A touching and worried email from a reader who is concerned about her daughter’s mild acne: what can be done?
Here is everything I know about zits – pre-teen, teen, post-teen, perimenopausal – the lot.
1 It’s probably not your diet
We all know what a good diet is and a bad diet is. If you are drinking a lot of fizzy pop and snacking from trash cans you may get breakouts on your cheeks.
(Unless you have actual, clinical acne, which has nothing to do with diet and will be very obvious and will show on the cheeks and forehead.)
If your problem is mainly chin, jawline and forehead, it’s something else.
If you are very keen, keep a food/skin diary. There is a small chance you will see a connection with wheat, dairy, yeast, booze and a breakout. I’d be surprised but it’s not impossible.
2 Having said that
Make sure you are taking your vitamins, just a daily multi-vit will do. If you really want to make this a project, take a ProBiotic. Drink a glass of water occasionally but don’t be obsessive about it.
3 It might be hormones, but don’t start messing about with them
I know probably 2 people, (and I may have made them up), whose zits were sorted out by going on the Pill. For everyone else is can make them worse and/or play havoc with emotions. Don’t do it.
If you are a medicine fiend and just want a goddamn cure, a dermatologist may prescribe you an antibiotic. (See below). But try topical treatments first.
4 Treat your skin like an Old Master
The no.1 temptation when you have ban skin is to fucking ATTACK IT. I HATE YOU U HAVE RUINED MY LIFE AAAAUUUUUUGHGHGH!!!
Do not do this. This is like kicking an abused dog. You ought to treat sensitive skin – because acne-prone skin is sensitive – like it is a precious painting or a fragile vase.
Never, ever use a foaming cleanser, or anything that bubbles. EVER. Never use anything that claims to be formulated for teenage skin or to be “blackhead-clearing”. They’re just having a laugh.
Use Exuviance cleanser or the Dr Sam Bunting Flawless Cleanser. Twice a day and rinse with tepid or cool water, never hot. PAT DRY. Do not rub hard with a flannel or towel.
Follow this with Clinisept or this from the Light Salon. Best practice is to spray directly on the skin and leave to dry but you can gently pat off excess with a tissue if it’s drippy.
Now apply a moisturiser like Sam Bunting Flawless moisturiser or Cetaphil.
I hear good things about this Salicylic serum from Garden of Widom.
5 Now leave it alone
To help you do that, those silicon zit patches are very helpful. For a monster lurking under the skin, use these from ViceReversa. For anything that you have squeezed, (sorry but the edict not to squeeze is unrealistic), apply a dots for spots patch, which will draw out all that lymph and anger and stop you from touching it or picking it further. It also provides a smooth surface for make up to adhere to.
6 If you are doing all this and you still have a problem and want to call in the big guns, here are some skin experts I can personally recommend.
Pamela Marshall, Mortar and Milk
For serious cases, Dr Edward Seaton
How about you? Any great products you’ve used for acne-prone teen skin? Please leave a comment in the handy box below.
My daughter who is 13 was really suffering with mild acne, not cystic but red and angry and lots of it. Our GP prescribed Duac cream, which is 30g benzoyl peroxide and Clindamycin. It has worked wonders. I know it goes against any instinct to leave young skin alone but we had tried natural remedies etc and it wasn’t her diet it was just raging hormones. She had become very self conscious and is much happier now so well worth it I think.
Oh yes Duac is very good
The pill brand Yasmin sorted out my skin before I had kids, my youngest is now 6m and the spots are creeping back and I’m not desperately keen to go back on anyrhing hormonal so this is useful!
This is the one I had success with until kids, afterwards it was a complete disaster.
Yasmin was amazing for skin but basically gave me a period every other week
Urgh. I‘ve got small red angry pimples at one corner of my mouth only, which I can’t shift. Hoping that they are stress-related, not perimenopausal, but I’ve had them for longer than the lockdown. At least I’m far less self-conscious now than I was as a teen. Spots really are the worst.
Sophie make sure you are regularly disinfecting your phone and change your pillowcase minimum once a week.
You also *might* possibly be a night-drooler (sorry but the most beautiful girl I know is a night drooler) – in which case use Clinisept in that area before bed and in the morning.
Thank you, will do. And I probably am a night drooler.
I woke up from an uncharacteristic nap this afternoon with basically a lake of drool on my pillow
The pill was a complete solution for me too (dianette). And I tried lots and lots of other things. I wished a doctor had given me a skin friendly pill before, so I would say don’t write that off as an option.
I went on the pill aged 16 and it cleared my neck, chest and back acne (!!) within six weeks and I didn’t see another spot until my 30’s when I went off the pill to have children. Clearly childbirth is a game-changer and I now can’t take contraception without non-stop bleeding, so I have had the the pleasure of enjoying neck acne in my late 30’s. The only thing that seems to work is Environ skincare and a a couple of Environ facials a year.
Esther, I’m 30 and this is the most reassuring thing I’ve read about acne in a long time – thank you.
I was put on a progesterone only pill after 2nd baby as I was 40. I have had awful skin ever since: red, flaky, spotty chin. I am still trying to sort it out. Don’t take a progesterone only pill! I now know it’s famous for messing up your skin.
Why no foaming cleanser? I love a good lather up! Now I’m wondering if maybe it was the manky facial/baby wipes I used to use in my twenties instead of face wash that stopped the spots rather than the pill….!? Shock horror!
the thing that cleansers use to create foam or bubbles basically strips the surface of your skin of all lipids and natural hydration, this mega irritates the follicles (I’m possibly starting to make this up) and can cause an endless zit cycle. “lather” is a modern construct around “clean” and not remotely necessary for ACTUAL skin clarity
I started with dreadful adult acne in my mid-twenties. Awful, painful jawline and cheek cystic bumps that throbbed and felt like bruises to the touch. I tried everything – topicals and oral antibiotics, expensive face washes and salicylics galore. Then I found a man on the internet – Professor Tony Chu – who was finding success in trials on acne patients at Hammersmith hospital using very specific blue and red lightwaves. I emailed him in desperation and he told me about a commercial light box that had exactly the same properties and, though it was expensive (around £170 back in the mid-nineties) I got it and used it religiously twice a day for 15 minutes. The blue light was found to kill the P-Acnes bacteria and the red light soothed inflammation and calmed the skin. After about 6 weeks I started seeing improvements and after about 3 months my acne was completely gone. I couldn’t believe it. I’d been referred to a dermatologist by my GP for Retin-A treatment and by the time my appointment came my skin was totally clear. I’m eternally grateful to Professor Chu! My light box was a massive thing like a tanning box with tubes but Lumie do a handheld version now. Obviously it won’t work for everyone but it was a saviour for me! If it helps one other person it’s been worth typing up this mammoth essay of a response!! (And I’ve got no links to the company, I’m a stage manager at a college in Manchester!)
https://www.lumie.com/products/clear
Good grief I think I missed a few years of that and I’m your sister! 😗
Totally agree Esther – the key here is to repair/maintain/strengthen the skin barrier – harsh foaming products, physical scrubs, picking, drying out the skin with alcohol-based stripping toners will simply DESTROY the barrier, leading to a major worsening of any skin problems, whether they be acne or eczema, rosacea, whatever. The principal remains the same. I would say that the Dr Sam Bunting Flawless cleanser would be brilliant for pre-teen skin (as well as older skin of course! I use it religiously) – I fully intend to give this to my boys when the time comes. Dr Sam also makes a light version of her moisturiser (called, nice plain speaking here, Flawless Light) which I think might be particularly brilliant for younger skin. For clarity, I have absolutely ZERO links to Dr Sam’s company, I am just a very grateful consumer of her products, which have been amazing for my skin. Her impeccable medical approach to skin of “do no harm” seems particularly appropriate, to my mind, to young, precious skin.
Really recommend Spots and Stripes face wash for pre-teens.
all natural ingredients and specially for delicate young skin.
Hi Esther, please let that lady know about Corinna at Monica Tolan Skincare. They use Environ products and Advanced Nutrition supplements (all of which can be used from infancy to adulthood) & they changed my skin forever. I had acne from adolescence and tried the pill, Roaccutane and everything else along the way & the only thing that’s worked are natural supplements and vitamin A based skincare. That lady can find Monica Tolan on Instagram or on their website & they do free online consultations & will recommend what’s needed. Best of luck x
I had mild acne on my face and horrible acne on my back from age 12 to 18, tried all the anti-biotic creams and the pill but the only thing that got rid of it for good was Roaccutane. Controversial these days but I saw no side effects apart from dry skin and in a year it was gone. Before we got to that point, it was the era of Clearasil and the like which dried up my skin of course, and after a few years of that crap a wise GP told mum to take me to a facialist. I started treating my skin more gently with Dermologica and it helped hugely. As an adult I now get those horrid hormonal chin/jaw line breakouts from time to time, but have been following Caroline Hirons’ advice for about 6 years. She truly is the queen of skincare and now I’ve stopped stripping my skin with foaming cleansers and using a properly hydrating routine my skin is in good condition and I can at least cover up the buggers easily as and when they inevitably appear. If I had a teenager with acne I’d be buying her La Roche Posay or any other decent inexpensive French pharma brand and making sure she’s using a good gel moisturiser like Clinique which isn’t too heavy. A facial once in a while if you can and trying to help her not to focus on it. NOT easy but hobbies help. I was a keen dancer as a teen and being in a leotard 4 times a week made me very used to the sight of my spots. Complete sympathy over here though, it is horrid.
Anyone got any hints for a teenager who picks her spots constantly? I think her skin would be ok if she could leave it alone. She picks until there are scabs everywhere (face, shoulders, upper arms) and she is starting to get scars (17 year old). I can’t say anything without her biting my head off about nagging. I’m at a loss. She is on tetracycline which helps a bit.
Oh this is really distressing… at 17 it’s very hard as her mother to really do anything except support her if she shoes signs of wanting to stop. Nagging her really won’t help. For scarring – Eight hour cream helps as does Creme de la Mer, which costs a billion pounds but you only need to use a weeny bit
Oh this very much sounds like my truly gorgeous looking niece .. but it was years later we realised it was a form of self harm! She picked skin off all over her face neck chest and arms 😢
Her beautiful skin is now permanently scarred ..
Mario Badescu specialised acne range is brilliant both for face and for body.
My 13 yr old’s skin has massively improved by using Differin gel once a day. It’s a retinoid, available over the counter in US, you can buy it online in UK It has almost cleared up entirely and got rid of the blackheads.
I’m seeing Dr Edward Seaton after suffering with acne since my teens. Never really terrible cystic acne thank goodness, but moderate to mild with some slight respite of more or less clearness and some quite severe periods, for 23 years. I do WISH I had had clinical intervention as a teenager. My mother was very anti this believing it would ‘clear up when you’re older’ (another of her favourite sayings was ‘it’s not that bad’, even though it was all I could see or think of when I saw my face in the mirror). This proved not to be the case for me, and I’ve been left with some quite noticeable scarring which won’t be fixable. So yes, if a couple of months of gentle home treatment doesn’t clear it please see a doctor and don’t think of doing so as a moral failing. Suffering with your skin for decades because of the weird social shame around medical intervention for acne (which can be chronic medical condition, and is most nothing to do with your lifestyle choices) is madness. Good luck. X
PS: as I wrote on another post I saw a massive improvement within 24 hours of being on medication, and it continues to improve as the weeks go on.
Ah! Good old Dr Seaton. He sorted out Giles’s chronic bacne and Giles was like OMG why didn’t I do this 25 years ago
I also wish I’d had dermatology intervention as a teenager and agree that trying to sort out scarring/sun damage (my parents were also oddly laissez-faire about sunburn) in my 30s is way harder than it would have been nipping it in the bud years ago. My GP prescribed antibiotics for my spots which I took for over a year in my mid-teens – absolutely terrible for your gut health to do this and it had precisely zero effect on my skin… I think what’s rubbish is that if you have “bad” skin but not “bad enough” then you sort of fall between two posts: your GP won’t refer you to Derm, but isn’t best placed to sort it out themselves.
My 7 year old already has a couple of fairly prominent blackheads on her nose and a has had a couple on her chin. I think they actually started when she was 5… I’m way more upset about than she is – she hasn’t even noticed. But I am worried it’s the start of something that might become an issue in a few years. She’s also incredibly tall (wears clothes for 11 year old s). I’m at a bit of a loss what’s caused it. She has good hygiene, good diet…Has anyone else had experience of this? 5-7 yrs seems to be taking the pre bit of pre-teen a little too far. I’ve bought her some very gentle face wash but it sure if I should be doing anything else?
Have you seen a doctor? Just to rule out early onset puberty or something like that? You could also get a referral to a dermatologist? Xx
Ah that’s a really good idea, thank you. She’s only recently turned 7 so I didn’t even think about early onset puberty. I’ve just been reading about it and an awful lot fits. Xx
A friend’s daughter had it, so your post just triggered my memory of that. Of course only a doctor will be able to diagnose. Hope your daughter is ok.xx
Children do have hormone surges at various times (I think boys often have a testosterone surge around age 5) so hormones can affect them before puberty.
I’ve had hormonal acne on my chin, jawline and sometimes cheeks since I was a teenager.
Tried every topical thing going. The best thing that worked before children was Lymecycline oral antibiotic but I had to stop taking when trying for a baby.
Between kids when breastfeeding my skin was okish but was awful when I stopped breastfeeding and my period returned- the spots came back with a vengeance. I begged my GP for an acne friendly pill- was prescribed Marvelon and it truly was/is marvellous and I’ve had the clearest skin I’ve ever had for about 4 years.
I recently had to stop taking it as been having lots of breakthrough bleeding and migraines. I’m 37 so wonder it it’s my age. It’s been about 8 weeks since I stopped- I’ve had a few spots- I’m just waiting with baited breath to see how things go over the next 6 months before deciding what to do next re acne treatment. I know the original question was about a teen but the tips on this article and comments are really helpful so thankyou.
As an aside- contraceptive wise there is no way in hell I will be going near anything that is progesterone only- for a hormonal acne sufferer it is the arch enemy!
Caroline Hirons. Caroline Hirons. Caroline Hirons.
If you haven’t seen her blog do check it out. Following her advice totally transformed my skin.
She’s straight talking and totally no BS. Highly recommend. My skin has never looked better just by using a flannel and some vitamin C serum. Even better when I bother with acids and face oil.
The cheat sheets on her blog tell you pretty much everything you need to know.
Used to be just a blog but now she’s on Insta and YouTube too. She was banging on about cleansing balms and flannels whilst everyone else was still on foaming cleansers and muslins and now all the beauty bloggers are catching up.
Promise you it’s worth a look!
All hail the humble flannel.
Bloody wish I’d have read this as a teen. Would’ve saved me a LOT of grief. One other thing I’d recommend: washing pillow cases, washing pillows, washing clothes. All the washing. X
So much washing. the disinfecting of the phone!