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Acne in Teens: Ways to Control It

What causes acne?

Acne
Acne commonly starts in the early teen years, when the oil glands in the body start making more sebum (oil). In people who have acne, dead skin cells mix with the extra oil and plug up hair follicles in the skin. Bacteria that grow in the hair follicles cause more skin irritation.

A "whitehead" occurs when the hair follicle is plugged with oil and skin cells. If the follicle is plugged near the surface of the skin and the air touches it, it turns black and is called a "blackhead." A blackhead isn't caused by dirt.

If the wall of a plugged hair follicle breaks, the area swells and turns into a red bump. If the hair follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the wall breaks deep in the skin, acne nodules or cysts can form. This is called "cystic acne."

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Things that often make acne worse

  • Oil-based makeup, suntan oil and hair products
  • Stress
  • Hormonal changes, especially during menstruation
  • Squeezing or picking at blemishes
  • Hard scrubbing of the skin

Things that don't cause acne

  • Dirt
  • Chocolate or french fries
  • Sexual activity
  • Masturbation

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Who gets acne?

Both boys and girls get acne. But it may be worse in boys because they have more skin oils.

Family history also plays a role. If your mother and father had bad acne, you may have it, too.

Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles.

For many people, acne fades by the age of 25, but it can continue well into the adult years.

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How can acne be treated?

Many treatments are available for acne, including over-the-counter creams and prescription medicines.

Over-the-counter Treatments

Over-the-counter acne products can help treat your acne. Benzoyl peroxide and salicylic acid are the most common and most effective over-the-counter medicines for acne. These medicines kill bacteria, dry up the oil and make your skin peel off. They are available in many forms, such as gels, lotions, creams, soaps or pads.

In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning or redness. Tell your doctor if you have side effects that are severe or that don't go away over time.

Keep in mind that it can take up to 8 weeks before you notice an improvement in the appearance of your skin. If an over-the-counter acne product doesn't seem to help after 2 months, talk to your doctor.

Prescription Medicines

If over-the-counter medicines are not effective, your doctor may prescribe a retinoid cream or gel. Retinoids, such as tretinoin and adapalene, are usually applied to the skin once a day. Be sure not to get them near your eyes, mouth and the area under your nose.

If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of getting a sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene because it can cause birth defects.

If your acne is severe, your doctor may prescribe an antibiotic to treat it. Antibiotics such as minocycline, doxycycline and tetracycline reduce bacteria and inflammation, and can be used in combination with other treatments for acne, such as benzoyl peroxide. Antibiotics can be taken by mouth or used on the skin as a lotion, cream or gel.

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How is severe cystic acne treated?

Isotretinoin may be used to treat severe cystic acne that doesn't get better with other treatments. It's a pill that is taken once a day by mouth for 15 to 20 weeks.

Pregnant women should never take isotretinoin. It can cause serious birth defects and miscarriages. Women on isotretinoin must use 2 types of birth control or not have sex starting 1 month before she begins taking the medication and lasting 1 month after she stops taking it.

There is a possibility that other serious side effects may occur, so people taking isotretinoin should be closely monitored by their doctor.

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Does acne cause scars?

Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments are available.

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Source

Written by familydoctor.org editorial staff.

American Academy of Family Physicians

Reviewed/Updated: 12/09
Created: 01/96