Online acne treatment clinics have become very popular thanks to how convenient and easy to reach they are. It’s not surprising, given that you can consult from anywhere and your treatments usually arrive at your door. However, what a lot of people don’t think enough about is follow-up. This is at least as important as the initial consultation. Good follow-up should help tackle problems, keep you on track and fine-tune your protocol. Sadly, it can be very variable, and a big reason people stop treatment is poor aftercare. In this article, we’ll review why follow-up matters 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 right, how your management plan changes over time matters just as much. That is because acne is a complex condition with many drivers, and it presents in different forms. As such, it tends to respond slowly and in stages. It may also flare up at the start of certain treatments, or even after seeming to improve, due to various triggers.
The type of acne treatment also affects how the condition progresses and how it turns out. Some acne treatments target the acute breakout phase, while others work in the long term to tackle the root causes. That is why it is important to monitor the acne and, where needed, adjust the treatment plan. This is only possible with realistic expectations and access to follow-up. Through follow-up, your clinician can check your tolerance, help with side effects and make sure the protocol is right. They can also offer support and reassurance so you can keep going on your treatment journey.
What Does Early Follow-up Involve?
In the early stages of acne treatment, follow-up is not about assessing progress. This is because acne modifying treatments can take weeks, if not months, before they yield visible improvements. Any early improvement is often subtle and limited. Suppressive treatments like antibiotics or benzoyl peroxide help reduce inflammation. So there may be some early improvement in the redness and size of pimples. So the main value of early follow-up in the first 4 to 6 weeks is to manage:
- Tolerance to the treatment
- Side effects
- Purging or an initial flare-up of acne
If there is any sign of allergy or serious side effects, then your clinician may advise stopping the treatment. At this stage, though, you usually need only a small adjustment. That might be to frequency, to dose for oral treatments, or to application method for topical treatments.
What Does Later Follow-up Involve?
By week 12 onwards, you are usually coming towards the later stages of the first course of acne treatment. At this point, treatments should normally be affecting how the acne behaves, even if complete clearance has not happened. Follow-up from around week 12 onwards works out whether the current approach is delivering real control. It tells you whether to continue, or whether the approach has reached its limit and needs serious adjustment. The main role of later follow-up is to assess:
- A reduction in the frequency, severity or duration of breakouts
- Changes in how lesions behave, such as faster resolution or less inflammation
- Any improvement in texture, scarring, post-inflammatory redness or hyperpigmentation
- Whether new acne is forming more slowly or more quickly
Improvement is often still slow and can be very modest, but there should usually be some sign of a response. Even when there is a response, this is also the stage at which plateaus may develop. How the acne responds at this stage helps your clinician decide how to improve your next course of treatment.
Why isn’t There a Mid-Course Follow-up?
Most online (and physical) acne clinics do not offer routine follow-up in the middle of a course of treatment. That is because a mid-course follow-up is usually neither needed nor useful. In fact, it can be harmful if you make decisions based on it. As long as you are tolerating the treatment, there is no value in following up again until the end of the course. At this stage it is still too early to judge whether the treatment is working. So any changes before 12 weeks are likely to backfire, and can actually set the acne back. During the middle of a course, follow-up is only useful if there is:
- A negative reaction or an inability to tolerate the treatment
- Ongoing issues like purging
- Significant worsening of the acne
Any adjustment at this stage is mainly to help manage problems created by the treatment itself, rather than to address the acne.
What if I Hit a Plateau?
Perhaps you have responded well to your treatment but find you have hit a plateau. The instinct might be to step things up. However, unless there is a problem, your clinician is unlikely to change much until you have finished the course. This is because the rate of progress normally appears to slow once your skin is better than before you started. So there might not actually be a plateau, just a normal change in the rate.
If you feel you are plateauing in the early or middle part of your course, then by all means reach out to your online acne clinic. There is no harm in asking for follow-up. However, prepare yourself for the likely answer. Your clinician will probably just check you are using the maximum frequency or dose prescribed. If you are, then the best option is usually to continue as you are until review at the end of the course. This gives the treatment enough time to work, so that your skin’s actual response guides any adjustments.
A good online acne clinic should provide follow-up and ongoing aftercare. Early follow-up exists to make sure you tolerate the treatment and use it well. It is not there to judge the outcome. Real changes, including stepping things up or switching strategy, are usually best reserved until the end of a full course. This is typically around 12 weeks, to allow enough time for acne treatments to work. As a bonus, most good online clinics give you access to your clinician at any point. They can help troubleshoot issues, answer questions and reassure you. This approach improves treatment and helps you stick with it. It puts online clinics at least on a par with, if not ahead of, physical clinics for aftercare.
At City Skin Clinic, we believe that skincare is personal and should always centre around your needs. Our doctors offer custom topical skin treatments for acne using ingredients like tretinoin, azelaic acid, clindamycin and spironolactone where appropriate. If you are interested in a personalised skincare treatment please use our online skin consultation form or book a video consultation. Start your treatment journey today and take your first step towards great skin.
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 professional with any concerns about your skin or treatment options.
