Online acne treatment clinics have become incredibly popular due to their convenience and accessibility. It’s not surprising given that consultations can be done from anywhere and treatments are usually directly delivered to the patient. However, what a lot of people don’t think enough about is follow-up. This is at least as important as the initial consultations. A good follow-up should help tackle problems, ensure you’re on track and fine-tune your protocol. Sadly, it can be very variable and a big reason for people discontinuing treatment is inadequate after-care. In this article, we’ll review why follow-up is important for acne treatment and what you should expect from a good online clinic.
Why Does Follow-up Matter for Acne Treatment?
Acne treatment is rarely a one-step process. Even when the initial diagnosis and treatment are appropriate, how your management plan evolves over time is just as important. That’s because acne is a complex condition with many drivers and presents in different forms. As such, it tends to respond gradually and in different stages. It may also flare-up at the beginning of certain treatments or even after seeming to improve due to certain triggers.
The type of acne treatment also affects the progression of the condition and outcomes. Some acne treatments target the acute breakout phase and others work in the long term to modify the underlying causes. That’s why it is important to monitor the activity of acne and where necessary adjust the treatment plan. This approach can only be achieved by having realistic expectations and access to follow-up to ensure treatment is appropriate. Through follow-up, your clinician can evaluate your tolerance to treatment, help with side effects and ensure the protocol is appropriate. They can also provide support and reassurance so you can continue on your treatment journey.
What Does Early Follow-up Involve?
In the early stages of acne treatment, follow-up is not to assess progress. This is because acne modifying treatments can take weeks if not months to before they yield visible improvements. If there is any early improvement it is often subtle and limited. With suppressive treatments like antibiotics or benzoyl peroxide which help reduce inflammation, there may be initial improvement in terms of redness and size of pimples sooner. As such the main value of early follow-up in the first 4-6 weeks is to manage:
- Tolerance to treatment
- Side-effects
- Purging or initial flare-up of acne
If there is any sign of allergy or serious side effects then your clinician may advise discontinuing treatment. However at this stage most of the time, only adjustment to frequency, dose in the case of oral treatments application method for topical treatments is usually necessary.
What Does Later Follow-up Involve?
By week 12 onwards you’re usually coming towards the later stages of the first course of acne treatment. At this point, acne treatments should normally be showing an effect on acne behaviour. This is even if complete clearance is not achieved. The purpose of follow-up from around weeks 12 onwards is to determine whether the current approach is delivering meaningful control and should continue or has reached its limit and needs serious adjustment. The main role of later follow-up is to assess:
- Reduction in frequency, severity or duration of breakouts
- Changes in lesion behaviour such as faster resolution or reduced inflammation
- Whether there is any improvement in texture, scarring, post-inflammatory redness or hyperpigmentation
- If there is a slowing down or speeding up of the rate of new acne formation
Improvement is often still gradual and can be very modest but there should usually be evidence that there is some response. Even if there is a response, this is also the stage at which plateaus may develop. The response to acne at this stage will help your clinician decide on how to optimise your next course of treatment.
Why isn’t There a Mid-Course Follow-up?
Most online (and physical) acne clinics don’t offer routine follow-up in the middle of the course of treatment. That;’s because a mid-course follow-up is usually neither necessary or even useful. In fact it can be harmful if decisions are made based on it. As long as you’re tolerating the treatment then there isn’t any value to following up again until the end of the course. This is because at this stage it is still too early to evaluate whether the treatment is working and not so any changes at before 12 weeks are likely to be disruptive and can actually set the acne back. During the middle of the course of treatment, follow-up is only useful if there’s:
- A negative reaction or inability to tolerate the treatment
- Ongoing issues like purging
- Significant worsening of the acne
Any adjustment to the treatment at this stage is mainly going to be to help with managing problems caused created by treatment itself rather than to address ongoing acne.
What if I Hit a Plateau?
If you’re fortunate enough to have responded to your treatment but find you’ve hit a plateau, the instinct might be to escalate. However, unless there’s a problem it is unlikely your clinician will change much until you’ve finished the course of treatment. This is because it is normal for rate of progress to appear to reduce once your skin is better than prior to starting treatment. As such, there might not actually be a plateau but just a normal change in rate.
If you feel that you’re experiencing a plateau in the early or middle part of your course of treatment, then by all means reach out to your online acne clinic for follow-up. However, ready yourself that your clinician is likely not to suggest anything other than ensure you’re using the maximum frequency/dose of treatment prescribed. If you are, then the best solution is likely to be to continue the treatment as is until review at the end of the course. This will have given the treatment enough time to work and at this stage adjustments are appropriate and guided by how your skin has actually responded.
A good online acne clinic should provide follow-up and ongoing aftercare. Early follow-up exists to ensure treatment is being tolerated and ensure optimal usage. It is not there to judge outcome. Meaningful changes to treatment, including escalation or switching strategy, are usually best reserved until the end of a full treatment course. This is typically around twelve weeks to allow adequate time for acne therapies to work. As a bonus, most good online acne clinics will provide access to your clinician at any point throughout your treatment to help troubleshoot issues, answer questions and provide reassurance. This approach to follow-up helps optimise treatment and ensure adherence and makes online clinics at leats in line if not ahead of physical acne clinics for aftercare.
At City Skin Clinic, we are beyond passionate about personalised skincare. Our virtual skin clinic offers safe and effective custom acne skin treatments. Where appropriate our doctors use ingredients such as Tretinoin, Hydroquinone, Azelaic acid, Clindamycin and Spironolactone to treat skin conditions like acne, hyperpigmentation, melasma and skin ageing. Start your online consultation today. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
