Acne in teens and adults: treatment by telehealth
Acne treatment aims to heal existing breakouts, stop new ones and prevent scarring, using skin products and, when needed, prescription medicines. By video, with good light, the doctor can look at your skin, recommend a plan and, if appropriate, prescribe treatment. We see teens and adults; patients under 21 need a parent or legal guardian on camera.
Can we help by telehealth? Yes, we can help by telehealth.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Swelling of the face, lips or tongue, or trouble breathing after starting a medicine
- A widespread rash with blisters, peeling skin or mouth sores after starting a medicine
- A very painful, hot, spreading bump with fever
- Deep sadness or thoughts of self-harm: call 988 or Línea PAS
Help lines:
- 911 — Emergencies
- 1-800-981-0023 — Línea PAS (mental-health crisis line)
- 988 — Suicide & Crisis Lifeline
- 1-800-222-1222 — Poison Help
Types of acne
Acne happens when pores get clogged with oil (sebum) and dead skin cells, and bacteria grow inside. It shows up mostly on the face, but also on the back, chest and shoulders. The types are:
- Whiteheads: clogged pores that stay under the skin.
- Blackheads: clogged pores that open at the surface. They look black because air darkens the oil, not because they are dirty.
- Papules: small, pink, tender bumps.
- Pustules: pimples topped with white or yellow pus.
- Nodules: large, solid, painful lumps deep in the skin.
- Severe nodular (cystic) acne: deep, painful, pus-filled lesions.
Causes and what makes it worse
Acne is most common in teens and young adults. In the teenage years it is more common in males; when it continues into adulthood, it is more common in women. Hormones (at puberty and in pregnancy), family history and some medicines, such as corticosteroids, lithium and hormone-containing medicines, all play a part.
These do not cause acne but can make it worse: stress, pressure from helmets, tight clothes or backpacks, pollution and high humidity, squeezing or picking at blemishes, and scrubbing your skin too hard.
Acne treatment
Skin treatments include benzoyl peroxide, retinoids, salicylic acid and sulfur, plus topical antibiotics used together with other products. They can cause irritation, burning or redness at first.
For moderate or severe acne, the doctor may consider medicines by mouth, such as antibiotics, or hormone therapy, which is used mainly in women. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances.
What we do not do: isotretinoin and office procedures
We do not prescribe oral isotretinoin. If your acne is nodular or severe, is scarring, or is not improving with treatment, the doctor will recommend a dermatologist, who can also offer injections into lesions, chemical peels, laser or scar treatments. See what we do not do by telehealth.
Acne, the sun and dermatology waits in Puerto Rico
Many acne medicines make you burn more easily. With Puerto Rico's year-round sun, use sunscreen and avoid sunburn and tanning; sunscreen also helps dark spots left by acne fade, especially on darker skin.
Getting a dermatology appointment can take time. In a study published in 2026 of 464 patients at 12 dermatology clinics in Puerto Rico (data from summer 2023), the average wait was 2.5 months, 55% waited more than 3 months, and 38.7% said their symptoms got worse while they waited. For mild or moderate acne, a video visit can help you start treatment sooner.
Daily skin care
These NIAMS recommendations help look after your skin while treatment takes effect:
- Wash with a mild cleanser in the morning, at night and after exercise. Avoid strong soaps, astringents and rough scrub pads.
- Rinse with lukewarm water, and shampoo regularly if your hair is oily.
- Do not touch, squeeze or pick at pimples: it can leave scars or dark marks.
- Shave carefully, with a sharp blade and only when needed.
- Choose cosmetics carefully.
Acne in teens: the visit with a parent or guardian
We see teens with acne; the doctor is a general practice physician, not a pediatrician. Like every patient under 21, a parent with patria potestad (parental authority) or a legal guardian must sign the consent, stay on camera for the whole visit and show photo ID. Visits are not recorded.
So the doctor can see the skin well, sit by a window with natural light and show the face, and the back or chest if needed, on camera. See the parents' guide and doctor visits for children and teens.
Video visit: US$79 · Pay by card · See the price and what is included
Before you book
- You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
- We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
- Real-time video only; we do not do phone-call visits.
- We do not prescribe controlled substances.
Frequently asked questions
- Can acne be treated by telehealth?
- Yes, in most cases of mild or moderate acne. In an online doctor visit, with good light, the doctor can see your skin on camera and, if appropriate, prescribe treatment. Severe or scarring acne needs a dermatologist.
- Can my teenager have the visit alone?
- No. Every patient under 21 needs a parent with patria potestad or a legal guardian on camera for the whole visit, with photo ID.
- Do you prescribe medicine for severe acne?
- Many cases can be treated with skin or oral medicines. We do not prescribe isotretinoin; if your acne is severe or scarring, the doctor will recommend a dermatologist.
- How long does acne treatment take to work?
- Acne improves gradually with treatment. The doctor will explain when to check the result and when to adjust the plan.
Sources
- NIAMS (NIH): Acne types, causes and risk factors (accessed 2026-09-30)
- NIAMS (NIH): Acne diagnosis and treatment (accessed 2026-09-30)
- Wait times for dermatology appointments in Puerto Rico, Cureus 2026 (PMC12904730) (accessed 2026-09-30)