Acne and eczema are two common skin conditions that often get confused because they can both cause bumps, redness, and irritation. While they may look similar, the causes, symptoms, and treatments for acne and eczema are different. Read on to learn more about how to help your teen manage their acne and/or eczema and overall skin health.

What is acne?

Acne is a common skin condition in teenagers and is often considered a normal part of adolescence. It occurs when skin pores become clogged with excess oil (sebum), bacteria, or dead skin cells. Acne is especially common during teenage years because hormonal changes increase the production of androgen hormones, which cause the oil glands (sebaceous glands) in the skin to enlarge and produce more sebum.

Clogged pores can lead to papules (small raised bumps) and pustules (bumps filled with pus). When a pore is blocked, the body’s immune system responds by triggering inflammation. This inflammatory response causes the affected area to become red and swollen, which is why acne often appears inflamed or irritated.

What is eczema?

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that causes redness, itching, rashes, and can often lead to skin infections. While it’s more common in younger children, teenagers can also have eczema.

Eczema is caused when the skin’s protective barrier doesn’t work as well as it should. Kids with eczema don’t have enough filaggrin, a protein which helps the outer skin layer stay strong and healthy. Without enough filaggrin, the skin struggles to retain moisture and keep out irritants, harmful microorganisms, and bacteria. This can cause an immune response that makes the skin dry, itchy, and more prone to inflammation and flare-ups. 

Eczema often runs in families, so teens with the condition frequently have a parent or close relative who also has eczema. Additionally, teenagers who regularly use makeup, hair care products, or other skincare products may experience flare-ups if certain ingredients irritate their skin.

How acne and eczema differ

“Although acne and eczema are both seen in teenagers, they are separate conditions," says Dr. Ashley McClary MD, MPH, FAAP, Pediatrician at Summer Health. She explains that acne symptoms result from blocked pores and bacterial overgrowth, while eczema is caused by breakdown of the skin barrier, which leads to dryness, itching, and inflammation.

Additionally, acne breakouts are often triggered by hormonal changes and genetic predisposition, whereas eczema is driven by an immune system response. Their symptoms also differ, with acne showing up as pimples or pustules, and eczema appearing as dry, red, itchy patches.

Here are a few other ways acne and eczema differ:

• Location: Acne usually appears on the face, chest, shoulders, and back, whereas eczema can appear anywhere on the body.

• Itchiness: Eczema is generally more itchy, while acne is often painful or tender rather than itchy.

• Appearance: Acne often includes whiteheads, blackheads, or pus-filled bumps, while eczema looks like scaly, rough, red, or inflamed patches.

Treating acne 

Acne treatments can range from medications, proper skincare, and healthy lifestyle changes, and they should be tailored to your teen’s individual needs. Here are some common medication-based treatment options:

• Topical retinoids: Vitamin A derivatives that help prevent the formation of comedones and have anti-inflammatory effects. Topical retinoids are over-the-counter (OTC) medications. 

• Prescription topicals: Stronger retinoids, combination products (such as a retinoid plus benzoyl peroxide), and topical antibiotics. These are used when OTC treatments are not sufficient. 

• Systemic medications: These include oral antibiotics or hormonal therapies, which can be used for moderate to severe inflammatory acne or for acne that has not responded to other treatments. These medications can be effective, but they also carry a higher risk of side effects and often require longer treatment periods. 

Skincare

For acne-prone skin, use non-comedogenic products, which are formulated not to clog pores. Encourage teens to choose gentle cleansers, face washes, makeup, moisturizers, and sunscreens labeled as “non-comedogenic” to help protect their skin.

When trying a new product, it’s a good idea to do a patch test and apply a small amount on the skin to check for a reaction. You can also check the brand’s website to learn more about the ingredients and how their products are formulated.

Remind your teen to wash their face every night before bed, especially if they are wearing makeup. This can help keep pores clear and prevent breakouts.

Diet 

Several studies link acne to diets with high-glycemic foods (carbohydrates that digest and absorb at a rapid pace and cause spikes in blood sugar levels) like refined carbohydrates and simple sugars, as well as dairy products in some populations. Consider limiting these foods and focusing on high-fiber carbohydrates like fresh produce, whole grains, and legumes. 

If your teen consumes a lot of dairy products and has bad acne, consider removing dairy products from the diet to see if it helps. A pediatric registered dietitian can help your teen create a personalized list of foods and a meal plan that supports both healthy skin and overall nutrition.

Stress 

Stress can make acne breakouts worse. Helping teens recognize their stressors and encouraging stress-management practices can be beneficial. Strategies include getting enough sleep, staying physically active, practicing mindfulness, and engaging in hobbies or activities they enjoy.

Treating eczema 

Treating eczema involves managing active flare-ups and preventing future ones. One of the most important steps is to keep the skin well-moisturized using a fragrance-free, thick cream or ointment. Applying moisturizer right after showering helps lock in moisture and protect the skin.

Teens should also use gentle, fragrance-free soaps and shampoos to avoid irritation. 

For more severe eczema or particularly bad flare-ups, healthcare providers may recommend topical corticosteroids or calcineurin inhibitors. These medications help reduce inflammation and calm the skin, but should be used under medical guidance.

Laundry products can also be a source of eczema flare-ups. Use fragrance-free detergents and avoid fabric softeners or dryer sheets, which may contain irritating chemicals. When choosing clothing, opt for breathable fabrics, like 100% cotton, to help prevent sweat from building up and irritating the skin, which is especially important for teens who play sports.

Additionally, water can aggravate eczema symptoms. Try to limit washing your face with water to once a day, and avoid scrubbing if possible. Overwashing can strip away the skin’s protective lipids (fats), leading to itchy dry skin, irritation, and flare-ups.

How to treat acne and eczema together 

If your teen has both acne and eczema, managing their skincare routine can be tricky. Many products designed to treat acne can irritate the skin and trigger an eczema flare-up. Using prescription medications properly and following a carefully planned skincare routine can help balance both conditions. Your pediatrician can guide you in choosing the right products and strategies to manage acne while keeping eczema under control.

If you have questions about teen acne or eczema, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health.