Teen Health: The Complete Guide

Key numbers at a glance

What happens during the teen years

Adolescence is a period of change as large as early childhood. Over a few years the body grows rapidly, sex hormones rise, sleep patterns shift, and the brain reorganizes itself in ways that shape judgment, emotions and relationships. Most teens come through it healthy, but this is also when many lifelong habits form, when mental health conditions often first appear, and when injuries from crashes, sports and risky situations become leading health threats.

The brain keeps maturing until about age 25. The regions that drive emotion and reward develop earlier than the areas at the front of the brain that handle planning, weighing consequences and impulse control. That gap helps explain why teens can be thoughtful and capable in calm moments yet more likely to take risks when excited, with friends, or under stress. It is not a lack of intelligence; it is a stage of development, and it is why adult guidance, clear rules and practice still matter even for teens who seem grown up.

This stage also brings growing independence. Teens start making more of their own decisions about food, sleep, friendships, screens and health care. The aim for parents and caregivers is to shift gradually from managing to coaching, keeping communication open so that teens bring problems to trusted adults rather than hiding them. Many of the most effective health strategies for this age group are less about rules and more about relationships.

Puberty: what is typical and when to check

Puberty is the set of changes that turns a child's body into an adult body, driven by rising sex hormones. For girls it typically starts between ages 8 and 13, usually with breast development, followed by growth of pubic and underarm hair, a growth spurt and, about 2 to 3 years after breasts begin to develop, the first period. For boys it typically starts between ages 9 and 14, usually with enlargement of the testicles, then growth of the penis and body hair, a deepening voice and a growth spurt that often comes later than in girls.

The timing varies a lot between healthy children, and comparing a child with siblings or friends tends to cause worry rather than help. What matters is whether puberty falls within the typical range and moves forward steadily. Signs of puberty before age 8 in girls or 9 in boys are considered early, and no signs by 13 in girls or 14 in boys are considered late. Either can signal a hormone or other condition worth checking, and both are reasons to see your doctor. So is having no period by age 15, or periods that are very heavy or painful.

Talking about body changes before they start, using correct names for body parts, makes them less frightening. Practical preparation helps too: period products in a backpack, deodorant, and a plan for what to do if a period starts at school. Expect bigger appetites during growth spurts, and offer nutritious meals and snacks rather than restricting food. Teasing about voice changes, body shape or acne can hurt more than adults realize.

Sleep: why teens need more and get less

The American Academy of Sleep Medicine recommends 8 to 10 hours of sleep per 24 hours for teens aged 13 to 18, and 9 to 12 hours for children aged 6 to 12. Yet most US high school students do not get enough sleep on school nights. Short sleep in teens is linked to poorer grades, low mood, more injuries and drowsy driving, and it can make anxiety and depression harder to manage.

Much of the problem is biology meeting the school schedule. During puberty the body clock shifts later, so many teens genuinely cannot fall asleep early even when they try. Early school start times then cut their sleep short. For this reason, the American Academy of Pediatrics recommends that middle and high schools start at 8:30 a.m. or later. Phones and other screens in the bedroom make things worse by delaying sleep and interrupting it with notifications.

Families can help in several ways. Keep wake-up times within about an hour or two on weekdays and weekends, because long weekend lie-ins shift the clock later and make Monday mornings harder. Encourage bright light, ideally outdoors, soon after waking. Charge phones and devices outside the bedroom overnight, and keep the bedroom cool, dark and quiet. Limit caffeine, especially in the afternoon and evening, and steer teens away from energy drinks as a way to push through homework.

• Snoring loudly or pauses in breathing during sleep
• Falling asleep in class despite enough time in bed
• Trouble sleeping that lasts several weeks or affects mood
• Drowsiness while driving

Nutrition, activity and sports

Teens need more of several nutrients than at almost any other time of life, because they are building bone and muscle and growing quickly. Calcium needs for ages 9 to 18 are 1,300 mg a day, higher than for most adults, and the teen years are when most bone mass is built. Teens also need more iron as they grow, and girls need more than boys once periods begin, because of the iron lost in menstrual blood. Regular meals with whole grains, protein, fruit, vegetables and dairy or fortified alternatives cover most of these needs.

The Physical Activity Guidelines for Americans recommend that children and teens aged 6 to 17 get 60 minutes or more of moderate-to-vigorous physical activity every day. That should include vigorous activity, muscle-strengthening and bone-strengthening activities on at least 3 days a week each. Activity does not have to mean organized sports: walking or cycling to school, dancing, skateboarding, swimming and active jobs all count. Activity is linked to better sleep, mood, concentration and long-term heart health.

Water is the best drink for most teens, before, during and after exercise. Sports drinks are mainly useful for long, intense sessions, and the American Academy of Pediatrics advises that energy drinks are not appropriate for children and teens because of their caffeine and other stimulants. Supplements sold for muscle gain, weight loss or performance are not checked by the FDA for safety or effectiveness before sale, and some have been found to contain hidden drugs.

The sports physical

Many schools require a preparticipation physical evaluation before sports. Ideally it happens several weeks before the season, as part of a yearly well visit, so there is time to follow up on anything that needs it. The exam reviews past injuries, asthma, concussions and medicines, and it includes questions about heart symptoms and family history designed to pick up rare heart conditions. Answer the family history questions honestly, including any relative who died suddenly before age 50. Chest pain or fainting with exercise, unusual shortness of breath, missed periods and unexplained weight loss are all reasons to be seen before training.

Weight, body image and eating disorders

Teens face strong pressure about how their bodies look, from peers, sports and social media. Cutting food or fluids to "make weight", rapid weight loss, rigid food rules, secretive eating or excessive exercise can be early signs of an eating disorder, which can affect teens of any gender, size or background. Focus family conversations on health, energy and strength rather than weight or appearance, eat together when you can, and avoid labeling foods as good or bad. If you are worried, talk to your teen's doctor early; eating disorders respond best to early treatment.

Mental health and getting help

Mental health is one of the biggest health concerns for US teens. CDC survey data show that about 4 in 10 high school students report persistent feelings of sadness or hopelessness, and about 1 in 5 report seriously considering suicide in the past year. Many mental health conditions, including depression, anxiety and eating disorders, first appear during adolescence. The encouraging news is that treatment works, and the earlier a teen gets support, the better the outlook tends to be.

It can be hard to tell normal teen ups and downs from something more serious. Changes that last two weeks or more and affect daily life deserve attention: low mood or irritability, withdrawal from friends and activities, changes in eating or sleep, falling grades, loss of interest in things they used to enjoy, or any self-harm. Dismissing these as "just a phase" can delay help. Ask directly and calmly how your teen is feeling, listen without rushing to fix things, and let them know you are on their side.

The US Preventive Services Task Force recommends screening for depression in adolescents aged 12 to 18 and it also recommends screening children and teens for anxiety. Your teen's doctor can do this at a yearly checkup, often using a short questionnaire, and can refer to a therapist or psychiatrist. Talking therapies such as cognitive behavioral therapy have good evidence for depression and anxiety in teens, and medicines may be added for some. Encourage regular sleep, physical activity and time with supportive friends and adults alongside any treatment.

If you are worried about suicide

Asking someone directly whether they are thinking about suicide does not put the idea in their head, and it can be a relief for them to be asked. Never promise to keep thoughts of suicide a secret. The 988 Suicide & Crisis Lifeline is free and available 24/7 by calling or texting 988 or chatting online, for teens in crisis and for adults worried about them. Reducing access to lethal means saves lives: store firearms locked and unloaded with ammunition locked separately, or keep them out of the home during a crisis, and lock up prescription and over-the-counter medicines. Save 988 in your phone and your teen's phone.

Social media, screens and online safety

Up to 95% of US teens aged 13 to 17 use social media, and many say they are online almost constantly. Social media can help teens stay connected, find community and explore interests. But the US Surgeon General's advisory on social media and youth mental health warns that teens who spend more than 3 hours a day on social media face double the risk of symptoms of depression and anxiety. Heavy use can also crowd out sleep, physical activity and face-to-face time, and it can expose teens to harmful content, bullying and exploitation.

Rather than banning social media, most experts recommend helping teens use it well. The AAP Family Media Plan is a free tool that helps families agree on screen-free times and places, such as meals and the hour before bed, and on keeping phones out of bedrooms overnight. Talk about how feeds are designed to keep people scrolling, how photos are edited and filtered, and how to notice when an app is making you feel worse. Encourage teens to unfollow or mute accounts that make them feel bad about their bodies or lives.

Online safety matters too. Review privacy settings together and who can contact your teen. Teach teens never to share location, intimate images or personal details with people they meet online, and not to respond to or forward bullying content. Sextortion, in which someone threatens to share sexual images unless a teen sends more images or money, is a growing threat. Make sure your teen knows it is never their fault, that they will not be in trouble for telling you, and that it can be reported to the NCMEC CyberTipline or the FBI.

Vaping, alcohol and other drugs

E-cigarettes have been the most commonly used tobacco product among US youth since 2014. Most contain nicotine, including some labeled nicotine-free, and nicotine is highly addictive for the developing brain, where it can harm attention, learning and impulse control. The aerosol can also contain heavy metals, flavorings linked to lung disease and cancer-causing chemicals. Federal law sets 21 as the minimum age to buy any tobacco product, including e-cigarettes. Vaping THC products, especially from informal or illicit sources, carries its own risks, including serious lung injury.

Alcohol is illegal for anyone under 21, and the earlier teens start drinking, the higher their risk of later alcohol problems. Cannabis use in the teen years is linked to problems with memory, attention and learning, and today's products are often much stronger than in the past. A newer and deadly danger is counterfeit pills. Pills sold on social media or by friends as painkillers, anxiety medicines or stimulants may contain fentanyl, and even one pill can cause a fatal overdose.

Talk with teens early and calmly, and ask what they know and what they see among friends rather than lecturing. Teens are more likely to be honest if conversations feel safe. If your teen vapes, help them make a quit plan with a quit date and strategies for cravings, and ask their doctor about support; free help is available through 1-800-QUIT-NOW, and counseling and text-message programs exist for teens. The opioid overdose reversal medicine naloxone is available without a prescription, and keeping it at home is a sensible precaution.

• Store e-liquids and devices locked away; swallowing e-liquid can poison young children
• Lock up prescription medicines, especially opioids, stimulants and sedatives, and dispose of leftovers safely
• Agree on a code word your teen can text to be picked up from an unsafe situation, no questions asked that night

Teen driving safety

Motor vehicle crashes are a leading cause of death for US teens, and teen drivers have a higher crash risk per mile than drivers of any other age. Inexperience is the biggest factor: new drivers are still learning to scan for hazards, judge speed and gaps, and handle surprises. Distraction, speeding, driving at night, carrying teen passengers, not wearing a seat belt, drowsiness and impaired driving all add to the risk, and crash risk rises with each additional teen passenger.

Every state uses graduated driver licensing, which lets new drivers gain experience under lower-risk conditions, typically with limits on night driving and teen passengers in the first months of licensing. Rules vary by state, so check yours. Parents can add to them with a written parent-teen driving agreement that sets out house rules on passengers, night driving, phones and consequences, loosening them as experience grows.

The most useful thing parents can do is supervise lots of practice driving in varied conditions: at night, in rain, on highways and on busy city streets. Model safe driving yourself, since teens copy what they see. Buckle up on every trip in every seat; seat belts are among the simplest ways to reduce death and serious injury. Put phones on "do not disturb while driving" or out of reach. Every state has zero-tolerance laws for underage drivers who have been drinking, and driving after cannabis or other drugs is also dangerous.

Relationships, consent and sexual health

Healthy relationships, whether friendships or dating, are built on respect, trust, honesty and the freedom to say no. Teen dating violence, which includes physical, sexual and psychological abuse and stalking, including online, is common and is linked to depression, substance use and later abuse. Warning signs include a partner who controls who you see, checks your phone, shows extreme jealousy, makes threats or pressures you for sex or sexual images. Talk with teens about what a healthy relationship looks like before they start dating.

Consent means agreement that is freely given and can be withdrawn at any time, and it cannot be given by someone who is drunk, high or asleep. Help teens practice both saying no and respecting a partner's no. Sending or forwarding sexual images can cause lasting harm and can also have legal consequences. If a teen confides in you about an unhealthy relationship, avoid blaming them, and do not confront the partner in a way that could make things more dangerous. For support, love is respect offers help for teens and young adults by calling 1-866-331-9474 or texting LOVEIS to 22522, and the National Domestic Violence Hotline is 1-800-799-7233.

Teens who are sexually active, or thinking about it, benefit from accurate information and confidential care. Doctors can discuss contraception, including long-acting methods, and condoms, which also lower the risk of sexually transmitted infections. The USPSTF recommends chlamydia and gonorrhea screening for sexually active young women, and HIV screening for teens and adults, so ask the doctor which tests make sense. Emergency contraception is available, and some types can be bought without a prescription. Planned Parenthood and local health departments also offer confidential services.

Checkups, vaccines and confidential care

A yearly well visit is one of the most useful things a teen can do for their health, even when they feel fine. The doctor tracks growth and puberty, checks blood pressure and weight, reviews vision, hearing and immunizations, and screens for depression, anxiety, substance use and other concerns. Under the Affordable Care Act, most private health plans must cover recommended preventive care for children and teens, including well visits and vaccines, without a copay when you use an in-network provider.

Part of the visit is usually spent with the teen alone. The American Academy of Pediatrics recommends this so teens can raise sensitive topics and start managing their own health. Many states protect the confidentiality of some teen care, such as sexual health and mental health services, though the rules vary by state. Doctors will still involve parents if a teen is at serious risk. Parents can help by stepping out without fuss and encouraging teens to write down their questions in advance.

Vaccines for preteens and teens

At ages 11 to 12, the CDC recommends a Tdap booster against tetanus, diphtheria and whooping cough, the first dose of the meningococcal conjugate (MenACWY) vaccine, and the HPV vaccine. A MenACWY booster is recommended later in the teen years, and older teens can also discuss the meningococcal B vaccine with their doctor. A flu vaccine is recommended every year, and your doctor can advise on COVID-19 vaccination under current recommendations. It is also a good time to check catch-up doses missed in childhood.

The HPV vaccine protects against the types of human papillomavirus most likely to cause cancers of the cervix, vagina, vulva, penis, anus and back of the throat, and genital warts. It works best when given years before any exposure, which is why it is routine at 11 to 12 and can start at 9. Teens who start before their 15th birthday need 2 doses, 6 to 12 months apart; those who start at 15 to 26, or who have a weakened immune system, need 3 doses. Catch-up is recommended through age 26. Boys benefit as well as girls, and if a dose was missed, the series continues rather than restarting.

Paying for care

Medicaid and the Children's Health Insurance Program (CHIP) cover millions of US children and teens, with income limits that vary by state and are higher than many families expect. Young adults can generally stay on a parent's health plan until age 26 under the Affordable Care Act. If your family is uninsured, HealthCare.gov or your state's marketplace can show which programs you qualify for, and community health centers offer care on a sliding fee scale. School-based health centers in some areas provide checkups and mental health care on campus.

Skin, acne and everyday health

Acne affects most teens, as rising hormones increase oil production and clog pores, causing blackheads, whiteheads and pimples. It is not caused by being dirty, and while it is common, it is not trivial: acne can leave scars and dark spots and can take a real toll on self-esteem. Effective treatments are available. Over-the-counter options include benzoyl peroxide, adapalene gel and salicylic acid, and they usually take a couple of months of daily use to show results, so switching products every few days rarely helps.

Wash twice a day and after sweating with a gentle cleanser, and avoid scrubbing hard or using harsh products. Choose products labeled "non-comedogenic" or "won't clog pores", and use a moisturizer and daily sunscreen, since some acne treatments dry the skin and make it sensitive to the sun. Wash pillowcases, hats and sports headbands regularly, and resist picking or squeezing pimples, which raises the risk of scars. See a doctor or dermatologist if over-the-counter products have not helped after a few months, for deep or painful cysts, for scarring, or if acne is affecting mood. Prescription options include stronger topical medicines, antibiotics and, for severe acne, isotretinoin, which requires a monitoring program because it causes serious birth defects.

Myths, conversations and a yearly plan

A few myths are worth retiring. Teens who sleep late are not simply lazy; their body clocks have shifted. Vaping is not harmless water vapor. Asking about suicide does not plant the idea. Acne is not caused by dirt or chocolate alone, and it does not have to be waited out. And teens who push back against parents still value their guidance, even if they rarely say so. Research on adolescent health consistently finds that a close, warm relationship with at least one trusted adult protects against many risks.

Good conversations are usually short and frequent rather than one big talk. Car rides, meals and walks work well because they feel less intense than sitting face to face. Ask open questions, listen more than you speak, and stay calm when you hear something worrying, so the door stays open next time. Teens can use the same approach with doctors: write down questions, ask for time alone, and ask what is confidential.

• Once a year: well visit with time alone with the doctor, depression and anxiety screening, vaccine review and a flu shot
• Before each sports season: sports physical several weeks ahead, or fold it into the well visit
• Every school term: review the family media plan, sleep routine and wake-up times
• When a teen starts driving: sign a parent-teen driving agreement and plan regular supervised practice
• Always: save 988 and Poison Control, 1-800-222-1222, in every family phone, and keep firearms and medicines locked

Every guide in this topic

• Teen Sleep: What Published Guidance Supports
• Sports Physicals and Teen Nutrition: What Published Guidance Supports
• Teen Acne: Sorting the Evidence From the Noise
• Vaping and Teens: What the Evidence Actually Says
• Teen Mental Health and 988: What Published Guidance Supports
• Social Media and Teens: What the Evidence Actually Says
• Puberty: What Published Guidance Supports
• HPV Vaccine: Sorting the Evidence From the Noise
• Teen Driving Safety: What the Evidence Actually Says
• Healthy Teen Relationships: What Published Guidance Supports

Frequently asked questions

How much sleep does a teenager need?

The American Academy of Sleep Medicine recommends 8 to 10 hours per 24 hours for teens aged 13 to 18. Their body clocks shift later in puberty, so early school starts often cut sleep short. Keeping wake times steady across the week, getting morning light and charging phones outside the bedroom can help them get closer to that target.

Is my teen's moodiness normal or a sign of depression?

Some ups and downs are normal. Be concerned when low mood, irritability, withdrawal, changes in sleep or eating, falling grades or loss of interest last two weeks or more, or if there is any self-harm. Ask your teen directly how they are feeling and talk to their doctor, who can screen for depression and anxiety and arrange treatment.

What should I do if my teen mentions suicide?

Take it seriously, stay calm and listen. Ask directly whether they are thinking about ending their life; asking does not increase risk. Do not promise secrecy. Call or text 988 for guidance, remove or lock up firearms and medicines, and contact their doctor or a mental health professional. Call 911 if they are in immediate danger or have harmed themselves.

How much social media is too much?

There is no single safe limit, but the US Surgeon General's advisory notes that teens using social media more than 3 hours a day face double the risk of depression and anxiety symptoms. Watch for effects on sleep, schoolwork, mood and activities. A family media plan with screen-free meals, no phones in bedrooms overnight and regular check-ins is a practical place to start.

How can I tell if my teen is vaping?

Devices can look like USB drives, pens or highlighters, and the aerosol often has a faint sweet smell that fades quickly. Signs can include irritability, trouble concentrating, more coughing or throat clearing, and unexplained purchases. Rather than searching their room, start a calm conversation, ask what they know, and offer help to quit through their doctor or 1-800-QUIT-NOW.

When should my child get the HPV vaccine?

The CDC recommends it routinely at 11 to 12, alongside other preteen vaccines, and it can start at 9. Starting before the 15th birthday means only 2 doses, 6 to 12 months apart. Teens who start at 15 or later, or who have a weakened immune system, need 3 doses. Catch-up is recommended through age 26 for both boys and girls.

Can my teen see a doctor without me?

Doctors usually spend part of each teen visit with the teen alone, which the American Academy of Pediatrics recommends. Many states allow teens to consent to some confidential care, such as sexual health or mental health services, but the rules vary by state. Doctors will involve parents if a teen is at serious risk. Ask your teen's doctor how confidentiality works in your state.

Are energy drinks and supplements safe for teen athletes?

The American Academy of Pediatrics advises against energy drinks for children and teens because of their caffeine and stimulants. Supplements sold for muscle gain or performance are not reviewed by the FDA for safety or effectiveness before sale and can contain hidden ingredients. Regular meals, a snack before practice and water work better. Sports drinks mainly help in long, intense sessions.

What are the biggest risks for new teen drivers?

Inexperience is the main one, made worse by phones and other distractions, speeding, driving at night, carrying teen passengers, skipping seat belts, drowsiness and alcohol or drugs. Graduated driver licensing in every state limits some of these early on. Plenty of supervised practice, a written parent-teen driving agreement and parents who model safe driving all help.

When is acne worth seeing a doctor about?

See your doctor or a dermatologist if over-the-counter treatments have not helped after a few months of consistent use, if there are deep, painful lumps or cysts, if acne is leaving scars or dark spots, or if it is affecting mood or confidence. Prescription treatments are effective, and treating acne early lowers the chance of permanent scarring.

When to speak to a doctor

See your doctor if a teen has low mood, anxiety, withdrawal, changes in eating or sleep, falling grades or self-harm lasting two weeks or more; if puberty starts before age 8 in girls or 9 in boys, there are no signs by 13 or 14, or there is no period by 15; if they snore loudly or fall asleep in class; if they have chest pain, fainting or unusual breathlessness with exercise; or if they need help quitting vaping or other substances. Call or text 988 for thoughts of suicide or emotional crisis. Call 911 if someone is in immediate danger, has taken an overdose, collapses during exercise, has a seizure, has been assaulted, or is in a crash with injuries, and start CPR if they are not breathing normally. Call Poison Control at 1-800-222-1222 if a child swallows e-liquid, medicines or chemicals.

Where this comes from

• American Academy of Sleep Medicine — Recommended Amount of Sleep for Pediatric Populations
• American Academy of Pediatrics — School Start Times for Adolescents
• Office of Disease Prevention and Health Promotion — Physical Activity Guidelines for Americans
• NIH Office of Dietary Supplements — Calcium Fact Sheet for Consumers
• CDC — Youth Risk Behavior Survey Data Summary & Trends
• US Preventive Services Task Force — Depression and Suicide Risk in Children and Adolescents: Screening
• HHS — Social Media and Youth Mental Health: The U.S. Surgeon General's Advisory
• CDC — Youth and E-Cigarettes
• CDC — HPV Vaccination
• Eunice Kennedy Shriver National Institute of Child Health and Human Development — Puberty and Precocious Puberty

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.