Pimples are par for the course during the teen years, thanks to hormonal changes that increase the skin’s oil production during puberty. When that oil mixes with dead skin cells, it clogs pores and traps bacteria inside. Then, poof! Here comes a pimple.
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While some teens experience only mild blemishes, others have acne so severe that it leaves them with physical — and sometimes even emotional — scars.
“To keep the damage to a minimum, address your teen’s acne as early as possible,” advises Vickie Baker, MD, a family medicine doctor who specializes in dermatology.
Teen acne: Where to start
Acne can start as early as age 9 or 10 and last all the way through adulthood. It often starts as clogged pores (called comedones) on the forehead or down the nose that become inflamed and appear as small bumps.
“Each teen reacts differently to their acne. While some will hardly notice it, others will feel self-conscious,” Dr. Baker says. “Either way, it’s important for parents to take it seriously and try to find a treatment that helps clear the skin, prevent scarring and avoid emotional distress.”
Where to start depends on what type of acne your teen has. If they’re dealing with lots of deep pimples that look like cysts and cause pain, start with a doctor. But if your teen is dealing with other types of blemishes, including blackheads and whiteheads, over-the-counter options can go a long way toward treatment.
Over-the-counter acne treatments
One of the best ways to begin is to get your teen in the habit of following a skin care routine.
“A lot of teens don’t understand that you have to be regimented about it, just like brushing your teeth every night,” Dr. Baker explains. “You have to wash your face in the morning and at night because when you wash it, you’re treating it with medicine that’s going to help your acne.”
That routine should include:
- Cleansing twice a day.
- Exfoliating a couple times a week.
- Applying a moisturizer after washing.
- Dabbing a spot treatment on pimples as needed.
- Wearing sunscreen during the day.
To give these treatments the best opportunity to work, Dr. Baker says your teen needs to use them regularly for about three months.
Your teen should be washing their face twice a day — once in the morning and once before bed — and no, makeup removal wipes don’t count.
Having trouble understanding skin care ingredients and what they do? Dr. Baker recommends finding a gentle face wash that contains an acne-fighting medication and is labeled “non-comedogenic” (meaning it won’t cause blackheads and whiteheads).
“Look for benzoyl peroxide, which kills bacteria and removes excess oil from the pores, or salicylic acid, which is good for exfoliating blocked pores,” Dr. Baker advises. How much of each depends on your child’s skin type.
- If your teen has oily skin, look for a face wash with a 5% to 10% of benzoyl peroxide formula.
- If your teen has sensitive skin, look for salicylic acid and a lower percentage of benzoyl peroxide.
Gels and creams
When a new pimple starts to appear, turn to a spot treatment designed to zap zits overnight. That doesn’t mean they’ll be gone by morning, but it gives your skin a huge head start. Here are some ingredients to look for:
- Benzoyl peroxide is an antiseptic, meaning it tackles bacteria — a key element of fighting acne.
- Salicylic acid, also known as beta hydroxy acid, helps remove dead skin. It’s not as irritating as other skin care ingredients, so it’s good for sensitive skin.
- Retinoids, which are made from vitamin A, help unstick dead skin cells and clear out pores. “One of the best retinoid options for acne-prone teens is adapalene, formerly a prescription-only medication that became available over the counter in 2016,” Dr. Baker says. Apply a pea-sized amount to the entire face after cleansing (rather than using it as a spot treatment).
How do dermatologists treat acne?
If your teen starts following a regular skin care routine but their blemishes still don’t seem to be under control after three months, it’s time to make an appointment.
“Many pediatricians are comfortable treating acne, so that’s likely the best place to start,” Dr. Baker says. “They can refer your teen to a dermatologist, if necessary.”
What treatment they recommend will depend on your teen’s individual needs — and sometimes it’s a matter of trial and error.
For pus-filled acne that is painful and inflamed, your teen’s doctor will likely consider topical antibiotics. “These medications are applied directly to the skin to control bacteria and inflammation,” Dr. Baker says.
Your teen’s doctor may prescribe:
- Clindamycin, a topical antibiotic that reduces acne-causing bacteria.
- Benzoyl peroxide to control the bacteria and inflammation.
- A retinoid like adapalene (Differin®) or tretinoin (Retin-A®) to unblock pores.
Although products containing benzoyl peroxide and adapalene are available over the counter, they also come in prescription strengths only available from a doctor. Topical antibiotics and tretinoin, meanwhile, are only available with a prescription.
And topical antibiotics should always be used with benzoyl peroxide. They work like a tag-team for skin health: They both kill bacteria, but they work differently, so using them together lessens the chances of bacteria becoming antibiotic-resistant.
“In the most severe cases, your teen’s dermatologist may consider more aggressive prescription medications,” Dr. Baker says. Possibilities include:
- Birth control pills: In teens assigned female at birth (AFAB), high androgen (male hormone) levels can cause acne, facial hair and other issues. A low dose of estrogen and progesterone may help.
- Oral antibiotics: Like topical antibiotics, antibiotics in pill form can kill bacteria and keep swelling to a minimum. There are risks associated with taking antibiotics, though, especially long term.
- Isotretinoin: Formerly known as Accutane®, isotretinoin is an oral retinoid that can shrink the size of oil glands. But it, too, is associated with health risks, so it’s typically only prescribed if nothing else has worked.
Tips for dealing with teen acne
Looking for good habits and lifestyle changes that will help your teen achieve (and maintain) clearer skin? Dr. Baker shares some insight that can help.
1. Establish a skin care routine
If your teen doesn’t already have a regular skin care regimen, it’s time to help them start one — and to explain why it’s so important.
“Oftentimes, teenagers aren’t routinely washing their faces in the morning, at night and after they exercise,” Dr. Baker notes. “Sometimes, just getting into a good routine will help clear up a lot of their acne.”
2. Don’t pick at problem areas
3. Shower after activity
Good hygiene habits can prevent skin woes, so encourage your teen to wash up after sweaty practices, games and other workouts. Sweat can trigger oil production and clog pores, which causes facial pimples and bacne (back + acne = bacne).
4. Keep things clean
Bacteria lurk all over the place — including on items that touch your teen’s face, like their cell phone, sports helmet, sunglasses, makeup brushes and pillowcases. Regularly clean these items to minimize bacteria and keep skin safe.
5. Help teens manage stress
Ever wondered why pimples inevitably seem to crop up just before important events? We’ve got one word for you: stress.
“Stress and anxiety trigger your body’s production of cortisol, a hormone that can also cause your body to produce more sebum, which can clog pores and lead to acne,” Dr. Baker explains.
Teach your teen healthy ways to cope (like through meditation) and support them in managing their mental health. The benefits of good stress management skills go way beyond clearer skin — but it’s definitely a nice bonus!