Acne is a very common cause of spots in teenagers; it tends to last for an average of five years, although it can last longer and may persist into adulthood. Acne usually affects the face, back or chest.
Acne can cause blackheads or whiteheads to form on the skin or in more severe cases, pus-filled spots or cysts which can become infected. In some cases, these spots can leave scarring on the skin after the acne has cleared up.
How can I treat acne?
Acne is often mild and easily treated with simple cleansing measures or over-the-counter medicines. However, in some more severe cases, it can require stronger treatments from a doctor, such as special creams, ointments or oral antibiotics. It is estimated that around 30% of teenagers with acne would need stronger treatments to prevent the skin from scarring in later life.
What causes acne?
Glands just under the surface of the skin naturally produce an oily substance called sebum, which keeps it smooth and supple. This is released onto the skin surface through small holes (pores), through which hairs also grow. During the teenage years, the skin produces a greater quantity of sebum in response to hormonal changes; some medicines also have this effect. There is also a greater chance of acne if one or both parents had it.
If too much sebum is produced by the skin, it may not be able to escape from the pores and they can become blocked, allowing spots, pimples, blackheads, and whiteheads to occur.
How is acne made worse?
If this trapped sebum becomes infected, the skin can become inflamed, and pustules or cysts can appear. These can be treated, but there is a greater chance of skin scarring if the symptoms are not managed quickly.
Acne can be made worse by picking or squeezing the spots, by excessive sweating, or by the monthly hormone cycle in women. Some medicines, such as the progestogen-only contraceptive pill (“mini pill”), can also make the appearance of acne more likely.
Acne is not made worse by stress, or poor hygiene. Other common myths are that using sunbeds, or washing the area more often, can help – this is not the case.
How can acne be managed?
For mild acne, a good daily cleansing routine is very important. Wash the area, but not excessively – twice a day is usually enough. The dark colour you see in blackheads is not dirt – it’s skin pigment, so no amount of extra washing will remove it. Use simple, hypo-allergenic cosmetics, and try to find products marked “non-comedogenic” (“comedones” means blackheads or whiteheads).
Instead of using soap, there are face washes and other products available designed specifically for people with acne, containing antiseptics and other ingredients to clean the skin and unblock the pores.
What medicines are available to treat acne?
There are many medicines that can help to treat acne. Some are applied directly to the skin, and others are taken orally.
Benzoyl peroxide is applied to the skin and is usually the best treatment to try first for mild to moderate acne. It can be purchased from pharmacies without a prescription in several branded products such as Quinoderm and Panoxyl. It works by removing the blockage from the skin pores, and it also has an anti-bacterial action. If you are using it for the first time, it’s best to start with a lower strength (4-5%) and try it on a small area of skin first, as some people find that it can irritate the skin. Higher strengths (up to 10%) are also available. Acne treatments that don’t require a prescription are available through your pharmacy.
Azelaic acid 20% cream (Skinoren Cream) works in a similar way to benzoyl peroxide and is only available with a prescription.
Another option is to use a product containing medicine that is related to vitamin A (“retinoids”). These have been shown to be very effective at treating moderate to severe acne. They can cause some redness and skin peeling at first, but this usually resolves with time. Products include Differin cream or gel, and Isotrex gel.
Epiduo Gel is a prescription-only product that contains both benzoyl peroxide in combination with adapalene for use in mild to moderate acne. Adapalene is a retinoid-like drug that specifically acts on the processes of the skin that cause acne by reducing the formation of blocked pores and it also has anti-inflammatory activity.
For moderate to severe acne, or where products applied to the skin are not working or irritate the skin too much, an oral antibiotic is another option to consider. Antibiotics used for this purpose include; Minocin MR capsules, Oxytetracycline tablets, and Tetralysal capsules.
If non-prescription treatments for acne have not done the job for you, where should you go from there? You could consider stronger treatments that are only available with a prescription. So see your doctor or online consultation with an Online Doctor.
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