Here's exactly how to approach your teenager's acne, according to a dermatologist.

I was one of those teenagers with really bad skin.

I still remember getting my first few pimples at age 11, which seemed like years before anyone else did. After a while, the pimples started to spread, got redder, and I became increasingly embarrassed about my new face. Neither my mum nor I had any clue what to do.

If you were in the same boat as me, you'll know that there was little information out there on teenage skin. There were a handful of brilliantly marketed products that are far too harsh on young skin (you probably know at least one of the major ones I'm referring to) and a pill that fixes the acne - but causes various other serious side effects.

Watch: Here's how to improve your skin while sleeping. Post continues after video.

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If you have a child going through those hormonal changes now, it's a good idea to understand what's going on with their skin and which products to introduce, before considering seeing a dermatologist or introducing harsher treatments.

I spoke to Dr Cara McDonald, a specialist dermatologist with a keen interest in acne, to learn about all things teenage skin. 

As we all know, when a teenager enters puberty there are plenty of physical hormonal changes that occur (fun!) including increased oil production, sweating under the arms and the development of pubic and underarm hair. It's the increased oil production that causes congestion and breakouts. 

While acne is common with almost all teenagers, some have it worse than others.

"Growth hormones, which cause excessive skin cell turnover within pores, along with increased oil production, results in congestion and subsequently acne. This is seen to some degree in most teenagers, but some have the right genetic makeup and hormonal factors to cause severe or extensive acne," Dr McDonald told Mamamia.

"Other changes commonly seen in teenagers are an improvement in skin sensitivity and eczema, but the onset of psoriasis in those that are predisposed. Excessive sweating can also become a problem in teenage years," she said.


During a teenager's high school years, there are plenty of things they'll be more interested in than starting a skincare routine (school, friends, first relationships, you know). But it's important to introduce one early, so they can keep the physical hormonal changes at bay.

"When a teenager starts experiencing hormonal changes, they will often notice that their skin is oilier and may be prone to congestion. My advice is that teenagers introduce gentle products which help break down congestion and reduce inflammation," Dr McDonald explained. 

"I generally recommend products such as the Effaclar range from La Roche Posay which contains salicylic acid to penetrate blocked pores and niacinamide to calm inflammation, without causing any excess stripping or drying of the skin," she said.

Once teenagers introduce a skincare routine, they'll most likely want to use products that will dry out the excess oil. But as Dr McDonald explains, they need to keep the skin hydrated.

"Many teenagers do not realise that they should continue with a non-greasy moisturiser even if they are experiencing oily skin and acne," she said. "Allowing the skin to become excessively dry or irritated tends to worsen inflammation and can increase breakouts. Sun protection is also important, and the correct sunscreen choice will not cause breakouts."

There are also some skincare practices that teenagers need to avoid.

"The biggest mistake teenagers make is over-cleansing or using excessively harsh products when they experience oily skin and breakouts. It is very important to continue to protect the skin with daily sun protection and a non-greasy moisturiser," Dr McDonald said. 

"Most teenagers try to spot treat their acne with harsh products whereas the most effective treatment is to use regular, ongoing preventative skincare ingredients to reduce blocked pores and congestion which will prevent breakouts down the track," she continued.

While teenage acne is most commonly known as hormonal acne, for obvious reasons, there are cases where it can be more severe, and is diagnosed as cystic acne.

"Hormonal acne describes breakouts that are predominantly due to hormonal fluctuations, imbalance or sensitivity. Typically, the male hormones, known as androgens, are responsible for acne causing excessive oil production and skin cell turnover resulting in blocked pores. Subsequent inflammation or infection creates a lesion we know as a pimple. Hormonal acne is most commonly seen on the chin and jawline but can be more widespread," Dr McDonald said.


"Cystic acne describes a more severe and often extensive type of acne," she continued. "Hormones still have a role in the cause of cystic acne but it can persist throughout life in some people. In cystic acne the lesions tend to be deep in the skin, painful and persist for longer, often leaving scars when they resolve."

If you're concerned that your teenager might have cystic acne, consider whether anyone else in the family has had it too.

"Most cases of cystic acne first occur during teenage years and often have a strong family history," she added.

Listen to You Beauty, Mamamia's podcast for your face. In this episode, co-hosts Kelly and Leigh discuss how to approach hormonal acne with tweens. Post continues after audio.

Now, there is a point when you should consider taking your teenager to see a professional about their skin. But when?

"The time to see your doctor for acne treatment is when you feel it is continuing to worsen despite appropriate skincare," Dr McDonald said. 

"In my opinion, any teenager who is self-conscious about their acne or in cases where the acne is widespread, involving the whole face or chest and back, should get some medical advice. Most GPs are experienced with acne treatment and can start prescription topical ingredients which should be much more effective in preventing and treating acne than over-the-counter skincare.

"If prescription-strength topicals are inadequate or the acne is too extensive to treat with creams, then it is most likely best to see a dermatologist for further treatment options," she said.

And if all other treatment has failed, it might be worth introducing oral retinoids. These can be appropriate if the acne "is severe enough to justify very proactive treatment," Dr McDonald said. "Acne scarring is a very difficult, expensive and time-consuming condition to treat, so prevention is by far the better option. Any acne that is leaving scars should be seen by a dermatologist to consider proactive and timely, effective treatment."

As someone who went through the dermatologist, prescription-strength topicals and oral retinoids, I wish I'd known about introducing a skincare routine early. While the results worked (in the end) the side effects are pretty rough. 

So if your teenager is going through these hormonal changes now, take Dr McDonald's advice and get them onto a routine, stat. Then they can focus on the important stuff like TikTok school.

Feature image: Getty and Mamamia.