Hormonal Teenage Acne: How to Spot It and What You Can Do to Help

Hormonal changes are a completely normal part of being a teenager, and we're certainly not trying to stop puberty or "balance" hormones that are doing exactly what they're supposed to be doing.

But that doesn't mean your teenager simply has to put up with acne and hope they'll eventually grow out of it.

Something I see often in clinic is teenagers who have been struggling with their skin for months, sometimes years, before coming to see me. By then they've usually tried all sorts - products recommended by friends, whatever is trending on TikTok, aggressive spot treatments, scrubs, acids and sometimes a completely different skincare routine every few weeks.

Often, the first thing we need to do is go back to basics and understand what's actually happening with their skin.

Because while hormones can play a big role in teenage acne, they're not necessarily the only thing contributing to it.

So, how do you spot hormonal acne? Sorry. I couldn't resist.

What Causes Hormonal Acne in Teenagers?

During puberty, levels of hormones called androgens increase. This is completely normal, but one of the effects these hormones can have is stimulating the sebaceous glands in the skin to produce more oil.

More oil isn't automatically a problem. But when that oil combines with dead skin cells inside the follicle, it can contribute to blocked pores. Add bacteria and inflammation into the mix and you've got the perfect environment for blackheads, whiteheads and those angry, inflamed spots teenagers know all too well.

Genetics can play a part too. If you struggled with acne as a teenager, there's a greater chance your child may experience it as well.

For girls who have started their periods, you may also notice that their skin changes at different points in their menstrual cycle as hormones naturally fluctuate.

But this is where I think we need to be careful with the term "hormonal acne".

Teenagers are hormonal. They're supposed to be! And not every spot that appears during puberty can be blamed entirely on hormones.

Skincare, stress, sleep, diet, genetics, sweat, friction, certain medications and the health of the skin barrier can all influence acne too.

That's why I always want to understand the whole picture rather than simply looking at where the spots are and declaring, "It's hormonal."

How Can You Spot Hormonal Teenage Acne?

I wish I could give you a little face map and say, "Spots here mean hormones, spots there mean something else."

Unfortunately, skin isn't quite that simple.

There's a common belief that acne around the chin and jawline automatically means it's hormonal. While that area can certainly be affected by hormonal acne, location alone can't tell us what's driving a breakout.

Instead, I look at patterns.

Is the skin noticeably oilier since puberty began? Are there persistent inflammatory breakouts rather than the occasional spot? Does the acne keep returning in similar areas? For girls who have started menstruating, does their skin consistently become worse at a particular point in their cycle?

I also want to know what's happening elsewhere.

Has the teenager suddenly started using lots of new skincare? Are they training several times a week and sitting in sweaty clothes afterwards? Are they under a lot of pressure at school? Are they sleeping enough? Have there been changes to their diet or medication?

Very often, the answer isn't hormones OR something else. It's hormones and several other factors working together. And that's actually good news, because while we can't, and shouldn't, try to stop the normal hormonal changes of puberty, there are plenty of other areas where we can support the skin.

What Can You Actually Do to Help Hormonal Teenage Acne?

This is usually the question parents really want answered, and my first piece of advice is not to panic and buy every acne product you can find.

Acne prone skin doesn't necessarily need more. It needs the right support.

When I'm working with a teenager, I'll look at their skincare, diet, lifestyle, stress, sleep and daily habits alongside the acne itself. From there, we can start identifying areas that might be making their skin more difficult to manage.

Sometimes surprisingly small changes can make a big difference!

And importantly, I don't expect a teenager to live like a wellness influencer to have good skin. They should be able to go out with their friends, eat foods they enjoy and be a teenager.

We're looking for realistic changes they can actually stick to.

Keep a Teenage Skincare Routine Simple

One of the biggest problems I see now isn't teenagers doing nothing to their skin.

It's teenagers doing far too much.

Social media has completely changed the way young people think about skincare. Teenagers are being exposed to routines involving multiple serums, exfoliating acids, retinoids, masks and active ingredients, all often without really understanding what those products do or whether their skin actually needs them.

More skincare does not automatically mean better skin. In fact, repeatedly stripping and irritating acne prone skin can damage the skin barrier and leave it red, sensitive, dehydrated and even more inflamed.

For most teenagers, I would much rather see a simple, consistent routine using products chosen for their skin.

That usually means an appropriate cleanser, hydration, daily SPF and carefully selected acne focused ingredients where they're actually needed. If we're introducing active ingredients, I want there to be a reason for every single one. Your teenager doesn't need a ten step skincare routine.

Can Diet Help Hormonal Teenage Acne?

This is another question I get asked a lot, particularly by parents.

"Should they stop eating dairy?"

"Is sugar causing it?"

"What about chocolate?"

There is evidence suggesting that dietary factors may influence acne in some people, particularly diets with a high glycaemic load, which can cause blood glucose and insulin levels to rise quickly. Research has also found an association between dairy consumption and acne in some populations, although that doesn't mean dairy automatically causes acne or that every teenager needs to remove it.

This is why I don't like blanket rules.

I'm never interested in putting a growing teenager on an unnecessarily restrictive diet for the sake of their skin. We're looking at what we can add and support, not creating fear around food.

Instead, I tend to look at the overall picture.

Are they eating regularly? Are they getting enough protein, fibre, healthy fats, fruit and vegetables? Are they surviving the school day on energy drinks and snacks and then coming home starving? Are they drinking enough water?

We can support more stable blood sugar levels by building balanced meals and snacks rather than immediately creating a list of foods they're "not allowed" to eat.

Food should never become something a teenager is frightened of because they think one meal is going to cause a breakout.

Can Stress and Sleep Make Teenage Acne Worse?

Being a teenager can be stressful.

Exams, schoolwork, friendships, relationships, sport, social media, decisions about the future... there's often far more going on underneath the surface than adults realise.

And then there's sleep.

Late night scrolling and early school mornings aren't exactly a match made in heaven.

Stress doesn't mean your teenager will automatically develop acne, but our stress response can influence inflammation and oil production, and some people notice their skin becomes more reactive during stressful periods.

Sleep is also when the body carries out a lot of its repair and recovery processes, so consistently getting too little of it isn't ideal for the skin… or much else, for that matter.

I'm not suggesting you tell a stressed 16 year old to simply "stress less". That's not particularly helpful.

Instead, I look for small, realistic changes. Could we improve their bedtime routine? Get the phone away a little earlier? Make sure they're eating properly during busy exam periods? Encourage exercise or downtime they actually enjoy?

Again, we're supporting the body rather than expecting perfection.

Please Stop Picking Your Spots (I Know, Easier Said Than Done)

If there's one piece of advice every teenager is fed up hearing, it's probably this one. But I have to say it.

Please, please stop picking your spots.

I know how tempting it is, especially when there's a big inflamed spot sitting right in the middle of your face before school.

The problem is that squeezing and picking creates additional trauma and inflammation in the skin. It can make the spot hang around for longer and increase the likelihood of post-inflammatory marks and scarring.

And once we're dealing with acne scarring, that's a very different conversation from treating active acne.

So yes, your mum was right about this one. Sorry.

When Should You Get Professional Help for Teenage Acne?

One thing I really want parents to understand is that you don't need to wait until your teenager's skin is "bad enough" before asking for help.

If acne is persistent, painful, becoming more inflamed, beginning to scar or having an impact on your teenager's confidence and wellbeing, it's worth getting proper support.

And please don't dismiss how they're feeling simply because teenage acne is common.

Something I see regularly in clinic is young people who are much more affected by their skin than they've admitted to their parents. They might stop wanting their photo taken, avoid certain social situations or spend a huge amount of time trying to cover their skin.

Early support can also help prevent teenagers from falling into the cycle of constantly buying new products, irritating their skin and becoming even more frustrated when nothing seems to work.

Hormonal Teenage Acne Isn't Something They Just Have to "Grow Out Of"

Hormones are a normal part of being a teenager, so acne can be part of that journey too. But I don't believe the answer should simply be, "They'll grow out of it."

We might not be able to control the hormonal fluctuations happening during puberty, but we can support the skin through them.

That might mean simplifying their skincare routine, looking at diet and blood sugar balance, supporting sleep and stress, changing a few everyday habits or introducing professional treatments where appropriate. And sometimes, simply understanding why their skin is behaving this way can make the whole experience feel a lot less overwhelming.

In my experience, the best results rarely come from one magic product or trying to attack every spot as soon as it appears. They come from understanding the skin, supporting it consistently and giving it time.

As I always say to my clients, healing your skin is a marathon, not a sprint.

If your teenager is struggling with acne and you're not sure where to start, I have an ebook written specifically on this subject that can give you a much deeper understanding of what teenage acne is, what can cause it, and how to treat it.

View my teenage acne ebook here.

If you're ready for action, an Initial Consultation at MW Skin Studio allows us to look at their skin, skincare, diet and lifestyle together and create a personalised Skin Plan that feels realistic for them. Or, if you're unable to come into clinic, you can find out more about my Virtual Consultations here.