Acne

Acne develops when hair follicles become clogged with oil (sebum) and dead skin cells, leading to the formation of pimples, blackheads, or cysts. Several factors contribute to this process, including:

• Excess oil production by sebaceous glands
• Bacterial overgrowth (particularly Cutibacterium acnes) causing inflammation
• Hormonal changes, especially during puberty, menstruation, and pregnancy
• Genetic predisposition – having family members with acne increases your risk
• Lifestyle factors such as stress or a diet high in refined sugars
• Use of comedogenic skincare products that clog pores

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Acne appears in different forms, and each type may require a specific treatment approach:

• Comedonal Acne: Characterised by blackheads (open comedones) and whiteheads (closed comedones), commonly appearing on the forehead and chin.
• Inflammatory Acne: Red, swollen pimples and pustules that arise due to inflammation and bacterial activity.
• Nodular Acne: Deep, painful lumps beneath the skin, which may lead to long-term scarring if untreated.
• Cystic Acne: The most severe form of acne, involving large, pus-filled lesions that penetrate deep into the skin and often cause significant scarring.

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Effective acne management often combines multiple treatment approaches based on the severity of your condition:

At-Home Care:

• Use a gentle, non-comedogenic cleanser twice daily.
• Apply over-the-counter creams with ingredients like benzoyl peroxide, salicylic acid, or mild retinoids.
• Avoid picking or squeezing pimples to reduce the risk of scarring.
• Stick to non-comedogenic makeup and skincare products.

Lifestyle Adjustments:

• Maintain a balanced diet rich in whole grains, vegetables, and lean proteins.
• Practice stress-reducing techniques like mindfulness or regular exercise.
• Avoid heavy, greasy products that may clog pores.

Professional Treatments:

• Prescription for Acne. See the FAQ below.
• In-practice dermatological treatments:
  • Chemical peels
  • Light therapy
  • Laser therapy
  • Photodynamic therapy (PDT)
  • Radiofrequency (RF) microneedling
  • Cortisone injections for inflamed or cystic acne

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Acne requires patience, consistency, and regular care. Results may take weeks or months to show. Dermatologists often recommend routine reviews to track progress and adjust treatments as needed. A referral from your GP can help streamline a consultation with a dermatology team for a tailored acne management plan.

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Prescription treatments for acne are tailored based on severity, skin type, and response to previous treatments. Below are the most commonly used medical therapies and how they help:

1. Retinoids (Topical and Oral)

Topical retinoids are often the first-line treatment for blackheads and closed comedones – those small, stubborn bumps on the forehead or jawline. They help unclog pores, reduce inflammation, and can be combined with antibiotics, the pill, or spironolactone for more inflamed acne.
Side effects: Redness, dryness, stinging, or itching are common. Your dermatologist will guide you on how to ease these with appropriate skincare support.
Oral retinoid (Isotretinoin) is reserved for severe or cystic acne. It reduces oil gland activity, prevents clogged pores, lowers inflammation, and controls bacteria. While very effective, it requires close monitoring and is unsuitable during pregnancy. Monthly in-person reviews are essential.

2. Benzoyl Peroxide

This antibacterial treatment targets the bacteria that contribute to acne breakouts. It’s useful for both ongoing prevention and treating flare-ups.
Tip: Apply only a thin layer to affected areas to avoid irritation and peeling. Be mindful—benzoyl peroxide can bleach fabrics like towels and clothes.

3. Antibiotics

Topical or oral antibiotics may be prescribed to reduce inflammation and bacterial overgrowth. They’re usually combined with other treatments like benzoyl peroxide or retinoids to prevent resistance.
Treatment duration: Often used for 2–6 months.
Note: Some oral antibiotics increase sun sensitivity or have dietary restrictions, and are not suitable during pregnancy.

4. Spironolactone (for women)

Spironolactone blocks the effects of testosterone on the skin, making it particularly effective for hormonal acne. It’s often used alongside the contraceptive pill to regulate periods.
Effectiveness: It significantly improves acne in some women, has partial benefits in others, and no effect in the remainder.
Important: Not suitable for those planning pregnancy.

5. Light and Laser Therapies

While not first-line, laser or light therapies may offer additional benefit for selected individuals. They’re not routinely used due to limited evidence, but may be recommended by your dermatologist in combination with medical therapy.
Scenarios where this may be suggested include patients with persistent redness, post-acne scarring, or those unresponsive to medication.

Lasers target the bacteria and inflammation responsible for acne. Blue light lasers kill acne-causing bacteria deep within the skin, while other lasers reduce inflammation and promote skin healing, helping to clear active breakouts and prevent future flare-ups.

Yes, lasers can help prevent acne scars by reducing inflammation early on and stimulating collagen production. This promotes faster healing of the skin and minimizes the likelihood of long-term scarring from acne lesions.

Most patients require multiple laser sessions, generally 3-5 treatments spaced 2-4 weeks apart, to see significant improvements. The exact number depends on the severity of the acne and the specific laser used.