My son is twelve and in full-on puberty. Despite our best attempts, he keeps getting acne on his face. It shows up in his T-zone and cheeks near his hairline. He washes his face twice a day, his hair once a day and blots the oil from his skin mid-day with blotting paper. He does not pick, squeeze or dig at his pimples, but I fear scarring. How do we know when it’s time to seek medical intervention?


Your son needs medical intervention for acne if:

— You are very concerned with the acne (even if no one else is).

— Your son is very concerned about the acne (even if you aren’t).


Most problems with acne are treated by pediatricians, sometimes with the use of prescription medications. However, if treatments and life modifications don’t help, or if the concern or anxiety about the acne persists (especially in your teenager), a visit to the dermatologist may be recommended.

I advise teenagers to try these things first to treat acne effectively and prevent its worst effects on their skin and their psyche:

1. Never scrub your face which will irritate your skin and make acne worse. Use a gentle soap and water twice a day — morning and night — and after sweating.

2. Let your face dry completely before applying any acne cream or gel (usually at bedtime).

3. There are many over-the-counter products you can try. Most pediatricians begin with a topical antibiotic called benzoyl peroxide which decreases the amount of acne-causing P. acnes bacteria. If significant improvement isn’t seen in 4-6 weeks, adding a second topical medication with a different mode of action is indicated. For example, while benzoyl peroxide gel can lessen the impact of P. acnes bacteria, adding a topical retinoid gel (adapalene is now available over-the-counter) will help unclog pores and reduce oiliness. It may take up to eight weeks to observe improvement and many months to see actual clearing of blemishes. Finally, since teenagers will be taking acne treatment into their own hands, every acne medicine should include this statement on the label: “This topical medication will only be effective if applied directly to the face.” In other words, it’s important for teens to use the medication properly and as directed.

4. Change or wash your pillowcase twice a week (every 3 days). Wash frequently-used hats regularly.

5. Make sure any skin care or cosmetic products say “oil-free” and “noncomedogenic” or “non-acnegenic” on the label.

6. Avoid picking and popping those pimples or otherwise touching your face with your fingers. (And keep those hands clean!)

7. Drink plenty of water and avoid sugar-sweetened and caffeinated beverages.

8. Avoid processed (packaged) foods high in sugar and salt. Instead, choose real food, especially fruits and vegetables.

9. Prepare and eat only hormone-free meats and dairy products.

10. Exercise combats stress, so get plenty of it!


Remember: Anything that causes stress in your body — sickness, poor diet (lots of sugar, salt, fat, and food additives and chemicals), loss of sleep, poor exercise regimen, school stress, etc. — will stress out your skin, too. Being kind to your body will allow your body to be kind to your skin.

The American Academy of Dermatology has more information on acne treatment here.


***Do you have a non-urgent, clinical or otherwise (but nothing personal!) question for your Pediatric Alliance doctor or provider? Send an email with your question to and we’ll do our best to answer them and post them on The PediaBlog. You don’t have to include your child’s name, but an idea of their age is helpful. Also, please include the name of the division you go to and your doctor’s or provider’s name.

Ask us anything! (But, please, no urgent or semi-urgent questions — we may not get to your question right away. If your child is sick, or you have acute concerns, please call our offices and speak with our triage staff.)


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