Acne occurs when the hair follicles and pores are blocked by oil. Teenagers have a much higher chance of getting acne as puberty results in the production of excess sex hormones (known as androgen), which enlarges their oil glands. Thus, the combination of increased amount of oil or sebum with dead skin cells will clog the hair follicles and pores, forming blackheads and whiteheads. At the same time, it leads to the growth of bacteria, Propionibacterium acnes, which forms pimples and zits when it comes into contact with the blocked hair follicles.

Apart from hormonal changes, other factors causing teenage acne include: stress, genetics, menstrual periods, bacteria buildup, climate, birth control pills, facial creams, cosmetics, hair dyes, friction from clothing or other accessories and hair ointment.

However, there is no proof that diet is directly associated to acne, but junk food, chocolates and fried food are generally unhealthy and should be avoided.

There are many different symptoms of acne that differ in terms of severity. The more common symptoms are pimples, blackheads (open clogged pores), whiteheads (closed clogged pores), small red tender bumps (papules) and large pus-filled lumps (cystic lesions). These can be seen on various parts of the body with more oil glands such as the face, shoulders, neck, chest, back or upper arms.

Acne will affect the self-esteem of many teenagers as majority of them would feel a lot more self-conscious of their external appearance, while some would get bullied and called negative names by their classmates. In the long run, teenagers who are greatly affected by serious acne may develop depression and/or anxiety. Based on previous studies, acne treatment will solve their emotional problems.

There is no clear explanation as to why some teenagers are more likely to get acne. However, one factor could be due to the production of hormones (known as androgens). Androgens causes the oil glands to grow bigger and produce more sebum. As such, different people will experience different hormonal changes and as such, some get teenage acne while other may not.

Another factor to consider would be your family history. Due to genetics, teenagers that have a higher chance of getting acne because they might have inherited it from their parents who had acne before.

Other environmental or external factors could be due to medications, for instance androgens consumed as medicine, epilepsy medicine, and lithium. Cosmetics that are oil-based could also cause pores to be clogged, which could affect girls.

Teenage acne can be treated by a range of medications, from face cleansers to antibiotic topical creams to oral medications, depending on the severity. In order to cure active teenage acne, teenagers must be proactive in their daily skincare routine. Applying creams and cleansers are the most basic form of acne treatment and it is a good solution for mild, non-inflammatory acne like whiteheads and blackheads. For more complicated acne, over-the-counter or prescribed medication can be taken for pimples and larger red bumps.

1. Non-prescriptive (Over the Counter)

Over-the-counter medication containing benzoyl peroxide and salicylic acid can be purchased from pharmacies and larger supermarkets. Benzoyl peroxide help to reduce mild inflammations and stops the growth of bacteria, whereas salicylic acid unclogs pores. It is recommended to stick to one acne product as using too many products will cause your skin to become too dry, according to dermatologists. Skin care products containing alcohol should be avoided as it will irritate the skin and cause your skin to breakout. Another point to note is that you should not aggravate your pimples by trying to pop, scratch or squeeze them as it will worsen the acne and lead to skin infections and scars in the long run.

2. Prescriptive Topical Treatment (e.g. topical antibiotics, retinoids)

Some examples and ingredients of prescribed topical treatment are azelaic acid, benzoyl peroxide, glycolic acid, lactic acid, retinoids, salicylic acid and antibiotics. When you visit your GP, he/she may prescribe antibiotics (for example oxytetracycline, lymecycline or doxycycline) and advise you the quantity of medicine to take, as well as the duration of the course and when to take it. This is effective as you can usually see the results within 6 months. For more severe cases of acne, your doctor would prescribe an oral retinoid medicine called isotretinoin or Roaccutane, which aids in reducing the amount of sebum production in your skin. However, it can only be prescribed with the permission of a dermatologist as it is a very strong medication. Prescription retinoids and antibiotics can reduce blackheads, whiteheads and pustules.

3. Prescriptive Oral Treatment (e.g. antibiotics, contraceptives, spironolactone)

Oral treatment such as antibiotics is usually taken for persistent acne as it is both antibacterial and anti-inflammatory. This is prescribed on a short-term basis of up to a few months. Oral contraceptives like birth control pills can also help reduce acne as it helps to control hormone levels. For example, Spironolactone can be used by teenage girls with acne as it works by blocking hormones.

Teenage acne can be prevented by ensuring your skin is clean. It is advised to wash your face and neck using mild soap and warm water twice a day to avoid oily skin. Scrubbing is discouraged as it will irritate your skin more and aggravate acne. If your acne still persists, it is perfectly fine. Premenstrual acne happens to girls a few days before their period and happens to 7 out of 10 women. Another way to prevent teenage acne is to make sure that you do not touch your pimples even though it is tempting. By doing so, it will cause more inflammation and the oil from your hands will worsen your acne.