Acne

Is this your child's symptom?

  • Pimples and blackheads on the face caused by blocked oil glands

Symptoms of Acne

  • Whiteheads (pimples) are plugged oil glands that are closed.
  • Blackheads are plugged oil glands that are open. Reason: The oil turns black when it is exposed to air.
  • Whiteheads and blackheads are also called "zits."
  • Red bumps are from blocked oil glands that have leaked oil. This causes irritation in the skin around them. Larger red bumps can be quite painful.
  • Acne mainly appears on your face, neck, and shoulders

Causes of Acne

  • Acne skin changes are from plugged oil glands. Acne has several causes.
  • Increased levels of hormones during puberty have a part. Heredity also plays an important role.
  • Some skin bacteria can make it worse.
  • Acne is not caused by diet. You do not need to avoid eating fried foods, chocolate, or any other food.
  • Acne is not caused by dirt or by not washing your face often enough.

When to Call for Acne

Call Doctor or Seek Care Now

  • Spreading red area around the acne with fever
  • Spreading red area or streak that's very large
  • Your child looks or acts very sick

Contact Doctor Within 24 Hours

  • Spreading red area or streak around the acne, but no fever
  • You think your child needs to be seen

Contact Doctor During Office Hours

  • Tender red lumps that are large occur
  • Yellow soft scab that drains pus or gets bigger occurs
  • After treating with Benzoyl Peroxide (BP) for 2 months, acne not improved
  • BP makes the face itchy or swollen
  • You have other questions or concerns

Self Care at Home

  • Mild acne

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Acne

  1. What You Should Know About Acne:
    • More than 90% of teenagers have some acne. Acne is a normal part of the teen years.
    • There is no medicine at this time that will cure acne.
    • However, good skin care can keep acne under control and at a mild level.
    • Here is some care advice that should help.
  2. Benzoyl Peroxide Gel:
    • Benzoyl Peroxide (BP) is the best OTC medicine for bringing acne under control. Use a Benzoyl Peroxide 5% gel product (such as the store brand). OTC means no prescription is needed.
    • It helps to open pimples and to unplug blackheads. It also kills bacteria.
    • Apply the lotion once a day at bedtime to the area with acne. Redheads and blonds should apply it every other day for the first 2 weeks. Reason: More sensitive skin.
    • Use an amount of lotion the size of a pea. This should be enough to cover most of the acne.
    • If the skin becomes red or peels, use less of it. Other option: You can use it less often.
    • Caution: Avoid the corners of the eyes, nose and mouth. Reason: These areas are very sensitive.
    • Caution: Benzoyl Peroxide bleaches clothing, towels, blankets, etc. Apply it only at bedtime and put it on sparingly. Use a plain white pillowcase.
  3. Antibiotics for Red Bumps:
    • Large red bumps mean the infection has spread beyond the oil gland. If you have several red bumps, your doctor may prescribe an antibiotic.
    • Antibiotics come as solutions for the skin or as pills.
    • The antibiotic will kill the bacteria that are causing the infection.
    • Give the antibiotic as directed.
  4. Washing the Face:
    • Wash your skin twice a day. The most important time to wash is bedtime. Just use warm water or you can use a mild soap (such as Dove).
    • Shampoo your hair daily.
    • Avoid scrubbing your skin. Reason: Hard scrubbing of the skin irritates the openings of the oil glands. This causes them to close off even more tightly.
  5. Pimple Opening:
    • Opening (popping) pimples is not advised by many doctors. But, most teens and adults do it anyway.
    • So, here's how to open a pimple safely without any squeezing.
    • Never open a pimple before it has come to a head.
    • Wash your face and hands first.
    • Use a sterile needle (cleaned with rubbing alcohol). Nick the surface of the yellow pimple with the tip of the needle. The pus should run out without squeezing.
    • Wipe away the pus and wash the area with soap and water.
    • Opening small pimples in this way will not cause skin damage.
  6. Avoid Picking or Squeezing Acne:
    • Many young people pick at their acne when they are not thinking about it. Picking makes acne worse.
    • Try not to touch the face at all during the day.
    • Squeezing blackheads causes bleeding into the skin. The bleeding turns into brownish blotches on the skin. They can take 1 or 2 months to fade.
    • Squeezing red lumps can force bacteria into the skin. This too leaves blotches. It can also cause a serious face infection.
  7. Prevention - Avoid Triggers of Acne:
    • Avoid putting any oily or greasy substances on your face. Reason: They block oil glands and make acne worse. If you use cosmetics, use water-based cosmetics.
    • Avoid hair tonics or hair creams (especially greasy ones). When you sweat, they will get on the face and irritate the acne.
  8. What to Expect:
    • With treatment, new whiteheads and blackheads will decrease. But, it takes 6 to 8 weeks.
    • Acne usually lasts until age 20 or 25.
    • So, you will need to continue the treatment for several years.
    • You don't need to worry about scarring. It is very rare for acne to leave any scars.
  9. Call Your Doctor If:
    • With treatment, the acne has not improved after 2 months
    • It looks infected (large, red, tender bumps)
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.