Open comedones are black, not because of dirt, but because of pigmented material at the opening of the pore. Some teens have only a few comedones. And in some young people, deep painful infected cysts can develop. Attempting to rid themselves of these unattractive bumps, adolescents often resort to scrubbing, squeezing and popping, all of which result in more skin irritation and, eventually, to tiny pits and scars on the face. In some young people, facial oil glands become over stimulated by these puberty androgens, and acne results.
Boys have higher amounts of androgen, of course, and boys also tend to have worse acne than girls.
Many girls notice a breakout of acne right before or during their menstrual periods. And about 5 percent to 10 percent of adolescent girls produce more androgens than usual and may have severe acne. The tendency to develop acne runs in families. First, don't make it worse. Ask your adolescent not to pick at or squeeze acne sores, which will result in infection spreading and comedones becoming more inflamed.