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Many of these are Japanese exclusives, so they might be hard to play if you can't read Japanese.
Notably, if one of a teen's close relatives (such as a parent or sibling) has or once had acne problems, the teen is significantly more likely to get acne too.
Teens can also use gym equipment, and it becomes necessary in order to stay fit.
Some teens will develop acne if their hygiene motive falls too low.
Teens will act frightened when they gussy up, and an option to "use acne cream" will appear when using a mirror.