Acne Treatments

Acne, or acne vulgaris, is a common long-term skin condition characterised by whiteheads, blackheads, oily skin and inflamed spots, generally on the back, face or chest. The condition is more commonly seen in teenagers and young adults between the ages of 11 and 30.

Acne is caused by an overgrowth of P. acnes bacteria on the skin. It is linked to changes in hormones, such as during puberty, but it can start at any age.

Hormones control the amount of oil released from the glands near the hair follicles, and when these are produced in excess, it can aggravate the normally harmless bacterium P. acnes, resulting in inflamed skin.

Acne can run in families, and hormonal changes during menstrual cycles or pregnancy can cause acne in women.

Clean the skin no more than twice a day with mild cleansers rather than soap, which can inflame the skin further.

Avoid squeezing spots and blackheads, as this can make things worse and may even lead to permanent scarring.

There are six main types of spots that make up acne. Whiteheads are firm bumps on the skin that are difficult to squeeze, while blackheads are black bumps that are not filled with dirt but get their colour from a pigmentation of the hair follicle's inner lining. Pustules are small, red bumps that may feel sore or tender, and papules are red bumps with a white centre caused by a buildup of pus. Nodules are painful, large, hard bumps under the skin, and cysts are large, pus-filled bumps that can cause scarring.

Although acne cannot be cured, there are several treatments available, including Duac and Epiduo. These medications work to reduce inflammation of the skin, reduce existing spots and blackheads, and kill acne-causing bacteria.

If your acne is particularly severe, you can visit your GP for antibiotics and prescription-strength anti-acne creams.

Most topical acne treatments, including Differin (adapalene), Epiduo and Duac, need around 8 to 12 weeks of consistent daily use before a noticeable improvement is seen. It is normal for skin to look slightly worse in the first few weeks as treatment brings blockages to the surface, so it is worth persevering rather than judging a treatment too early. If there is no improvement after two full 12-week courses, speak to a GP or dermatologist.

Yes, and this is expected. Differin speeds up skin cell turnover, so in the first few weeks it can bring underlying blockages to the surface before the skin starts to clear. Mild redness, dryness, stinging or a short-lived flare-up are common early on and usually settle with continued use. If irritation becomes severe, or you notice signs of an allergic reaction such as swelling of the lips or eyelids, stop using the product and seek medical advice.

Retinol is a mild, over-the-counter form of vitamin A found in many cosmetic skincare products, while Differin contains adapalene, a prescription-strength topical retinoid. Adapalene binds more effectively to the skin's retinoic acid receptors than retinol, which is why it tends to work faster and more reliably on active acne, although it can also be more likely to cause initial irritation. Retinol is generally better suited to general skin texture concerns, while adapalene is specifically licensed to treat acne.

Acne on the back, chest and body develops in the same way as facial acne and can respond to the same active ingredients, such as benzoyl peroxide and adapalene. The skin on the body is thicker than facial skin and breakouts often cover a larger area, so it is worth confirming suitability for body acne during an online consultation before starting treatment. Severe or widespread body acne may need a stronger prescription approach from a GP or dermatologist.

Hormonal acne is acne linked to fluctuations in hormone levels, such as those that occur during puberty, the menstrual cycle, pregnancy or with conditions like polycystic ovary syndrome (PCOS). It typically appears along the jawline, chin and lower face, and often flares around the time of a period. Treatment options include the same topical medications used for other types of acne, such as adapalene or benzoyl peroxide, and in some cases a doctor may recommend a hormonal treatment such as the combined contraceptive pill.

Cystic acne is a severe form of acne in which large, deep, pus-filled cysts form under the skin. It is more painful than other types of spots and carries a higher risk of permanent scarring. Cystic acne often does not respond fully to over-the-counter treatments alone and may need a combination of prescription topical treatment and oral antibiotics, or referral to a dermatologist for further options such as isotretinoin.

The combined contraceptive pill can help some women manage acne, as it lowers the level of androgen hormones that drive oil production in the skin. The progestogen-only pill does not have this effect and can sometimes make acne worse. A prescriber can advise on whether the combined pill is a suitable option for you as part of an online consultation for the contraceptive pill.

Doxycycline is an oral antibiotic that a GP or dermatologist may prescribe for moderate to severe acne that has not responded to topical treatment, usually alongside a topical treatment such as adapalene and benzoyl peroxide. Courses typically run for around 12 weeks. Doxycycline is not suitable during pregnancy, when breastfeeding, or for children under 12, and it can increase sensitivity to sunlight. Doxycycline is not currently part of Pharmica's online acne range, so speak to your GP if you think this may be a suitable option for you.

Treating active acne early and consistently is the best way to reduce the risk of new scarring, since the risk of scarring increases the longer breakouts are left untreated. Topical retinoids such as Differin can help by reducing inflammation and preventing new spots from forming. Treatment cannot reverse scarring that has already formed. Existing scars are usually managed with dermatological treatments such as chemical peels or laser therapy, which are not currently offered by Pharmica.

Topical retinoids, including Differin, Epiduo and adapalene, should not be used during pregnancy or if you are planning a pregnancy. Benzoyl peroxide, found in Duac, and Cetaphil cleansers are generally considered lower risk, but any acne treatment should always be confirmed with a doctor or midwife before use if you are pregnant or breastfeeding.