Acne In Teenagers

Acne In Teenagers

Acne is a common skin condition that usually starts in the teenage years. It usually clears up after several years, but for some people, it can last a lot longer.

Key points to remember about acne in teenagers

A teenager with acne

  • acne is very common in teenagers
  • acne is related to hormonal changes
  • creams and other treatments from your pharmacy may help your teen's acne
  • acne treatments usually take several weeks or months to work
  • acne usually clears up after several years, but for some people, it can last a lot longer
  • if your teen has severe acne, bad acne on their back or chest, scarring or acne that goes on for a long time, see your family doctor

What causes acne?

During teenage years, young men and women have higher levels of a male hormone called testosterone in their blood. Testosterone makes the oil glands (called sebaceous (seb-ay-shus) glands) produce too much oil. The oil glands are connected to the hair follicles on your teen's face, neck, chest and back.

  • the extra oil blocks the hair follicles (pores)
  • bacteria can grow in the blocked pores
  • the bacteria can break down the wall of the follicle
  • oil, bacteria and dead skin cells escape from the follicle
  • this creates whiteheads, blackheads, pimples or deep cysts

What are the different types of acne?

Whiteheads

Whiteheads are round, white blemishes that form when plugs of oil and dead skin cells block hair follicles.

A diagram showing a whitehead

Blackheads

Blackheads are round, dark blemishes that form when plugs of oil and dead skin reach the skin's surface and the air.

A diagram showing a blackhead

Pimples

Pimples are red, swollen bumps that form when the plugged follicle walls break near the skin's surface.

A diagram showing a pimple

Deep cysts

Deep cysts are red, pus-filled pimples. They form when plugged follicle walls break deep within the skin.

A diagram of a deep cyst

How can I treat my teen's acne?

In most cases, your family doctor will recommend treatments that go on the skin (topical treatments). Some of these are available from the pharmacy without a prescription. Acne treatments don't do much for existing pimples - their job is to help prevent the next round. As a result, treatments can take weeks or months to show improvement. Your teen should try any new cream or lotion on a small area first, in case it irritates their skin. They can then put it on their face, shoulders and back (if affected) rather than just the individual spots. Follow the specific product directions.

What treatments are available for mild acne?

Face washes/cleansers

Acne face washes/cleansers can help reduce skin greasiness. These may include an antiseptic or antibacterial agent or mild salicylic acid.

Benzoyl peroxide

Benzoyl peroxide (cream, gel, wash), gets rid of some of the bacteria on the skin and makes the top layer of skin peel off, unblocking the pores. It can help if your teen has a lot of blackheads, but it may irritate their skin. If this happens, use a lower strength or use every second night.

Your teen should stop using a lotion/cream if severe irritation develops - talk to your doctor or pharmacist.

Retinoid gels or creams

Retinoid gels or creams (such as tretinoin or differin), which are mainly for blackheads, make the skin dry and peel. They can be very irritating so make sure your teen only spreads a small amount very thinly on their face, no more than once a day. It may make their acne worse at first, but it should improve after a few weeks. Make sure your teen takes care in the sun as they may burn more easily. They shouldn't use them if they are pregnant or there is any likelihood of becoming pregnant.

Azelaic acid cream

If your teen uses azelaic acid cream, (such as skinoren, acnederm), they will need to put it on twice a day. If it irritates their skin, get them to use less or use only once a day.

What if my teen has severe acne?

Early treatment for severe acne may help prevent scarring. If your teen uses treatments for mild acne for 3 months and their acne doesn't improve, take them to see your family doctor. You should also take them to the doctor if they feel down or depressed.

Mild acne treatments will not work for:

  • tender lumps under the skin (cysts)
  • acne on the back or chest
  • scarring

If your teen has any of these symptoms, then take them to see your family doctor.

What are the treatments for severe acne?

Oral antibiotics

Your teen may need to take antibiotics by mouth for 3 months or more, depending on how bad their acne is. If your teen is pregnant, then they may not be able to use many of the acne antibiotics available. If your child is under 12, they also won't be able to take them.

Oral retinoids

Your doctor may prescribe oral retinoids (such as isotretinoin) for your teenager, although your teen may need to see a skin specialist (dermatologist) for this. Common side effects include skin dryness and increased sun sensitivity. They are not suitable for women who are pregnant and women must not become pregnant during this treatment or for 1 month after treatment (because of a high risk of causing damage to the baby). Your family doctor or dermatologist will discuss these medicines with you.

Hormone treatments

Hormone treatments such as 'the pill' (combined oral contraceptive pill) may be an option if your teen has a hormonal imbalance.

Light treatments

Your teen's skin specialist may suggest other treatments like blue-light or other light-based systems.

How can I help care for my teen's acne at home?

There is no instant or permanent cure for acne, but it is possible to control it. Proper treatment of your teen's acne will help to prevent permanent scars. Below are some suggestions to help them take care of their skin.

Hygiene

Even though dirt does not cause acne, taking care of the skin with good hygiene is important. The darkness of a blackhead is not dirt, but is due mostly to dried oil and shed skin cells in the openings of the hair follicles. Your teen should wash their face with a gentle, pH-balanced soap-free face wash and warm water twice a day. It's important not to wash too often as this may aggravate their acne. Regular shampooing of your teen's hair is also a good idea, especially if their hair is oily and rests against their forehead.

Makeup

When buying makeup, make sure it's non-comedogenic or non-acnegenic. This means the cosmetic should not cause whiteheads or blackheads. Encourage your teen to remove makeup every night with face wash and water.

Non-prescription creams

Many non-prescription acne lotions and creams can help mild acne and are available over the counter at your local pharmacy. But, many of these products will make your teen's skin dry if they use them too often or if they use more than one of them at the same time (such as using an acne wash and an acne cream). If your teen uses these products, make sure they follow the instructions carefully. Using the wrong products can irritate your teen's skin and make their acne worse. Ask your pharmacist for advice on the best product to use.

Don't squeeze

Your teen shouldn't pick, scratch, pop or squeeze their pimples themselves. If your teen squeezes their pimples, it may cause more redness, swelling, inflammation and scarring.

Shaving

If your teen shaves their face and has acne, encourage them to try both an electric and a safety razor to see which is more comfortable. If they use a safety razor, encourage them to soften their facial hair thoroughly with soap and warm water. To avoid nicking pimples, tell them to shave as lightly as possible. They should only shave when necessary and always use a sharp blade.

Diet

Food does not generally cause acne. Research has shown acne can sometimes improve after reducing the amount of processed food in the diet.  Following a strict diet will not clear your teen's skin by itself.

Sunlight

Acne may improve after your teen has been out in the sun, but sunlight only helps for the short term. In the long run, sunlight may worsen acne. Too much sun over many years could also cause early ageing of the skin and skin cancer.

Starship Foundation and the Paediatric Society of New Zealand thank Health Navgiator and the Royal Children's Hospital, Melbourne, Australia, and for making this content available to parents and families.

The acne photo is courtesy of Dermnet.

This page last reviewed 25 July 2019.
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