermatologists to remove blackheads and whiteheads safely. They don’t do anything to address the underlying cause of acne but can help provide temporary improvement.
As mentioned earlier, lifestyle factors can worsen teenage acne and so its worth giving this a little attention. Encourage your teenage to:
- Diet: Maintain a balanced diet with low glycemic index foods, and reduce dairy intake if it seems to trigger acne.
- Stress Management: Engage in stress-reducing activities as stress can exacerbate acne.
- Exercise: Regular exercise can help in overall health and stress reduction.
When To Get Professional Help
For more persistent or severe cases, professional treatment may be necessary in order to prevent long term damage such as scars and negative psychological effects. Dermatologists can offer a range of options for teenage acne including prescription medications and professional treatments. They can also provide guidance on topical treatments tailored to your child’s individual needs. Here are some signs that it’s time to get help from a specialist:
- Severe Acne: If the acne is widespread, deeply inflamed or includes nodules and cysts then its best to seek help sooner than later. This is because severe acne can lead to scarring and usually requires more potent treatments.
- Acne Not Responding to Over-the-Counter Treatments: If there’s no improvement after using over-the-counter products for 8-12 weeks.
- Acne Is Causing Scars or Dark Spots: Medical treatments can help prevent permanent scarring and long term hyperpigmentation.
- Emotional Distress: If acne is negatively impacting a teenager’s self-esteem, social interactions, or causing anxiety or depression, it’s essential to seek help before this gets worse.
- Painful Acne: This is a sign of severe inflammation and often requires medical treatment.
- Other Symptoms: If the acne is accompanied by other symptoms like excessive hair growth or irregular periods, it could indicate an underlying medical condition that needs investigating.
- Underlying Skin Conditions: You many need help finding the right treatments if your teen has sensitive skin or other skin conditions like eczema.
- Recurring Acne: If acne keeps coming back after treatment, a dermatologist can help determine the cause of this and provide a long term solution.
Skincare Routine For Teenage Acne
No matter how severe the acne and whether you need medical or professional treatments, a good skincare routine is vital to treat teenage acne. A good skincare routine for teenagers should be gentle yet effective and aimed at managing breakouts whilst maintaining healthy skin. Below is all you need for putting together a skincare routine to treat teenage acne:
- Gentle Cleansing:
- Morning and Night Routine: Use a hydrating foam or gel cleanser twice a day. This helps remove excess oil and impurities without over-drying the skin. Avoid soaps or physical scrubs as these will dry out the skin and make acne worse.
- Morning: Use a BHA (salicylic acid toner) in the mornings after cleansing. This helps to unclog pores and remove dead skin cells. Start with 1-2 times a week and build up frequency as your child’s skin tolerates.
- Spot Treatments:
- Morning and/or Evenings: Apply gels or creams containing benzoyl peroxide to new spots once or twice a day after cleanser/toner. This will help clear them up more quickly.
- Active Treatments:
- Evenings: After cleansing your skin use a retinoid to help exfoliate the skin and clear out pores. Over time, this can also smooth skin and even out texture.
- Morning & Evening: Acne treatments can dry out the skin and moisturising helps maintain the skin’s natural barrier. Use a hydrating lotion or gel moisturiser.
- Sun Protection:
- Mornings: Some acne treatments can make the skin more sensitive to the sun. Apply a broad-spectrum sunscreen with at least SPF30 every day.
Supporting Your Teen Emotionally
The impact of teenage acne can be far-reaching and its important to take this into account when figuring out how to treat it. Beyond the physical, it can affect a teen’s self-esteem and social life. This can make them feel self-conscious and insecure at a time when they highly value approval from their peers. as such, supporting a teenager emotionally through their battle with acne is as important as addressing the physical aspects of the condition. Parents and caregivers have a really important role in treating teenage acne.
First of all, reassure your teen and provide a safe space for them to deal with teenage acne. It’s vital to acknowledge their feelings and reassure them that acne is a common and treatable condition. Try to dispel harmful myths and reassure your teen that it is not a reflection of their worth or hygiene. Its also important to encourage open communication, allowing them to express their frustrations and concerns without fear of dismissal or judgment.
Empowering your teen is also crucial in helping them navigate acne. Educate your child about acne and emphasise that it’s a temporary and manageable condition. This will give them home and dispel any feelings of isolation or embarrassment. Crucially, always involve your teenager in any decisions regarding how to treat acne. This will empower them and provide a sense of control over the situation. Beyond their appearance, try to recognise and praise your teen’s strengths and achievements to instil a greater sense of confidence and self-worth. Finally, don’t struggle alone. If your teen is showing signs of depression or severe anxiety due to acne, seek help from a mental health professional.
As you’ll have seen, teenage acne is a medical condition that can have serious negative physical and psychological effects. The best way to treat teenage acne will depend on causes, severity and your child’s skin as well as overall health. Whilst it can be a difficult condition to treat, there are many options to clear up teenage acne. Parents and caregivers can provide vital guidance and support in helping treat teenage acne and steering adolescents during this difficult period. However, to be in the best position to help, arm yourself with information and understand that teenage acne is a journey that requires patience and a personalised approach. Also learn when to seek professional help from your GP or a dermatologist. This is vital as early intervention can prevent long-term skin damage and emotional distress.