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Teen (12–18 years) · Young adult (18–21 years) · Teens, Illness & symptoms

Acne in teens: what works over the counter, and when to see us

Acne affects most teens and is driven by hormones, not dirt or chocolate. Benzoyl peroxide and adapalene, used nightly for 8 to 12 weeks, clear most mild acne. Moderate or scarring acne needs prescription treatment, and we start it early.

Key takeaways

  • Wash twice a day with a gentle cleanser; scrubbing makes it worse
  • Adapalene 0.1% gel and benzoyl peroxide 2.5 to 5% are the over-the-counter workhorses
  • Give any treatment 8 to 12 weeks before judging it
  • Moisturizer and sunscreen labeled non-comedogenic every morning
  • Deep, painful bumps, scarring, or acne affecting mood means a visit, not more waiting

What causes acne

Puberty hormones enlarge oil glands, pores clog with oil and skin cells, bacteria multiply and the skin inflames. Genetics decide how much. Dirt does not cause it; neither do fries or chocolate, though high-sugar diets and some whey protein supplements can aggravate it. Picking and squeezing turn small spots into scars.

A routine that works for mild acne

  1. Morning: gentle cleanser, oil-free moisturizer with SPF 30
  2. Evening: gentle cleanser, then a thin layer of adapalene 0.1% gel over the whole acne-prone area, not just spots
  3. Add benzoyl peroxide 2.5 to 5% wash or leave-on in the morning if there are red bumps; it bleaches towels and pillowcases
  4. Expect dryness and some peeling in weeks 2 to 4; use less, not more, and keep going
  5. Judge at 12 weeks; most teens see clear improvement by then

When over-the-counter is not enough

Moderate acne (many red bumps, some deeper), acne on the chest and back, dark marks or scars forming, or acne that is affecting confidence needs a visit. We prescribe stronger retinoids, topical or oral antibiotics for a limited course, and for girls hormonal options, and we refer to dermatology for severe or scarring acne, where isotretinoin can be life-changing. Treating early prevents scars that are hard to fix later.

Myths that waste time

  • Toothpaste, lemon juice and rubbing alcohol irritate skin and do nothing for acne
  • Tanning does not clear acne; it darkens marks and raises skin cancer risk
  • Scrubs and harsh soaps strip the skin, which makes more oil
  • Skipping moisturizer because skin is oily backfires

When to call us

  • No improvement after 12 weeks of a consistent over-the-counter routine
  • Painful deep bumps, cysts, or acne on the back and chest
  • Dark spots or scars developing
  • Your teen is avoiding school, sports or photos because of their skin

Go to the emergency room or call 911 if…

  • Facial swelling, hives or difficulty breathing after a new product: stop it and seek urgent care

Questions parents ask

Does makeup cause acne?

Non-comedogenic makeup, removed every night, is fine. Heavy or old products and sleeping in makeup are not.

Will diet changes help?

A little, for some. Cutting sugary drinks and skim milk and whey supplements helps a subset of teens. Diet alone does not treat acne.

Not sure? Ask us

Call or text the office during hours, or send a portal message. For emergencies call 911.

(770) 615-7000

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