Acne Treatment

What is Acne?

Acne is a chronic disorder involving the hair follicles and sebaceous (oil) glands. It occurs when follicles become blocked with oil and dead skin cells, creating an environment where bacteria can thrive and inflammation can take hold. This leads to visible signs such as blackheads, whiteheads, pustules, and in more severe cases, nodules or cysts.

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There are several types of acne, and its appearance can vary significantly from person to person. Importantly, acne isn't just "bad skin”—it's a medically recognised condition with known causes and proven treatments.

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Who Gets Acne?

Acne affects people of all genders, ages, and ethnic backgrounds. While it is most common during adolescence—impacting up to 85% of 16 to 18-year-olds—it can also occur in childhood or persist well into adulthood. In fact, adult acne, especially in women, is increasingly recognised and treated.

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What Causes Acne?

The development of acne is multifactorial. Contributing factors include:

• Hormonal changes (such as those during puberty, menstruation, or in polycystic ovarian syndrome)

• Genetic predisposition

• Excess sebum (oil) production

• Blocked hair follicles due to dead skin cells

• Overgrowth of acne-associated bacteria on the skin

• Immune system activation and inflammation

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Flares may be triggered by:

• Polycystic ovary syndrome (PCOS)

• Certain medications (e.g., steroids, hormone treatments, anticonvulsants)

• Occlusive skin or hair products

• High humidity environments

• Diets high in dairy or foods with a high glycaemic index

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What Does Acne Look Like?

Acne may be confined to the face, or extend to the neck, chest, shoulders, and back. Lesions may include:

• Comedones (blackheads and whiteheads)

• Papules and pustules (red, inflamed spots)

• Nodules or cysts (larger, deeper, painful lumps)

• Post-inflammatory marks or scarring

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In addition to physical symptoms, acne can significantly affect psychological wellbeing, leading to low self-esteem, social anxiety, and even depression. At Domain Dermatology, we take this impact seriously and integrate holistic care into your treatment plan.

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Do I Need Tests for Acne?

In most cases, acne can be diagnosed by a dermatologist with a thorough skin examination.

 

Blood tests or hormone screening may be recommended in specific circumstances, such as suspected PCOS or if acne is severe, sudden-onset, or treatment-resistant. Blood tests are required for certain acne treatments.

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General Measures for Managing Acne at Home

There is no instant or permanent cure for acne, but it can be effectively controlled. The right treatment will help prevent permanent scarring and support skin healing. These at-home recommendations offer practical ways to care for your skin and complement any treatment plan prescribed by your dermatologist.

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Daily Skin Care Routine

Gentle cleansing
While acne is not caused by dirt, clean skin is important. The black colour of blackheads is due to oxidised oil and dead skin cells—not dirt.

• Wash your face twice daily using a gentle, pH-balanced, soap-free cleanser.

• Cleansers containing salicylic acid can help break down sebum and unclog pores.

• Avoid over-washing, which can irritate and worsen acne.

• Shampoo regularly, especially if your hair is oily or touches your face.

• Pull hair away from your face and neck where possible.

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Makeup, Moisturisers and Sunscreen

Choosing the right products

• Use oil-free or matte-finish makeup (look for non-comedogenic or non-acnegenic on the label).

• Only moisturise acne-prone areas if they are dry or irritated—excess moisturiser can clog pores.

• Opt for oil-free, lightweight sunscreens such as gels, light creams, sprays, or fluids.

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Removing makeup

• Always remove makeup at night with a soap-free cleanser or micellar water.

• Avoid using makeup remover wipes, which can irritate the skin.

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Over-the-Counter (Non-Prescription) Creams

Mild acne may respond to pharmacy-supplied products.

• Look for ingredients like benzoyl peroxide or salicylic acid.

• Follow usage instructions carefully—overuse can cause dryness and irritation.

• Be patient—visible improvement may take 2–3 months.

• Speak to your Dermatologist, GP or pharmacist for personalised advice. Avoid relying on advertisements or influencer endorsements.

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What to Avoid

Don’t squeeze pimples

• Picking or squeezing increases inflammation, infection risk, and scarring.

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Shaving tips

• Try both an electric razor and safety razor to see what suits your skin.

• If using a safety razor, use a sensitive-skin shaving cream and warm water to soften hair.

• Shave gently, only when necessary, and use a clean, sharp blade.

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Diet and Acne

There is no consistent evidence that any one food causes acne, but individual triggers do exist.

• If you notice certain foods worsen your acne, try avoiding them.

• Extreme diets are unlikely to resolve acne on their own.

• A balanced, healthy diet is always encouraged for general wellbeing.

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Sun Exposure

While brief sun exposure may improve acne temporarily, it is not a treatment.

• Long-term sun exposure can make acne worse and damage the skin.

• Many acne treatments increase sun sensitivity.

• Always use sun protection and practice sun avoidance where possible.

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How is Acne Treated?

There is no one-size-fits-all solution, but effective treatment can significantly reduce breakouts and prevent scarring. The choice of treatment depends on the severity and type of acne, your skin type, and any underlying hormonal issues.

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Topical Treatments (applied directly to the skin):

These are often the first-line treatment, especially for mild to moderate acne. Common topical agents include:

• Benzoyl peroxide

• Azelaic acid

• Topical retinoids (such as trifarotene, tretinoin or adapalene)

• Niacinamide (Vitamin B3)

• Topical antibiotics (typically combined with other agents)

• Other topical prescription ingredients 

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These ingredients help reduce inflammation, kill acne-causing bacteria, and prevent clogged pores. Mild skin irritation or dryness may occur initially, but this often settles with continued use or modified application.

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Oral Medications:

For moderate to severe acne, or if topical treatments aren't sufficient, oral medications may be considered. These may include:

• Oral antibiotics to reduce inflammation and bacterial overgrowth

• Hormonal treatments such as certain oral contraceptives or anti-androgens, especially for female patients with hormonal acne

• Other oral medications that work to reduce oil production and inflammation in severe or resistant cases

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Dermatologist-Directed Therapies:

In cases of severe, scarring, or persistent acne, a dermatologist may recommend:

• Prescription-only oral retinoids under close supervision - including Isotretinoin (Oratane, Roaccutane, Accutane)

• Intralesional steroid injections for large, painful nodules

• Light and laser therapies

• Chemical peels or microdermabrasion

• Scar treatments for post-acne marks and texture irregularities

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All treatments are tailored to your unique skin and lifestyle needs. Ongoing follow-up ensures adjustments can be made for maximum effectiveness and minimal side effects.

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What is the Outlook for Acne?

The good news? Acne is treatable, and long-term improvement is possible. While acne often improves with age, it may persist beyond the mid-twenties, particularly in women. Early and effective treatment helps prevent long-term scarring and improves quality of life.

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With the right treatment plan, many patients achieve long periods of remission—even with more stubborn cases.

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Ready to Take Control of Your Skin?

You don’t have to battle acne alone—or endlessly trial over-the-counter products without results. At Domain Dermatology, we offer expert-led, evidence-based treatment for all types and severities of acne. Whether you're seeking clear skin, prevention of scarring, or simply a renewed sense of confidence, we’re here to support you every step of the way.

 

Book your telehealth consultation today and take the first step toward healthier skin.