Most teenage acne does improve with time. The problem with waiting is that inflammatory acne can scar permanently while you are waiting, and scarring is far harder and more expensive to treat than the acne was.
The other reason is that acne in adolescence has a well-documented effect on mood, confidence and social withdrawal. NICE guidance explicitly covers the impact of acne on mental health and wellbeing — it is treated as part of the condition, not a side issue.
Where to Start
Over-the-counter treatment is a reasonable first step for mild acne:
- Benzoyl peroxide — the most useful single OTC ingredient. Start at a lower strength; it can irritate and it bleaches fabric, so white towels and pillowcases save arguments later.
- Adapalene — a topical retinoid available OTC in some formulations. Effective, but needs the slow introduction described for any retinoid.
- Salicylic acid washes — mild, helpful for blackheads and comedones.
Give any of these at least eight to twelve weeks before judging. Teenagers, reasonably enough, expect faster. Setting that expectation at the start is most of the battle.
When to See a GP
Do not wait it out if:
- There are painful, deep lumps or cysts rather than surface spots
- Any scarring is appearing — pitting or textural change, not just marks
- OTC treatment has been used properly for three months without improvement
- It is affecting mood, school or social life
- Acne is widespread on the back or chest as well as the face
Children's prescriptions are free in the UK, so an appointment may cost nothing and result in a more effective treatment than the products being bought.
What a GP Can Offer
Beyond OTC products: prescription-strength topical combinations such as adapalene with benzoyl peroxide, topical antibiotics in combination products, and oral antibiotics — usually lymecycline or doxycycline — for moderate to severe inflammatory acne, always alongside a topical.
Referral to dermatology is appropriate for severe acne, scarring, or acne that has not responded to adequate treatment.
Isotretinoin and Under-18s
Isotretinoin is initiated under consultant dermatologist supervision. In January 2026 the MHRA removed the requirement for two prescribers to agree treatment for under-18s, having found it delayed access with little evidence of prescribers disagreeing. It was replaced with a revised risk acknowledgement form, a patient information video from the British Association of Dermatologists, and clinical audit.
A second opinion can still be requested. Everything else — counselling, pregnancy prevention, monitoring — is unchanged.
Expect follow-up appointments to include direct questions about mental health and sexual side effects. Those questions are now explicitly part of the guidance, and honest answers are the point of asking.
Things That Do Not Help
- Harsh scrubbing and astringents. Acne is not caused by dirt, and damaging the skin barrier makes treatment less tolerable.
- Picking and squeezing. The most direct route to scarring.
- Changing products every fortnight. Nothing gets the twelve weeks it needs.
- Elaborate multi-step routines from social media, which tend to combine too many actives and irritate.
The Conversation Worth Having
Acne in a teenager is often more distressing than they let on, and "it will pass" reads as dismissal even when it is meant kindly. Treating it seriously — a proper product, given proper time, and a GP appointment if that fails — is both better medicine and a better message.