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Acne Information and Treatments

What is acne?

Acne is a skin problem that is characterised by blackheads, whiteheads, pustules (pimples), papules (small bumps), cysts (painful pus-filled lumps) and nodules (hard painful lumps). These heal over time but, as one disappears, then another appears. Acne mainly affects the skin on your face, neck, chest, back and shoulders. It can lead to scarring, leaving red marks and darkened areas, and forming pits and undulations in the skin.

Getting acne treatment online

The Online Clinic is able to prescribe certain acne treatments online following the completion of a consultation form. We can prescribe lotions and oral antibiotics. Please click on the free consultation button to begin.

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How common is acne?

Acne is a common problem that can occur in people of all ages, although it is most common in young people. About 20% of young people have moderate-to-severe acne, but the vast majority of these people are not troubled with acne beyond their early twenties.

What causes acne?

Acne arises when the hair follicles in the skin become blocked with dead skin cells and oil. Usually, dead skin cells are shed from the body and the sebaceous glands (which are connected to hair follicles) produce an oily substance called sebum to oil the hair and skin. Dead skin cells and sebum normally move up the hair follicle to the skin surface. When overmuch sebum is produced, it sticks the dead skin cells together forming a plug inside the hair follicle. The blocked follicle may appear white (a whitehead) or black (a blackhead). Bacteria living on the skin may infect the blocked hair follicle, which provides an ideal environment for the bacteria to multiply. In this case, the follicle becomes inflamed, causing red swollen pimples, papules, cysts and nodules.

What makes acne worse?

Various factors can make your acne worse. Changes in your hormones (called androgens) are the main cause of acne because they result in an increase in the secretion of sebum. This is why acne commonly occurs in young people during puberty and is also seen in pregnant women and women taking oral contraceptives. Acne can also be caused or aggravated by some medicines (e.g. corticosteroids, androgens, and lithium); dairy products and foods that increase blood sugar levels (e.g. carbohydrates); and oily products and some cosmetics put on the skin. You are more likely to get acne if there is a family history of it and, while acne is not caused by stress, stress can make it worse. Contrary to belief, dirty skin, chocolate, and greasy foods do not cause acne.

How is acne treated?

Medications for acne work by reducing inflammation and infection of the skin. This is achieved by reducing the amount of sebum produced (and therefore the skin’s oiliness), breaking down the protein keratin that is part of skin cells (thus unblocking the hair follicles and sebaceous glands), and by preventing bacterial growth and multiplication. Acne medications will not give instant results and it may take four to eight weeks before your skin improves.

Mild acne can be treated with a medicine bought ‘over-the-counter’ - that is without a prescription. These products often contain benzoyl peroxide or salicylic acid or sulphur, which can cause your skin to become itchy, dry and flaky. However, if these products do not work or if you have moderate-to-severe acne, it is likely that you will require a stronger product that is available on prescription only.

Acne treatments can either be applied directly to the skin (i.e. topically, such as creams and ointments, or be administered orally (e.g. tablets and capsules). Topical medicines include azelaic acid (Skinoren) that reduces keratin skin cell growth and sebum production. Some topical medicines contain a combination of products, including combinations of the antibiotic clindamycin and benzoyl peroxide that breaks down keratin (Duac), and the antibiotic erythromycin and the mineral zinc (Zineryt).

Acne treatments taken orally include antibiotics, such as lymecycline and oxytetracycline, which reduce inflammation and infection by preventing bacteria multiplying and helping your body to kill them. Oral contraceptives and other treatments that act on your hormones can help to resolve acne in women. Various cosmetic procedures may also be recommended for acne, such as laser therapy and light therapy.

Retinols can be helpful in treating mild, moderate or severe acne, for example, Tretinoin or Aklief. They work by replacing skin cells at a faster rate, removing old cells in the process which helps to stop new acne developing.

How can I reduce the risk of acne spreading?

To reduce the risk of new areas of acne, you should wash your skin twice daily with a gentle oil-free cleanser and lukewarm water, and particularly after perspiring or sports activity. Some products, such as those with benzoyl peroxide or salicylic acid, can help to dry up some of the oil. Avoid anything tightfitting as these increase the likelihood of sweating. Also keep your hair clean and away from your face and affected skin areas. Do not scrub the skin or use anything that will irritate the skin (e.g. astringents, toners, exfoliants, ‘heavy’ oily makeup), as this can make acne look or become worse. Likewise, touching the affected area can make acne worse. The sun can aggravate acne, and some acne treatments make the skin more sensitive to ultraviolet light from the sun and sunbeds. Importantly, never pick or squeeze acne, as this increases the chance of scarring and it will take longer to disappear.

Left untreated, acne can take a long time to heal and may cause permanent scarring. If your acne is causing you embarrassment or inhibiting your social life, the medicines that you have used have not been successful, or your acne is leaving unsightly scars or darkened skin areas, then consult your doctor. If your acne is not severe then The Online Clinic can prescribe a medication for next day delivery.

Free Online Assessment Quick and Without Obligation
Reviewed by: Dr Loraine Haslam MBBS, DRCOG, DFSRH, LoC SDI, LoC IUT, MRCGP
GMC registration number: 4524038
Date: 3 November 2023
Next review: 2 November 2025
All UK registered doctors can have their registration checked on
The Medical Register at the GMC website.

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