Teenage Acne: Why It Happens and Treatments

Vicky Davis, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 11/23/2020

It’s a common occurrence for teens — after waking up, you look in the mirror and spot a pimple on your nose, cheek, chin or another highly visible part of your face. 

Teenage acne can be very frustrating. It often develops suddenly, leaving you with whiteheads, blackheads and painful, inflamed acne that can affect your appearance and take a toll on your self-confidence.

If you’re in your teens or early 20s and have acne, it’s important to realize that you’re not alone. Research indicates that acne can affect up to 95 percent of people during adolescence, making it one of the most common skin conditions in the world.

Luckily, acne is almost always treatable, with a variety of products and medications designed to help you take control of acne and improve your skin. 

Below, we’ve explained why and how teen acne develops, as well as the basics of what acne is from a medical perspective. We’ve also listed the numerous treatment options that are available to help you keep acne under control and prevent breakouts in the future. 

What Is Acne?

Acne is a type of inflammatory skin condition. It’s an extremely common condition, affecting up to 50 million Americans annually according to the American Academy of Dermatology.

For most people, acne begins during adolescence. However, can often continue into adulthood, with some people affected by acne well into their 20s and thirties. 

Most people start to notice acne developing at the beginning of their teens. You might begin by noticing small, single pimples that develop on your face, or significant breakouts when multiple pimples form at once. 

For most teens, acne isn’t physically harmful or dangerous. However, it can be frustrating and embarrassing, especially when it’s severe. In certain cases, acne breakouts can even become physically painful. 

How and Why Does Teen Acne Develop?

Acne develops when a combination of sebum and dead skin cells cause your hair follicles, or pores, to become blocked.

Pores are small, canal-shaped openings in the surface of your skin. Each pore contains a hair follicle and a sebaceous gland — a type of gland that’s responsible for keeping your skin moist and protected.

To understand how acne develops, it’s important to go over the basics of how your skin keeps itself fresh and healthy.

As you may know, your skin is constantly exposed to damage — whether it’s UV radiation from exposure to the sun, cuts and scratches that result from impacts with harsh surfaces or just dryness caused by wind and harsh temperatures. 

To keep itself healthy and repair this damage, your skin is constantly renewing and repairing itself. As your skin cells become worn and old, they die, with newer skin cells replacing them through a process called skin cell turnover. 

As well as repairing itself through the production of new cells, your skin protects itself against damage by producing a substance called sebum.

Sebum is a natural oil that’s produced by your sebaceous glands. It’s made up of waxes, fatty acids, sugars and other chemicals created by your body. Sebum’s role is to ensure your skin stays adequately hydrated by limiting the amount of water that evaporates and disappears. 

There’s also some scientific evidence that sebum may help to protect your skin against certain types of fungi and bacteria.

In short, sebum works as a type of a barrier that keeps your skin hydrated and healthy. When your sebaceous glands don’t create enough sebum, your skin can become dry, cracked, flaky and itchy. 

While the skin cell turnover cycle and sebum are both essential for healthy skin, they can have some side effects. 

For example, dead skin cells — a byproduct of your body’s skin cell turnover cycle — can build up on the surface of your skin over time. When these skin cells mix with sebum, they can clog your pores and cause acne to develop. 

Types of Teenage Acne

If you’re prone to acne, you may have noticed that your skin develops different types of acne lesions, such as whiteheads, blackheads and red, inflamed acne.

The specific type of acne you develop depends on how your pores are blocked. When a pore becomes completely blocked by sebum and dead skin cells, it can form into a whitehead — an acne lesion that’s either white or similar in color to your natural skin tone.

When a pore is blocked by sebum and dead skin cells, it can also form into a blackhead. The distinctive dark color of a blackhead is caused by a chemical reaction that occurs when dead skin cells and sebum are exposed to oxygen in the air.

Whiteheads and blackheads can be annoying and embarrassing, but they usually aren’t red or painful. However, some types of acne can become infected and inflamed, resulting in irritation, tenderness and pain when they’re touched.

When bacteria is trapped inside a pore that’s blocked by sebum and dead skin cells, it can form into a red, inflamed pimple. When an inflamed pimple forms deep inside the skin, it can become a painful, pus-filled form of acne that’s referred to as cystic acne.

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Why Is Acne So Common During Your Teens?

For most people, acne usually begins to develop during their pre-teen and teen years. Just like other changes in your body that happen during your teens, teenage acne is typically caused by increasing levels of sex hormones that can affect your skin.

According to UC Davis Health, acne usually starts to develop around the age of 11 for girls, with boys usually starting to develop acne a couple years later.

Your skin’s production of sebum is associated with certain hormones. In particular, the androgen hormone testosterone, which is present in women as well as men, plays a key role in controlling the amount of sebum your skin’s sebaceous glands secrete.

As you enter your teens, a part of your brain called the hypothalamus signals to your body that it’s time to produce more sex hormones, including the hormones estrogen and testosterone. 

This rapid increase in hormone production can cause your sebaceous glands to secrete more sebum, resulting in oilier skin and an increased risk of developing whiteheads, blackheads and pimples. 

We’ve explained more about how hormones can affect your skin and cause acne in our guide to hormonal acne

How to Treat Teenage Acne

Acne, whether during your teens or later in life, is almost always treatable. A variety of effective, safe treatments are available for teenage acne, many of which can help you to get rid of pimples and reduce the severity of acne breakouts.

There’s no one-size-fits-all treatment for acne. Instead, your healthcare provider may suggest a variety of treatments based on the severity of your acne. 

Over-the-Counter Products for Treating Acne

Most of the time, mild acne can be treated using topical medications. These are usually sold as creams, gels or face washes that you apply directly to acne-prone skin. Non-prescription topical treatments for acne include one or several of the following ingredients:

  • Benzoyl peroxide. If you have inflamed pimples or cystic acne, your healthcare provider may recommend using a topical cream, gel or scrub that contains benzoyl peroxide.

    Benzoyl peroxide is an antiseptic that kills bacteria on your skin, helping to prevent acne from becoming infected, inflamed and painful. It’s often used as an alternative to topical or oral antibiotics, as it’s less likely to cause bacteria to become resistant to treatment.

    Research shows that benzoyl peroxide can help to reduce the number of acne lesions in people prone to acne. You can often find benzoyl peroxide as an ingredient in many over-the-counter acne scrubs and face washes.

  • Salicylic acid. Another common over-the-counter acne treatment ingredient, salicylic acid is an exfoliant that strips away dead skin cells and lowers your risk of developing blocked pores.

    Research has generally found that salicylic acid is effective at getting rid of acne, with comparative studies finding that it’s sometimes more effective at reducing acne lesions than benzoyl peroxide, often with less severe side effects.

  • Sulfur. Some acne creams, gels and scrubs contain sulfur — an ingredient that can dry the skin and may help to reduce the risk of sebum clogging pores and causing acne to develop. 

Prescription Medications for Treating Acne

If you develop severe, painful or persistent acne during your teens, it’s important to talk to your healthcare provider. Numerous prescription medications are available that can help you to bring acne under control and prevent future breakouts. These include:

  • Clindamycin. Clindamycin is a prescription antibiotic. It’s a topical medication that works by killing the bacteria that can multiply inside clogged pores and cause red, inflamed and painful acne lesions to develop.

    Clindamycin is one of several ingredients in our acne cream. It’s typically used to treat inflamed acne that doesn’t go away with over-the-counter facial creams or other acne treatments.

    We’ve explained more about how clindamycin works, its effects and potential side effects in our guide to clindamycin and acne.

  • Tretinoin. Tretinoin is a type of prescription retinoid. It’s a topical medication that works by increasing the speed at which your body creates new skin cells. By helping your skin to create new cells faster, it can prevent old, dead skin cells from contributing to acne.

    Tretinoin is another active ingredient in our acne cream. It’s backed by scientific data and works very effectively, although it may cause dryness during the first few weeks of use.

  • Isotretinoin. Isotretinoin is also a prescription retinoid. Unlike tretinoin, which is a topical medication that you apply directly to affected skin, isotretinoin is an oral medication that’s sold in capsule form.

    Isotretinoin can cause side effects, including dry skin and chapped lips. Due to the risk of side effects, you’ll need to talk to your dermatologist and closely follow their advice if you need to use this medication to treat and control acne.

  • Hormonal birth control. Believe it or not, the hormonal birth control pill isn’t just used for preventing pregnancy — it’s also commonly prescribed as a treatment for hormonal acne breakouts.

    Certain birth control pills, including the combination birth control pills Yaz®, Estrostep® and Ortho Tri-Cyclen®, are approved by the FDA to treat hormonal acne. These medications work by controlling the level of hormones, called androgens, produced by your body.

    We’ve explained more about how birth control can help to treat acne in our guide to birth control and acne.

Whether you’re prescribed a topical medication for acne such as tretinoin or clindamycin, or an oral medication such as isotretinoin, it’s important to be patient once you begin treatment. 

Even the most effective acne treatments can take several weeks to start working. After you start using medication to treat acne, make sure you give the medication an adequate amount of time before you begin to assess your results.

If you don’t experience improvements after a few weeks, contact your healthcare provider. If you have particularly persistent or difficult acne, you may need to adjust your dosage or switch to a different type of medication to bring your acne under control. 

How to Prevent Teenage Acne

There’s more to acne than just sebum, skin cells and hormones. Your habits, from how often you wash your face to whether or not you touch your pimples, can have a real impact on your risk of dealing with acne breakouts. 

If you’re prone to acne and want to reduce your risk of dealing with pimples, try the following preventative tips:

  • Follow your healthcare provider’s instructions. If you’re prescribed a medication to treat and prevent acne, such as tretinoin or isotretinoin, make sure that you follow your healthcare provider’s instructions and use the medication as prescribed.

    Although results aren’t immediate, acne medications generally work. Stick to the medication even if you don’t notice results during the first few weeks.

  • Avoid popping pimples or picking at your acne. As tempting as it can be to pop a pimple as soon as you notice it, it’s much better for your skin to leave your acne alone and let it heal naturally.

    Popping a pimple can force bacteria deeper under the surface of your skin, potentially worsening the inflammation and discomfort. Because of the worsened inflammation, it may also increase your risk of developing long-term acne scarring.

  • Wash your face twice a day. Washing your face, especially with an acne prevention face wash, helps to get rid of dead skin, sebum, dirt and other particles that can block pores and cause acne to develop.

    Although it’s important to wash your face, it’s also important not to wash your face too often. Stick to washing twice a day — once when you wake up, and once just before you go to bed — to prevent acne without damaging or irritating your skin.

  • When you wash, avoid scrubbing. While it’s good to wash your skin, try not to scrub your skin aggressively when you shower. Instead, it’s better to gently wash your facial skin using your fingertips.

  • Avoid touching your face, especially with dirty or oily fingers. Touching your face can transfer dirt, oils and other particles onto your skin, all of which can become stuck inside pores and contribute to acne breakouts.

    If you need to touch your face — for example, to apply makeup or medication — make sure to wash your hands thoroughly using soap and warm water first.

  • Avoid using oily, comedogenic makeup products. Some makeup products contain natural and artificial oils that can collect inside your pores, causing blockages that can result in whiteheads, blackheads and inflamed pimples.

    If you’re prone to acne, try avoiding oily or irritating makeup products. When you shop for makeup, look for products labeled “non-comedogenic,” which are less likely to clog pores and cause acne breakouts.

  • Use non-comedogenic, face-friendly sunscreen and moisturizer. Likewise, certain types of sunscreen, lotion and moisturizer can make your skin oily, increasing your risk of dealing with an acne breakout.

    If you’re going to the beach or spending time outdoors in the sun, make sure to apply a non-comedogenic sunscreen. When it comes to moisturizer, try to look for products that contain glycerine and hyaluronic acid, both of which can help your skin retain moisture.

  • Always remove your makeup before you sleep. Sleeping in makeup — even makeup that’s labeled non-comedogenic” can contribute to acne breakouts. Make sure to fully remove any makeup before you sleep.

  • Make sure that oil from your hair doesn’t affect your skin. Acne breakouts can occur when the natural oil from your hair, or artificial oils contained in hair care products, make their way onto your forehead and clog your pores.

    If you often develop acne around your hairline, your hair could be the culprit. If your hair is naturally oily, make sure to wash it regularly to prevent oil from building up. If you use hair styling products, check the ingredients to ensure they don’t contain any oils.

  • Change your sheets every week. Oil, dirt and other substances can easily spread from your face to your pillows and bedsheets. When you sleep, these can spread back to your face, causing blocked pores that develop into whiteheads, blackheads and pimples.

    If you’re prone to acne, make sure to wash and change your bedsheets and pillowcases every week. Make sure to follow the care instructions provided with your bedding to keep your sheets and pillowcases soft, clean and comfortable.

  • Shower after exercising. Working out is fantastic for your general health, but spending too long in sweaty clothes after working out may increase your risk of developing acne by causing bacteria to stay on your skin.

    After you work out, it’s best to take a shower as soon as you can, especially if you sweat a lot during your workout. Carefully wash your face after working out to clean sweat that can cling to your skin and combine with acne-causing bacteria.

  • Try reducing your consumption of high-GI foods. Although research in this area isn’t conclusive, some small-scale studies have found that eating high glycemic index foods — foods that are rich in simple carbohydrates — may contribute to acne breakouts.

    There’s also some research indicating that cow’s milk, whether skim, low-fat or whole, may be a diet-related cause of acne.

    Instead of eating high-GI foods, researchers suggest eating a diet primarily made up of foods that release sugar slowly, such as fresh vegetables, complex carbohydrates and healthy proteins.

  • If you get body acne, try to avoid wearing tight, restrictive clothing. Tight clothing can allow dirt, sweat and oil to build up on the surface of your skin, all while preventing your skin from getting adequate airflow.

In Conclusion

If you’re currently in your teens, it’s common and normal to deal with the occasional pimple or acne breakout. 

While mild acne can often be treated using the over-the-counter products listed above, it’s best to talk to your healthcare provider if you have severe or persistent acne. It’s especially important to seek out expert advice if your acne is inflamed, painful or cystic (meaning it contains pus).

Although acne can be frustrating and embarrassing, it is treatable. With the right combination of medication, good skincare habits and enough time, it’s almost always possible to get your acne under control and enjoy clear, pimple-free skin. 

Learn More About Treating and Preventing Acne

Worried about acne? You’re definitely not alone. Acne is extremely common, affecting women of all ages and backgrounds.

If you’re looking for more information on treating acne, our guides to common skincare mistakes and getting rid of acne fast provide more science-backed tips on what you can do to avoid acne breakouts and keep your skin clear, smooth and acne-free.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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