I used to run an acne clinic and my patients were often surprised when I told them their condition was curable. With all the latest approaches and medications, most acne can be tempered – but most problem acne should be assessed by a specialist dermatologist first.
Acne is the eighth most common condition globally, with more than 70,000 patients being referred for specialist care in the UK each year.
While it affects adolescents most often, it isn’t uncommon in adults and can occur in children too. If it suddenly appears in adult women, it can be sign of a hormonal imbalance.
Severe acne can lead to scarring and cause psychological distress, so it is always best to get help. And Jingyuan Xu, a dermatologist at University College London has some advice.
For mild to moderate acne, with its characteristic blackheads and pus-filled spots, first-line treatments would include combination products like tretinoin cream combined with clindamycin, an antibiotic.
If acne is moderate to severe, options include the same skin treatment, plus the addition of an antibiotic tablet, either oral lymecycline or doxycycline. If it fails to respond to a 12-week course of treatment that includes an antibiotic, or if mild to moderate acne does not respond to two different 12-week courses, it’s time to see a dermatologist.
But people with acne can do a lot for themselves, such as using a slightly acidic detergent to cleanse the skin twice a day. They should avoid oil-based skincare products – and make sure make-up is removed at the end of the day. Picking or scratching spots is a no-no because it increases the risk of scarring.
In my clinics I saw the distress acne causes, especially the scarring, which increases with the severity and duration. Anyone feeling this level of upset should be seen by a specialist.
There are some extremely severe forms which should be seen as soon as possible and most hospitals have a dermatology team with this in mind.
Options also include physical treatments, such as light devices, and specific treatment for acne scarring.
If the condition is resistant to standard therapy with oral antibiotics and there is a risk of permanent scarring, then isotretinoin capsules can be considered.
Where scarring is severe and persists a year after acne has cleared, a consultant dermatologist-led team with expertise in scar management should take over.
CO2 laser treatment or glycolic acid skin peel can be considered – so you do not have to live with the physical and mental scarring acne can cause.
