Acne

Four processes interact at the hair follicle: excess sebum production, abnormal skin cell shedding (forming a comedone), proliferation of Cutibacterium acnes bacteria, and the resulting inflammatory immune response. Androgens, present in both men and women, drive sebum production and hormonal acne patterns. In women, conditions such as polycystic ovarian syndrome (PCOS) can significantly elevate androgen levels. Diet, stress, medications, and certain skincare products also influence severity.

How is it diagnosed?

A dermatologist assesses lesion type, distribution, inflammation, and scarring, and considers whether hormonal or systemic factors are contributing. Blood tests may be recommended for women with suspected hormonal acne. Accurate diagnosis matters because different acne types respond to different treatments, and some approaches can worsen certain presentations.

Treatment is guided by type, severity, and individual health. A dermatologist will discuss a personalised plan, which may include:

Topical treatments including retinoids (vitamin A derivatives that regulate skin cell turnover), benzoyl peroxide, topical antibiotics, and azelaic acid are first-line for mild to moderate acne.

Oral treatments for moderate to severe acne may include oral antibiotics (used for a defined period), hormonal therapies for women with an androgenic component, and isotretinoin, which is highly effective for severe or scarring-prone acne and requires careful monitoring and specific eligibility criteria.

Procedural treatments such as chemical peels, laser therapy, and light-based devices may address active acne or acne scarring once the underlying condition is controlled.

Most regimens require 8–12 weeks before meaningful improvement. Consistency matters more than intensity.

Treatment is highly individual. The options above are a starting point for conversation with a dermatologist, not a prescription.