Understanding teen acne
Understanding teen acne
Post Author
Post Author
Dahlia Rimmon, MS, RDN
Editorial Manager
Medically reviewed by
Medically reviewed by
Dr. Ashley McClary
Pediatrician
Dr. Leo Damasco
Pediatrics and Emergency Medicine
Acne is a common challenge for teenagers, and for their parents too. It affects up to 85% of teens and is often considered a normal part of adolescence. However, teen acne can also be associated with an increased risk of mental health issues. Read on to learn more about what causes teen acne, the risk factors, and practical ways you can help your teen effectively manage their skin health.
Why is acne common in teenagers and what causes it?
“Teens are particularly vulnerable because of the hormonal surges of puberty,” says Dr. Ashley McClary MD, MPH, FAAP, Pediatrician at Summer Health. Several changes during puberty cause acne, including:
Hormonal changes: In both boys and girls, there is an increase in production of androgens (male-type hormones), which cause sebaceous glands (oil glands) in the skin to enlarge and produce more sebum (oil). Excess oil production can clog pores more easily, which contributes to the development of acne.
Inflammation: A teenager’s immune system plays a key role in the formation of acne lesions, such as papules (small raised bumps) and pustules (bumps filled with pus). When a pore becomes clogged with sebum and dead skin cells, the body’s immune system responds by triggering inflammatory markers. This immune response causes the affected area to become red and swollen, which is why acne often appears inflamed.
Bacterial involvement: The skin naturally contains symbiotic bacteria, but when pores become clogged with oil and dead skin cells, bacteria can multiply, which triggers additional inflammation. Dr. McClary explains that although bacteria plays a role in acne, it’s not considered a bacterial infection, rather an inflammatory process triggered by harmless bacteria.
Genetic predisposition: Teenagers who have parents who have or had severe acne are more likely to develop acne. “Severity, persistence, and how reactive the skin is can all have a genetic component,” says Dr. McClary.
Common types of acne in teenagers
“Acne isn't just pimples,” says Dr. McClary. “There are different kinds, from mild to more serious.” Understanding the various forms of acne can help determine the best treatment approach and when it’s time to consult a doctor.
Non-inflammatory comedonal acne
Non-inflammatory acne primarily includes blackheads (open comedones) and whiteheads (closed comedones). Blackheads are clogged pores with a dark surface, while whiteheads are small bumps that remain under the skin. These types of acne are generally less likely to be painful and can often be managed with over-the-counter topical treatments. However, if they persist, they can still lead to complications or skin issues over time.
Inflammatory acne
Inflammatory acne includes papules (small red bumps) and pustules (bumps filled with pus), which may be tender to the touch. This type of acne is typically more uncomfortable and carries a higher risk of skin irritation and scarring.
Nodules and cysts
Nodules and cysts are larger, deeper lumps beneath the skin. Cysts are filled with pus, while nodules are solid and firm. These forms of acne are often painful and carry the highest risk of leaving scars. They usually require prescription-strength treatments from a healthcare provider.
Severe acne
Severe acne includes rare variants such as acne conglobata and acne fulminans, which can be widespread across the body and, in extreme cases, cause systemic symptoms. These forms of acne require prompt medical attention and intensive treatment.
What are risk factors for teenage acne?
Several factors can make acne more likely to develop or become more severe in teenagers, such as:
Hormones
Environmental factors, like sweating, friction/pressure on skin (helmets, tight clothing), and cosmetics that block pores
Medications (like corticosteroids)
Diet
When it comes to 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. “High glycemic index foods, such as candy and white bread, are linked to more acne,” says McClary. These foods may influence hormone levels that play a role in the development and severity of acne.
Encourage your teenager to eat low-glucenic foods, like whole grains and fresh fruits vegetables, while limiting sweets, soft drinks, and dessert foods. 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
Dr. McClary explains that stress is often an indirect cause of acne but can make 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 acne in teens
The choice of acne treatment depends on several factors, including the severity of the acne, the types of lesions, how long the acne has persisted, and its physical and emotional impact on the teen. “Treatment has been shown to significantly improve the quality of life for teenagers with acne,” says Dr. McClary.
Acne treatments can range from mild options to more aggressive therapies, tailored to the individual needs of each teen. Here are treatment options, from mild to more aggressive:
Topical retinoids
Topical retinoids are vitamin A derivatives that help prevent the formation of comedones and have anti-inflammatory effects. Retinoid creams are available over-the-counter (OTC). These treatments are generally effective for mild to moderate acne. Common side effects include skin dryness and irritation. Keep in mind that consistent use is important, and it may take 4 to 8 weeks or longer to see noticeable skin improvements.
Prescription topicals
Prescription topical treatments include stronger retinoids, combination products (such as a retinoid plus benzoyl peroxide), and topical antibiotics. These are used when OTC treatments are not sufficient. Your prescribing doctor will carefully monitor the skin to check for potential skin irritation. Topical antibiotics should not be used alone due to the risk of antibiotic resistance. Instead, your doctor will likely prescribe a topical antibiotic with benzoyl peroxide or retinoid.
Systemic medications
Systemic treatments such as oral antibiotics or hormonal therapies 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.
How long does acne last in teens?
“This is a hard question because “how long” can vary widely,” says McClary. “Most people begin to develop acne with puberty onset, with prevalence peaking in mid-teens.” One longitudinal study found that by ages 15 to 16 in girls and 17 to 18 in boys, around 75–90% of teens had facial acne.For many teens, acne improves as they get older, but it’s common for some breakouts to linger into the 20s. In fact, a study suggests about 25% of people still struggle with acne at age 25.
How long acne lasts also depends on its severity. Mild breakouts may clear up sooner, but moderate-to-severe acne, especially with nodules or cysts, can stick around for years if not treated. One study found that only about 10% of teens saw major skin improvements in the first three years after their acne began. “In short, expect acne to last several years for many teens, with peaks and valleys, and for some, to continue into early adulthood,” says McClary.
Is acne preventable?
“Preventing acne completely may not be realistic for many teens, because so much of it depends on hormonal changes and genetics,” says McClary. However, there are steps you can take to reduce severity, decrease frequency, minimize scarring, and help your teen feel more confident in their skin. Preventive strategies include:
Early treatment: In children at risk for severe or cystic acne, starting early treatment can help.
Healthy skincare: Teaching your teen about cleansing their skin with gentle skincare products (and not harsh scrubs) can promote healthy skin. Similarly, remove products from the household that irritate skin or block pores, like coconut butter or algae extract.
Lifestyle changes: Poor diet and lifestyle choices can trigger acne symptoms. Simple habits, like quality sleep, stress management, and a balanced diet can help reduce acne flare-ups.
Educating about what acne: Explain what acne is in age-appropriate language so your teen understands it’s not their fault. Emphasize that improvements take time, and consistent care is key.
How parents can help
Many acne treatments take weeks to months to improve, and it’s common for breakouts to appear worse at first, which can be discouraging. Staying positive and encouraging your teen to stick with their treatment plan can make a big difference in long-term outcomes.“Acne can hit self-esteem hard,” says McClary. “Be there to listen, offer encouragement, and help your teen access effective treatment.”
Promoting a healthy lifestyle is another important step. Encouraging regular sleep, a balanced diet, stress management, and proper skincare routines can support both their skin and overall quality of life.
Know when to seek professional help. If acne is severe, painful, causing scarring, or affects mental health, reach out to your local or Summer Health pediatrician for next steps.
FAQs
Does picking or squeezing acne bumps help?
No, picking or squeezing acne makes inflammation worse and increases the risk of infection and scarring. It’s important to teach your teen not to pick at their skin. If a spot is painful or persistent, they should consult a doctor for safe and effective treatment rather than trying to force it out themselves.
What are non-comedogenic cosmetics?
Non-comedogenic cosmetics are products formulated not to clog pores, which can help reduce the risk of acne breakouts. Encourage teens to choose gentle cleansers, face wash, makeup, moisturizers, and sunscreens labeled as “non-comedogenic” to protect their skin. You can also check a skincare brand’s website to learn more about the ingredients and formulations in their products.
If you have questions about your teen’s acne, 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.
Acne is a common challenge for teenagers, and for their parents too. It affects up to 85% of teens and is often considered a normal part of adolescence. However, teen acne can also be associated with an increased risk of mental health issues. Read on to learn more about what causes teen acne, the risk factors, and practical ways you can help your teen effectively manage their skin health.
Why is acne common in teenagers and what causes it?
“Teens are particularly vulnerable because of the hormonal surges of puberty,” says Dr. Ashley McClary MD, MPH, FAAP, Pediatrician at Summer Health. Several changes during puberty cause acne, including:
Hormonal changes: In both boys and girls, there is an increase in production of androgens (male-type hormones), which cause sebaceous glands (oil glands) in the skin to enlarge and produce more sebum (oil). Excess oil production can clog pores more easily, which contributes to the development of acne.
Inflammation: A teenager’s immune system plays a key role in the formation of acne lesions, such as papules (small raised bumps) and pustules (bumps filled with pus). When a pore becomes clogged with sebum and dead skin cells, the body’s immune system responds by triggering inflammatory markers. This immune response causes the affected area to become red and swollen, which is why acne often appears inflamed.
Bacterial involvement: The skin naturally contains symbiotic bacteria, but when pores become clogged with oil and dead skin cells, bacteria can multiply, which triggers additional inflammation. Dr. McClary explains that although bacteria plays a role in acne, it’s not considered a bacterial infection, rather an inflammatory process triggered by harmless bacteria.
Genetic predisposition: Teenagers who have parents who have or had severe acne are more likely to develop acne. “Severity, persistence, and how reactive the skin is can all have a genetic component,” says Dr. McClary.
Common types of acne in teenagers
“Acne isn't just pimples,” says Dr. McClary. “There are different kinds, from mild to more serious.” Understanding the various forms of acne can help determine the best treatment approach and when it’s time to consult a doctor.
Non-inflammatory comedonal acne
Non-inflammatory acne primarily includes blackheads (open comedones) and whiteheads (closed comedones). Blackheads are clogged pores with a dark surface, while whiteheads are small bumps that remain under the skin. These types of acne are generally less likely to be painful and can often be managed with over-the-counter topical treatments. However, if they persist, they can still lead to complications or skin issues over time.
Inflammatory acne
Inflammatory acne includes papules (small red bumps) and pustules (bumps filled with pus), which may be tender to the touch. This type of acne is typically more uncomfortable and carries a higher risk of skin irritation and scarring.
Nodules and cysts
Nodules and cysts are larger, deeper lumps beneath the skin. Cysts are filled with pus, while nodules are solid and firm. These forms of acne are often painful and carry the highest risk of leaving scars. They usually require prescription-strength treatments from a healthcare provider.
Severe acne
Severe acne includes rare variants such as acne conglobata and acne fulminans, which can be widespread across the body and, in extreme cases, cause systemic symptoms. These forms of acne require prompt medical attention and intensive treatment.
What are risk factors for teenage acne?
Several factors can make acne more likely to develop or become more severe in teenagers, such as:
Hormones
Environmental factors, like sweating, friction/pressure on skin (helmets, tight clothing), and cosmetics that block pores
Medications (like corticosteroids)
Diet
When it comes to 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. “High glycemic index foods, such as candy and white bread, are linked to more acne,” says McClary. These foods may influence hormone levels that play a role in the development and severity of acne.
Encourage your teenager to eat low-glucenic foods, like whole grains and fresh fruits vegetables, while limiting sweets, soft drinks, and dessert foods. 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
Dr. McClary explains that stress is often an indirect cause of acne but can make 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 acne in teens
The choice of acne treatment depends on several factors, including the severity of the acne, the types of lesions, how long the acne has persisted, and its physical and emotional impact on the teen. “Treatment has been shown to significantly improve the quality of life for teenagers with acne,” says Dr. McClary.
Acne treatments can range from mild options to more aggressive therapies, tailored to the individual needs of each teen. Here are treatment options, from mild to more aggressive:
Topical retinoids
Topical retinoids are vitamin A derivatives that help prevent the formation of comedones and have anti-inflammatory effects. Retinoid creams are available over-the-counter (OTC). These treatments are generally effective for mild to moderate acne. Common side effects include skin dryness and irritation. Keep in mind that consistent use is important, and it may take 4 to 8 weeks or longer to see noticeable skin improvements.
Prescription topicals
Prescription topical treatments include stronger retinoids, combination products (such as a retinoid plus benzoyl peroxide), and topical antibiotics. These are used when OTC treatments are not sufficient. Your prescribing doctor will carefully monitor the skin to check for potential skin irritation. Topical antibiotics should not be used alone due to the risk of antibiotic resistance. Instead, your doctor will likely prescribe a topical antibiotic with benzoyl peroxide or retinoid.
Systemic medications
Systemic treatments such as oral antibiotics or hormonal therapies 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.
How long does acne last in teens?
“This is a hard question because “how long” can vary widely,” says McClary. “Most people begin to develop acne with puberty onset, with prevalence peaking in mid-teens.” One longitudinal study found that by ages 15 to 16 in girls and 17 to 18 in boys, around 75–90% of teens had facial acne.For many teens, acne improves as they get older, but it’s common for some breakouts to linger into the 20s. In fact, a study suggests about 25% of people still struggle with acne at age 25.
How long acne lasts also depends on its severity. Mild breakouts may clear up sooner, but moderate-to-severe acne, especially with nodules or cysts, can stick around for years if not treated. One study found that only about 10% of teens saw major skin improvements in the first three years after their acne began. “In short, expect acne to last several years for many teens, with peaks and valleys, and for some, to continue into early adulthood,” says McClary.
Is acne preventable?
“Preventing acne completely may not be realistic for many teens, because so much of it depends on hormonal changes and genetics,” says McClary. However, there are steps you can take to reduce severity, decrease frequency, minimize scarring, and help your teen feel more confident in their skin. Preventive strategies include:
Early treatment: In children at risk for severe or cystic acne, starting early treatment can help.
Healthy skincare: Teaching your teen about cleansing their skin with gentle skincare products (and not harsh scrubs) can promote healthy skin. Similarly, remove products from the household that irritate skin or block pores, like coconut butter or algae extract.
Lifestyle changes: Poor diet and lifestyle choices can trigger acne symptoms. Simple habits, like quality sleep, stress management, and a balanced diet can help reduce acne flare-ups.
Educating about what acne: Explain what acne is in age-appropriate language so your teen understands it’s not their fault. Emphasize that improvements take time, and consistent care is key.
How parents can help
Many acne treatments take weeks to months to improve, and it’s common for breakouts to appear worse at first, which can be discouraging. Staying positive and encouraging your teen to stick with their treatment plan can make a big difference in long-term outcomes.“Acne can hit self-esteem hard,” says McClary. “Be there to listen, offer encouragement, and help your teen access effective treatment.”
Promoting a healthy lifestyle is another important step. Encouraging regular sleep, a balanced diet, stress management, and proper skincare routines can support both their skin and overall quality of life.
Know when to seek professional help. If acne is severe, painful, causing scarring, or affects mental health, reach out to your local or Summer Health pediatrician for next steps.
FAQs
Does picking or squeezing acne bumps help?
No, picking or squeezing acne makes inflammation worse and increases the risk of infection and scarring. It’s important to teach your teen not to pick at their skin. If a spot is painful or persistent, they should consult a doctor for safe and effective treatment rather than trying to force it out themselves.
What are non-comedogenic cosmetics?
Non-comedogenic cosmetics are products formulated not to clog pores, which can help reduce the risk of acne breakouts. Encourage teens to choose gentle cleansers, face wash, makeup, moisturizers, and sunscreens labeled as “non-comedogenic” to protect their skin. You can also check a skincare brand’s website to learn more about the ingredients and formulations in their products.
If you have questions about your teen’s acne, 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.
References
Medline Plus: Papules
Medline Plus: Pastules
JAAD International: Diet and acne: A systematic review
AAP: Current Issues in the Treatment of Acne Vulgaris
Cambridge University Press: Is acne a sign of normal puberty? A longitudinal study
Dermatological review: Acne and its association with internalizing problems
Oxford academic: Young people's perceptions of acne and acne treatments: secondary analysis of qualitative interview data
Medline Plus: Papules
Medline Plus: Pastules
JAAD International: Diet and acne: A systematic review
AAP: Current Issues in the Treatment of Acne Vulgaris
Cambridge University Press: Is acne a sign of normal puberty? A longitudinal study
Dermatological review: Acne and its association with internalizing problems
Oxford academic: Young people's perceptions of acne and acne treatments: secondary analysis of qualitative interview data
Medline Plus: Papules
Medline Plus: Pastules
JAAD International: Diet and acne: A systematic review
AAP: Current Issues in the Treatment of Acne Vulgaris
Cambridge University Press: Is acne a sign of normal puberty? A longitudinal study
Dermatological review: Acne and its association with internalizing problems
Oxford academic: Young people's perceptions of acne and acne treatments: secondary analysis of qualitative interview data
Summer Health offers fast and reliable pediatric urgent care through online doctors, all via text. Whether you’re worried about your baby's fever, rashes, or other children's health concerns, we provide expert advice and support anytime, right from your phone.
Never miss a post!
Sign up for our newsletter to receive articles and guides directly to your inbox!
