Acne Treatments

Acne is a common inflammatory skin condition that’s caused when our hair follicles are blocked with dead skin cells and sebum. Sebum is a type of oil that is made by a gland in our follicles and helps to moisturise and protect our skin. Bacteria can also collect in the follicle, causing pus to form.

Acne often affects the face but can also affect other areas of the body like the back, chest, neck, shoulders, and upper arms. Acne can cause the skin to become red as well as causing spots, pimples, and cysts. It is treatable in many cases, although the most suitable treatment varies from case to case.

Acne is quite common, affecting around 95% of people aged between 11 and 30 years old. How bad the acne can get can be very different from person to person. Most people will find that their acne clears up in early adulthood, but around 3% of people will continue to have acne when they are over 35 years old.

A doctor can diagnose acne by looking at your skin, usually your face, neck, chest, and/or back, to identify specific acne lesions or spots, such as blackheads, whiteheads, pustules, and papules. The severity of acne is determined by the types and number of lesions you have. For example:

• mild acne – mostly whiteheads and blackheads with some papules and pustules
• moderate acne – lots of whiteheads and blackheads, and many papules and pustules
• severe acne – lots of large painful lesions, including papules, pustules, nodules and cysts, which can be painful

If you have mild acne, a pharmacist can usually diagnose it and suggest effective treatments, but for more moderate or severe acne, you should make an appointment with your GP.

Alternatively, you can get a diagnosis using our photo diagnosis service. It is quick and easy to use – just upload 2 photos of the affected area, and our doctors will provide a diagnosis and advice on what to do next, including acne treatments, within 24 hours.

Acne can appear in different forms, and some of the most common types are listed here.

Blackheads

Blackheads are caused when a follicle becomes clogged by dead skin cells and sebum, and the follicle remains open. With the follicle open, the contents are exposed to air, allowing them to react with oxygen in the air. This causes the contents to turn black in a process known as oxidation.

Whiteheads

Whiteheads are similar to blackheads. The main difference between them is that the follicle is closed. With the follicle closed, oxidation does not occur, and the contents remain white instead of turning black.

Papules

Papules are small bumps on the skin that usually turn red and have no pus visible beneath the skin. With a papule, the contents of the plugged follicle have put enough pressure on the walls of the follicle to cause them to break. The contents then spill out into the surrounding area, causing irritation and tenderness to the surrounding tissues.

Pustules

A papule can sometimes turn into a pustule within a few days. The main difference between a pustule and a papule is that a pustule will contain pus that’s visible on the surface. Much like a papule, a pustule will typically have a red or pink base, although the centre of the bump will be white or yellow in colour.

Nodules

Nodules occur when clogged pores grow larger and become more irritated. One of the key differences between nodules and the acne types already mentioned is that nodules are deeper under the skin. They can be hard and painful.

Cysts

Cysts are the largest type of acne. They go even deeper than nodules do and often occur because of an infection. Cysts can be very painful to the touch and can also result in permanent scars.

A hair follicle is a small opening in the outer layer of the skin. Individual hairs grow from the base of follicles and through the opening of the follicle on the skin surface. Next to our hair follicles are glands that make sebum and once secreted from the gland, sebum will usually travel up the hair follicle to the surface where it can nourish and protect the skin. 

Sebum will sometimes not make it to the surface of the skin, becoming clogged in the follicle instead, potentially causing the follicle to become inflamed and swollen. Dead skin can also gather in the follicle, along with bacteria, and where bacteria collect you are also likely to find pus. The result is the spots and pimples that acne causes.

There is a large selection of acne treatments available, and which treatment is most suitable for you will depend on the severity of your case, among other factors. Our doctors will be able to recommend the most suitable option for your case.

Topical acne treatments

Topical treatments are applied directly to the affected skin. For people with mild-to-moderate acne, the doctor will recommend trying a single topical treatment, like benzoyl peroxide, a topical retinoid, an antibiotic cream in combination with benzoyl peroxide or a retinoid, or azelaic acid. They work in various ways, such as:

• killing bacteria and reducing inflammation
• unclogging pores
• reducing inflammation
• increasing skin cell turnover

Topical acne treatments are usually applied once or twice daily, at night, and can take 4 to 8 weeks to visibly improve your skin’s appearance. They can be very effective, with topical treatments containing azelaic acid reducing acne lesions by an average of 48%. A 10% benzoyl peroxide product can reduce acne-causing bacteria numbers by 98% in 2 weeks, making this an effective option for mild acne.

At Superdrug Online Doctor, we can offer the following topical treatments:

• Acnecide 5% gel
• Aknemycin Plus
• Clindamycin 1% + benzoyl peroxide 5% gel
• Differin cream
• Differin gel
• Epiduo Forte gel
• Epiduo gel
• Finacea gel
• Skinoren cream
• Treclin gel
• Zineryt solution (for pregnancy use only)

Antibiotic tablets for acne

Antibiotic tablets, such as lymecycline and doxycycline, are prescribed for moderate to severe acne, in combination with a topical treatment. They work by reducing bacteria on the skin that cause acne and by reducing inflammation. Antibiotics reduce the body’s inflammatory response, which reduces redness, swelling, and sebum production, helping prevent pores from becoming clogged.

Research shows that antibiotics, like lymecycline, can reduce acne severity by 42% in people with moderately severe acne. While doxycycline can reduce inflammatory lesions by up to 75%. Antibiotic tablets are usually prescribed for 3 to 6 months to treat acne, so it can take a while for you to notice improvements in your skin.

You’ll usually need to take the tablets once per day, as your doctor directs, but they will always be prescribed alongside a topical acne treatment. This is to help maximise the effectiveness of your treatment, speed up the healing process, and stop the bacteria from becoming resistant to antibiotics.

At Superdrug Online Doctor, we can provide the following antibiotic tablet and topical treatment combinations:

• Doxycycline + Skinoren 20% cream
• Doxycycline 100mg + Epiduo gel 0.1%
• Lymecycline 408mg + Skinoren 20% cream
• Lymecycline 408mg + Epiduo gel 0.1%
• Oxytetracycline 250mg + Epiduo gel 0.1%

Hormonal acne treatments

Hormonal treatment may work well for women with acne, especially if it flares up around the time of their period. Some combined contraceptive pills will reduce the levels of certain hormones known as androgens in the body. A reduction in androgens will, in turn, help to reduce how much sebum is produced, helping to control acne.

It’s important that combined contraceptive pills are used because they need to contain both oestrogen and progestogen to be effective. The mini pill, which contains only progestogen, may actually make acne worse.

Retinoid tablets

Retinoids are a group of drugs that are made from vitamin A. Vitamin A is important for healthy skin because it encourages the production of elastin and collagen, and retinoids encourage the production of new skin cells.

New skin cell growth will cause dead skin cells to be removed (exfoliation), helping to clear pores of dead skin cells and excess oil. Retinoids also help to reduce inflammation, reducing pain and irritation and helping to improve the appearance of the skin.

Isotretinoin is available as an oral retinoid capsule that is also available under the brand names Rizuderm, Reticutan, or Accutane. At Superdrug Online Doctor, we do not prescribe retinoid tablets for acne, but we can offer topical retinoid creams.

Over-the-counter acne treatments

Most people will use acne treatment that’s available without a prescription. Such treatments will usually be in the form of face washes or creams that are applied directly to the affected area and help to keep follicles clean of oil and debris, as well as helping to kill bacteria. It’s important not to over wash the face as acne is not caused by poor hygiene. Washing twice a day with a gentle soap or face wash is enough.

One of the most common ingredients in acne washes and creams is benzoyl peroxide (BP), which is an antibacterial agent. The effectiveness of non-prescription acne treatments varies. Those that contain active ingredients like BP are more likely to be effective.

The treatment that is right for you will depend on how severe your acne is, the types of lesions you have, and even your skin type. Acne can range from mild to severe, and topical treatments are usually recommended for mild cases.

Over-the-counter treatments, such as benzoyl peroxide, can be given by a pharmacist, while prescription-strength creams and gels, such as topical retinoids, either alone or in combination with an antibiotic cream or azelaic acid, are usually used for more moderate cases.

If you have severe acne, such as cystic acne, you may be given oral antibiotics alongside a topical treatment to improve your skin.

Which acne treatment is right for you will depend on various factors, including the type of acne you have. If you are unsure of which treatment you need, our doctors will be able to recommend the most suitable treatment for you and give you a prescription if needed.

Acne is not down to poor hygiene, but regular cleaning can still help to keep acne under control. Wash the affected area regularly using a mild soap to avoid irritating the skin. Also, be mindful of which cosmetics or other products you are using on your face.

You should also try and identify triggers that might be causing flare-ups. Keeping a diary of your activities, including what you eat, can help you identify what makes your acne worse.