Finding The Very Best Teen Acne Treatment System

Teen woman with headache holding her hand to the head

Stress hormones are the biggest cause of teenage acne.

Teenage acne is not like acne at other times of life. Teens are more likely to get acne than any other age group, in fact as many as 85% of teens will experience some type of acne, whether the pimples come in the form of whiteheads, blackheads, papules, or cysts… but they are also the most likely to recover—if they don’t make certain devastating mistakes. Here are 13 truths about teenage acne that can help you find the best treatment system for your skin.


  • Stress hormones are the most important trigger for teenaged acne.
  • Just because you haven’t developed acne by the age of 18 doesn’t mean you won’t. Blacks and Hispanics often develop acne for the first time in their early 20’s.
  • When teenaged girls experience both acne and unwanted hair growth, a low-carb diet may help.
  • Drinking alcohol and smoking cigarettes increase acne breakouts.
  • Treating acne with Accutane can give you a side effect most teens find worse than acne.
  • Raw vegetables and salads can help you feel better.
  • If your doctor gives you a prescription for the antibiotic minocycline, ask about “blue smile.”
  • Be careful about scalp acne if you get bald fades or shave your head.

1. Teenage acne is normally caused by hormones, but primarily by stress hormones, not sex hormones.

Everybody knows that middle schoolers tend to be what Americans euphemistically term “hormonal.” Sex hormones rage by the teenage years. But acne breaks out as soon as the age of eight, several years before puberty. In many teens, acne is caused more by stress hormones than by sex hormones. And controlling stress also minimizes acne.

Children tend to develop allergy-prone skin before they develop pimple-prone skin. About the age of eight, the adrenal glands begin to make large amounts of a substance known as 5-dehydroepiandrosterone, or DHEA. This chemical becomes many different kinds of hormones, including stress hormones made by the adrenal glands and stress hormones made by the skin. When the skin makes its own stress hormones, the activate chemicals that cause the release of histamine. This causes allergy-like reactions even when there is nothing to which to be allergic. And it also makes the skin more sensitive to acne bacteria—which may or may not be present in large numbers.

Other potential causes include:

Genetics – Unfortunately, some research shows that acne may actually be somewhat hereditary. Yep, that means that if your parents suffered with acne then there’s a good chance you will too at some point.

Medication – If you take medications, talk to your doctor to see if they may be a culprit. Just some that are known to sometimes cause breakouts are prednisone, lithium, medications used for epilepsy and androgens that are used as medicine.

2. Different skin types get acne and get over acne at different ages.

Most of the time mild to moderate teenage acne clears up eventually no matter what you do, although improper treatment can leave brown spots or scars that last for years. Children of European heritage tend to get acne early and get over it early. Children of Asian, Hispanic, or African heritage tend to get acne later and get over it later, and also to have much more severe acne. Peak age for newly diagnosed acne in Black and dark-skinned Hispanic males, often a devastating form of acne of the scalp known as acne keloidalis nuchae, is 22.

3. Teenaged girls who get acne sometimes have an underlying problem with insulin resistance.

Sometimes cutting down carbs and simple sugars may help, especially with girls.

Sometimes cutting down carbs and simple sugars may help, especially with girls.

Sometimes the cause of acne in teenaged girls is a variation of polycystic ovarian syndrome, only without any ovarian cysts or disruption of the menstrual cycles. Insulin resistance raises blood sugar levels, although not necessarily to levels that would be termed “diabetic.” Most tissues in the body can protect themselves from receiving excessive sugar from the bloodstream by becoming insensitive, or resistant, to insulin.

The ovaries, however, cannot resist the effects of insulin, and they receive large amounts of glucose that they have to “burn.” One of the ways the ovaries use their excess energy is to make excessive testosterone, which can cause the appearance of both acne on the face and body hair in places it is not supposed to be.

When teenaged girls notice both acne and hair growth, one way to deal with both problems is simply to cut down on calories, especially carbohydrate calories and simple sugars. If the ovaries are not exposed to excessive blood sugar levels, they stop making excessive testosterone, and acne begins to clear up on its own. A doctor’s evaluation, of course, is helpful in finding other treatments that work.

4. Teens who drink alcohol, especially teens of Asian descent who drink alcohol, tend to get acne.

Many people of Asian descent lack the enzymes the liver uses to break down acetaldehyde, an irritant chemical produced as a byproduct of its processing of alcohol. The acetaldehyde quickly circulates to the surface of the body, and the result is reddening and irritation of the skin, usually within just a few minutes of taking the first drink. The irritation of the skin triggers the production of sebum, which clogs pores. After redness fades, whiteheads break out.

Teens who are not of Asian descent sometimes break out in tiny red bumps over the cheeks of the face, around the eyes, and on the nose after they drink, especially after they drink gin. This reaction is a form of acne known as rosacea. Drinking too often can make the bumps both prominent and permanent.

5. Teens who smoke cigarettes tend to get blemishes.

Some of the chemicals in tobacco smoke destroy the antioxidants that reduce the tendency of the skin to produce sebum in response to stress. This effect is especially strong in teens, and stronger in females than in males. Smoking increases the production of whiteheads rather than pimples, although whiteheads left untreated can become pimples.

The nicotine in tobacco can also cause a condition known as “smoker’s face.” Nicotine receptors in the skin cause blood vessels to contract. Blood gets trapped in pockets under the skin, making it look red, but circulation is cut off, depriving most of the skin of its usual supply of nutrients and oxygen, and trapping irritant chemicals in the skin.

6. Accutane can give teens gas (although adults who use Accutane usually don’t have this problem).

One of the side effects of Accutane (isotretinoin) treatment of acne that almost never gets mentioned is that, in teenagers, it can cause uncontrollable flatulence, and then diarrhea and ulcerative colitis. If zits on your face is a social problem for you, probably uncontrollable flatulence would be, too. Be sure to discuss this possibility with your doctor before you accept a prescription for Accutane. There are other acne treatments of similar strength that do no have this side effect.

7. If it tingles, it’s working (NO, it is not)

Many teenagers believe, as did many of today’s adults when they were teens, that if a product makes your skin tingle or have a cooling sensation then it was working hard at getting rid of acne. Unfortunately, that couldn’t be farther from the truth. This sensation is often caused by alcohol and menthol, which are commonly found in acne care products but are actually irritants. They dry out the skin and encourage increased oil production, which will only lead to more breakouts.

8. Eating raw veggies can help teens who have acne feel better.

Eating raw vegetables, like celery sticks, carrot sticks, radishes, and salad greens, Norwegian scientists have found out, seems to help teens feel better about their acne, getting depressed less often. At least in Norway, where most people have fair, dry, sensitive skin, eating enough raw vegetables is the single most important change in diet that can improve health in teens who have acne. Just don’t eat too many tomatoes—the lycopene in tomatoes can increase sebum production in your skin.

9. Benzoyl peroxide usually helps control acne on teenaged skin.

Adults usually have problems with using benzoyl peroxide gels, lotions, and washes to control acne. In people 25 years old and older, benzoyl peroxide often causes itching, burning, tingling, and peeling of skin. In teens, however, benzoyl peroxide has fewer side effects because the skin is more actively growing. Always start with the lowest possible concentration of benzoyl peroxide, which you can find in many over the counter skin care products. Just make sure the label states that the product is 2.5% benzoyl peroxide or less—and keep it off hair and clothes, since it can bleach them. Teens usually should not use tea tree oil products, often offered as an alternative to benzoyl peroxide, because they sometimes interfere with the action of sex hormones, most noticeably increasing breast tissue growth in males.

Another ingredient in many cleansers and products for teen acne is salicylic acid, which not only helps clear blackheads, whiteheads and unclog pores, but is also helpful for irritation and inflammation. Even better, look for something that has both benzoyl peroxide for the bacteria and salicylic acid for its soothing, anti-inflammatory properties.

Note: If you have dark skin, talk to your doctor before using benzoyl peroxide. It has the potential to cause skin discoloration.

In severe cases when all else fails, it may be time to seek professional help.

In severe cases when all else fails, it may be time to seek professional help.

10. Sometimes you need professional help

In most cases, acne can be dealt with by the use of carefully chosen over the counter products. It might be a matter of time before you find the one that works for you, but unless there’s an underlying medical cause, it’s serious cyst-like acne or acne that poses a big risk of scarring, you can normally clear your skin on your own. With that said though, there are times when a doctor or dermatologist is needed. A few of the things they may be able to give you that you couldn’t get without a prescription are:

Antibiotics – There was a time when antibiotics were one of the first treatments recommended. But with the prevalence of antibiotic resistance, this is rarely the first choice anymore. If it is prescribed, there’s a good chance it will be in the form of a topical solution, although there are some cases where oral antibiotics make sense to try. In many cases, you will be given both an oral medication and topical application.

Birth control – Girls may be given certain birth control pills that are known to help clear and keep acne under control by regulating hormones.

Retinoids – Retin-A (and Retin-A Micro), Renova, Differin. These are some of the acne-treating retinoids that may be prescribed to you.

Benzoyl peroxide – Yes, you can get this over the counter, but only in lower concentrations. Stronger concentrations require a prescription.

11. Teens who have acne should ask their doctors about prescriptions for clindamycin instead of minocycline.

In the United States, dermatologists never give minocycline to children whose adult teeth have not yet come in, because the drug can cause blue or black discoloration of the teeth, especially at the gum line. In Europe, dermatologists almost never give minocycline to anyone under the age of 22, for the same reason. Clindamycin does not cause “blue smile” and similar problems.

12. Shaving your head may look cool, but it in certain teens can also trigger an especially severe form of acne.

Sometimes hairs get trapped inside pores when the head is shaved. Especially in Black males aged 16 and older and Hispanic males aged 18 and older, the immune system can attack the hair in the hair shaft as if it were bacteria. The pore turns bright red, and skin grows over the pore so that the redness becomes permanent.

Unless you have been to barber school, don’t do your own bald fades and don’t shave your own head. See a licensed barber or beautician to get you bald fades or head shave. If you get the hair of your scalp shaved, look at the back of your head in a mirror at least once a day and see a doctor at the first sign of a pimple.

13. Don’t try to rush or overdo it

Slathering on more topical treatments, scrubbing vigorously multiple time per day and (definitely) not taking more oral medications isn’t going to speed up the process. Not only could you just irritate skin more, but there could be devastating effects on your health, too. Clearing and getting acne under control isn’t an overnight process. You have to give it time. Many people don’t see the results they want simply because they try it for a week, don’t suddenly see clear skin in the mirror and give up on the product – before it has even had time to do what it’s supposed to do. Stick to the treatment plan and recommended duration. Cleanse, moisturize, exfoliate and protect skin from the skin. Eat well and stay hydrated. If it still doesn’t clear up, only then consider trying something new or seeking professional help.

Note to parents: 

The hype created around skin care and anti-acne products like Proactiv is often outrageous – and desperate teens are often open to believing anything, even if deep down they might not believe it’s true. Help them to understand that getting acne under control is going to take time and help them to develop realistic expectations. At the same time, let them know you understand how it can affect them in their everyday lives. It may merely be a few pimples, but to them it is probably much more than that. This is a time, more than pretty much any other, when appearance is quickly and easily judged and many teen acne sufferers may be susceptible to depression.

Remember, too, that any skin care routine that’s tedious or difficult will be a challenge for most teens to stick to. All they really need in most cases are a few simple products designed to open pores, kill bacteria, fight inflammation, keep skin moisturized and keep it protected from too much sun exposure. And for the most part, kits like Exposed Skin Care will cover all the basics needed to fight acne.


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