Acne is a very common skin condition that can affect people across all age groups. It happens when your pores become clogged up with oil and dead skin cells.


Acne is a very common skin condition that can affect people across all age groups. It happens when your pores become clogged up with oil and dead skin cells. This gives rise to whiteheads, blackheads or pimples. It can also leave behind acne scars and hyperpigmentation.


Acne is an inflammatory disorder that centres around the pores of the skin. This is where you find the hair follicles and oil glands (sebaceous glands). In normal skin, your pores clear out excess oil and dead skin cells. In acne, the skin cells that line your pores produce too much keratin and the glands make too much oil (sebum). These two factors make it harder for pores to clear themselves and they eventually become clogged up with dead skin cells. Worse still, the excess oil causes an overgrowth of the bacteria p.acnes that feed on sebum. These bacteria are normally present on your skin but if they over proliferate, they end up triggering inflammation. These inflamed and blocked up hair follicles and pores is what gives the appearance of pimples. If you do not treat it, these blocked, angry and infected pores may continue to get bigger then burst. At this stage, the damaged skin begins to heal itself. As a result, you may end up with scarring or post-inflammatory hyperpigmentation.


Acne can develop anywhere on the body. Whilst it’s most commonly found on the face and neck, you can also get it on your back (aka backne), chest, arms, legs, buttocks or groin. There are different types and it is possible to have more than one of the following at the same time:
– Comedonal Acne – whiteheads (closed plugged pores) and/or blackheads (open plugged pores)
 Papular Acne – small red, tender bumps (papules)
 Pustular Acne –  or pimples (pustules) which are papules with pus at their tips
 Nodular Acne – large, solid, painful lumps under the skin
 Cystic Acne – painful, pus-filled lumps under the skin


As with most things in life, the triggers for acne are complex. This is an area of ongoing research. We do know for a fact that hormones (specifically Androgens) cause the sebaceous glands to get bigger and make more oil. They also cause excess keratin production by skin cells. This is what triggers blocking of the pores, overgrowth of bacteria, and then leads to inflammation. Androgens also increase during puberty. This is why acne is very common in this age group. Women can also experience increased androgen levels during menopause and in conditions like polycystic ovarian syndrome. Medications like corticosteroids, testosterone and lithium can also cause breakouts.

Whilst there is no proof that food or stress causes acne, increased stress and high glycaemic index diets can worsen it. There is also no solid connection between wearing makeup and developing acne. That being said, cleansing your face properly and using a regular skincare routine can help.


There are a number of ways to treat acne and which one works best depends on the type and how severe your acne is. Typically, it is graded as mild, moderate or severe based on how many lesions you have and their type (comedones, pustules, nodular etc).


Regardless of your type of acne, you will need a good regular skincare routine to help reduce breakouts and maintain the results of any medical treatments if you choose to have any. Look for skincare products containing Benzoyl Peroxide, Azelaic Acid, Salicylic AcidRetinol and Vitamin C. These products can help improve breakouts, smooth texture and even out skin tone.

Mild acne can generally be treated at home using over the counter skincare containing Benzoyl Peroxide, salicylic acid and Retinol. These can be used with prescription Adapalene or Tretinoin to target acne faster and treat texture, scars and dark marks.

Moderate acne may need prescription-strength topical skincare treatments containing more powerful ingredients. This is often used alongside at-home skin treatments such as benzoyl peroxide spot treatments and salicylic acid toners. If you suffer from severe acne, you may also benefit from prescription skincare. However, it is likely you will need add-on treatments such as antibiotics and/or oral isotretinoin (Roaccutane).

You can also use your skincare treatments to address scarring and post-inflammatory hyperpigmentation. This typically involves over the counter products like arbutin, azelaic acid, retinol and niacinamide or in more severe cases treatments like Hydroquinone alongside Tretinoin.

Professional Skin Treatments

Professional clinic treatments for all types of acne usually involve chemical peels that reduce inflammation, unclog pores, even out skin tone and smooth skin. Microneedling, RF microneedling and laser therapy are also effective treatments for acne scars and rough texture. These treatments do work but selecting the right patients who will benefit is important and they require a course of treatments. It is especially important for patients with skin of colour to seek an experienced medical professional as these treatments can sometimes trigger post-inflammatory hyperpigmentation.

At City Skin Clinic, we really believe in personalised skincare. We provide personalised prescription-strength skincare through our our virtual skin clinic to treat common skin conditions including acne. Book an online consultation today with one of our doctors to start your bespoke skincare treatment.

For more about acne treatments:

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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