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acne tips

What parents need to know about acne | Ask the Pediatrician

Doctor's tips on understanding, managing and treating acne.

The teenage years can be tough — especially with zits or pimples. Acne isn’t caused by eating chocolate or junk food or having long hair. It all comes down to hormones and genetics. Sorry, kids.

Teens start to undergo hormonal changes related to puberty and the development of acne as early as age 10. (Here’s my column on the stages of adolescence in case you missed it last month.)

Acne is one of the most common skin conditions, with 85% of young people age 12-25 affected by it. Teens won’t want to hear that acne can extend into their 20s and 30s (and beyond!)


What is acne?

  • Acne is a skin problem that starts when oil and dead skin cells clog up our pores. Hormone changes in puberty make the skin oilier, and an overproduction of sebum (an oily wax on our skin) can feed the bacteria and cause swelling, redness and pus.
  • Acne can occur on the face, neck, shoulders, back or chest. Mild acne usually causes only whiteheads and blackheads. Severe acne can produce hundreds of blemishes that cover large areas of skin.


Acne tips: Blemish types

Think a pimple’s just a pimple? Nuh-uh. There are different types of blemishes.

  • Blackheads are pinhead-sized dark spots on the skin that are caused by small plugs in pores. When a clogged pore remains open, the pimple rises to the surface of your skin and looks black.
  • Whiteheads stay under the surface of your skin and cause white bumps on the skin that are collections of oil and skin cells inside pores.
  • Papules are small, inflamed bumps caused by excess oil in your skin, bacteria, hormones and some medications. They don’t have a pus-filled tip like other forms of acne.
  • Pustules are red at the bottom. The tops are white or yellow and filled with pus.
  • Nodules form deep under the skin. They tend to be large, solid and painful.
  • Cystic lesions from acne, sometimes called acne cysts, are large and painful pimples deep under a person’s skin that develop most often on the face, neck or upper body. Symptoms may include a red, hard, tender lump under the skin.

acne tips

Acne tips: Treating acne

Treatment of acne differs somewhat depending on the severity. Help your teen keep their skin clean and look for products that say “noncomedogenic” on the label—that means they won’t clog pores.

Mild acne, which is most common, may be treated by simple hygiene and over the counter (OTC) creams or topical treatments. Treatment for mild acne may include:

  • Washing gently with soap and water: Your teen should wash their skin once or twice a day with a gentle soap or acne wash. The most important time to wash is at bedtime. Encourage your teen to not scrub or pick at their pimples. This can make them worse and cause scars.
  • Using ‘over the counter’ treatments:Acne products work in different ways, depending on their active ingredients. Some work by killing acne-causing bacteria, while others remove excess oil from the skin or speed the growth of new skin cells and the removal of dead skin cells. Look for a treatment with adapalene, benzoyl peroxide or salicylic acid.
  • If you’re not sure which product to buy, start with a Benzoyl Peroxide 5% gel product (such as the store brand). It helps to open pimples and to unplug blackheads. It also kills bacteria. Have your teen apply a pea-sized amount of the lotion once a day at bedtime. This should be enough to cover most of the acne. Don’t overdo it—using more than you’re supposed to is tempting but can make skin very red and dry.

More acne tips

With treatment, you’ll see a decrease in new whiteheads and blackheads. Urge your teen to not give up if they don’t see results the next day. Acne medicine can take weeks or months to work.

And don’t believe that old myth that the sun is good for your skin. Wrong! Sun may redden your skin, temporarily making pimples less visible. The sun also seriously damages skin, so remind your teen to use a sunscreen that says “non-comedogenic” or “won’t clog pores—their future selves will thank them.

If your teen’s acne doesn’t improve after 2 to 3 months, consider seeing your health care provider or a skin specialist (dermatologist). Treatment for moderate to severe acne requires the use of topical or oral prescription medications, visit These include antibiotics, retinoids (derived from vitamin A) and others that your doctor may suggest.

Kids will get pimples, even when they do their best to prevent it, and it’s totally normal. It’s our job as parents to remind our teens that they are not alone.


More from Dr. Block and Kaiser Permanente in Seattle’s Child:

Tips for getting through the pre-teen and teen years

Kids and melatonin: new warnings + sleep tips

Why does my kid suddenly stink?


About the Author

Susanna Block

Dr. Susanna Block, MD, MPH, is a pediatrician with Kaiser Permanente in Seattle and lives with her family in Queen Anne.