POSTED: 7 Nov 2023

Here’s How To Help Your Teenager Overcome Acne

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 heart 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 change. Furthermore, teenage acne can significantly impact self-esteem and social interactions, both now and in the long term. All of this makes early intervention and effective treatment vital. In this article, we cover the causes, prevention and best treatments for teenage acne. We believe that parental support and guidance is a core part of how to treat it.

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, the oily substance that the sebaceous glands secrete. When excess sebum mixes with dead skin cells, it can clog pores. This then creates an ideal environment for a bacterium called Cutibacterium acnes (C. acnes, formerly 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, it can have a major emotional and psychological impact. So it can affect self-esteem and social interactions during these important years. Therefore, addressing this condition holistically, considering both the physical and emotional wellbeing of the teenager, is essential.

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 when pores become blocked 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 caused by hormonal changes during puberty. These hormonal shifts lead to more oil production. Combined with dead skin cells, this 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 it.

Whilst critical, hormonal changes are not the only drivers of teenage acne. There are a number of other factors that contribute. Firstly, genetic predisposition plays a significant role in the skin’s sensitivity to hormones and its tendency to produce excess sebum. So 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 is still an ongoing area of research, but there are some signs that it plays a part in 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 inflammation. Dairy has also been linked in some studies to making acne worse. There’s also evidence that stress can worsen teenage acne. It increases the production of hormones such as cortisol, which raise oil production in the skin. Finally, certain medications can trigger acne breakouts. Drugs like corticosteroids, testosterone and lithium may also trigger or worsen acne in some people.

Why is it Important to Understand Teenage Acne?

Understanding the causes, triggers and exacerbating factors of teenage acne is vital for a number of reasons. They give you a path for how to effectively treat teenage acne, as well as how to support your child throughout this journey. Here is an overview of how this can help you:

  • Effective treatment: acne is not just a cosmetic issue, it’s a medical condition. A proper understanding of teenage acne enables parents, caregivers and teenagers themselves to find the best treatments. A huge part of this 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 the drivers of acne can encourage 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.

Myths About Teenage Acne That Should Be Debunked

There is a lot of misinformation around acne. This can lead to stigma and drive teens towards useless or even harmful treatments. Debunking these myths is a vital part of treating acne and helping your teenager. Here 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 myth 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 and resist the urge to squeeze or pop spots.
  • Sunshine clears up acne: whilst short-term sun exposure may dry out pimples, it can also damage the skin and increase the risk of skin cancer. In addition, 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 clear by itself. It’s important to treat it early to prevent worsening and potential scars.

Best Treatments for Teenage Acne

There are a large number of acne treatments, 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. How well the skin responds and the time it takes to see results will also vary from person to person. For mild or moderate acne, it’s best to start with a combination of proper skincare and lifestyle improvements. Where the acne is not responding to this, getting worse or severe, it may be best to seek medical help early. This includes widespread acne, nodules and cysts, or scarring.

SeverityTypical first-line treatmentWhen to escalate
MildOTC salicylic acid, benzoyl peroxide and a gentle Retinoidif no improvement after 8 to 12 weeks
Moderateprescription Retinoids and topical or oral antibioticsif breakouts spread or start to scar
Severe (nodules, cysts)dermatologist care and oral isotretinoinseek help early to prevent scarring

Skincare for Teenage Acne

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 ingredients that tackle the underlying problems that cause acne. Look for products that contain the following:

  • 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 and pustules.
  • Salicylic acid: beta hydroxy acids (BHAs) like salicylic acid exfoliate the skin and unclog pores. It’s especially good for blackheads and whiteheads but will also help with other acne lesions. The best way to use a BHA is in a toner, swiped all over the face 2 to 3 times a week.
  • Retinoids: these include Retinol and Retinal, which increase cell turnover and boost collagen production. They help unclog pores, control oil and brighten the skin. They can help with all forms of acne, as well as fade hyperpigmentation and smooth texture.

Prescription Treatments for Teenage Acne

Sometimes, skincare alone isn’t enough to clear acne. This is especially likely in more severe forms like cystic or nodular acne. In cases like this, medical treatments can be invaluable. You will need to see your family doctor, who may either start treatment or refer your child to a dermatologist depending on the severity. In general, these are the most common prescription medicines used to treat teenage acne:

  • Oral antibiotics: examples include doxycycline and lymecycline, 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 and creams are effective for severe acne, hyperpigmentation and scars. They may be 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 can help balance the hormones that drive acne. These are given as a daily tablet and are often reserved for more severe acne, due to potential side effects and the long treatment duration.
  • Isotretinoin: commonly known as Accutane or Roaccutane, this is the most powerful medication for severe acne or acne that hasn’t responded to other treatments. It is a tablet medicine often used for 6 to 12 months, and it can completely clear acne, scars and hyperpigmentation. However, it does have potential risks, so it needs monitoring and can only be given by a dermatologist.
  • Corticosteroid injections: these are used for large, painful acne cysts or nodules. They significantly reduce oil production and inflammation. However, they are reserved for isolated severe lesions and are not a long-term treatment option.

Professional Treatments for Teenage Acne

These aren’t usually effective for treating acne by themselves, but they can help manage severe acne as part of a comprehensive routine. Again, in most cases it’s best to try medical treatments before adding professional treatments. These should be performed by a medical professional with experience in treating teenage acne. They will ensure the correct protocols are used and minimise the risk of skin irritation or injury:

  • Chemical peels: these remove the top layers of skin, opening pores and improving texture. Often a course of chemical peels is needed, followed by maintenance with skincare. They are best for mild to moderate acne.
  • Laser therapy: this reduces oil production and bacteria. Laser therapy can also help with scars, texture and hyperpigmentation. The number of sessions needed depends on the type of laser and the desired outcomes. It is usually reserved for severe acne.
  • Extraction procedures: these are done by dermatologists to remove blackheads and whiteheads safely. They don’t address the underlying cause of acne, but they can provide temporary improvement.

Lifestyle Changes for Teenage Acne

As mentioned earlier, lifestyle factors can worsen teenage acne, so it’s worth giving this some attention. Encourage your teenager to follow the advice below:

  • 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 with overall health and stress reduction.

When to Get Professional Help

For more persistent or severe cases, professional treatment may be necessary 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, it’s best to seek help sooner rather 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 to 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 life or mood, 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 may 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 and provide a long-term solution.

Skincare Routine for Teenage Acne

No matter how severe the acne, and whether or not you need medical or professional treatments, a good skincare routine is vital. A routine for teenagers should be gentle yet effective, aimed at managing breakouts whilst maintaining healthy skin. Here is everything you need to put together a skincare routine for teenage acne:

  • Gentle cleansing: use a hydrating foam or gel cleanser twice a day, morning and night. This removes excess oil and impurities without over-drying the skin. Avoid soaps or physical scrubs, as these dry out the skin and make acne worse.
  • Exfoliation: use a BHA (salicylic acid toner) in the mornings after cleansing to unclog pores and remove dead skin cells. Start with 1 to 2 times a week and build up as your child’s skin tolerates it.
  • Spot treatments: apply gels or creams containing benzoyl peroxide to new spots once or twice a day after cleansing. This helps clear them up more quickly.
  • Active treatments: in the evenings, after cleansing, use a Retinoid to exfoliate the skin and clear out pores. Over time, this can also smooth the skin and even out texture.
  • Moisturising: acne treatments can dry out the skin, so a moisturiser helps maintain its natural barrier. Use a hydrating lotion or gel moisturiser morning and evening.
  • Sun protection: some acne treatments make the skin more sensitive to the sun. Apply a broad-spectrum sunscreen with at least SPF 30 every morning.

Supporting Your Teen Emotionally

The impact of teenage acne can be far-reaching, and it’s 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. Parents and caregivers have a really important role here.

First of all, reassure your teen and provide a safe space for them to deal with acne. It’s vital to acknowledge their feelings and reassure them that acne is common and treatable. Try to dispel harmful myths and reassure your teen that it is not a reflection of their worth or hygiene. It’s 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. Educate your child about acne and emphasise that it’s a temporary and manageable condition. This will give them hope and dispel any feelings of isolation or embarrassment. Crucially, always involve your teenager in any decisions about how to treat their acne. This will empower them and give them a sense of control. 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 physical and psychological effects. The best way to treat it will depend on the causes, severity and your child’s skin and overall health. Whilst it can be a difficult condition to treat, there are many options to clear it up. Parents and caregivers can provide vital guidance and support, steering adolescents through 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, as early intervention can prevent long-term skin damage and emotional distress.

At City Skin Clinic, we are passionate about personalised skincare. Our doctors offer safe and effective custom treatments for adults using ingredients like tretinoin, clindamycin, azelaic acid and spironolactone where appropriate, through our online clinic. Our doctors treat acne, hyperpigmentation, melasma, rosacea and skin ageing through bespoke compounded treatments designed around you. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.

This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any health concerns or questions you might have.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
BSC (HONS) MBBS MRCS PHD
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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