Acne
Acne develops when a hair follicle becomes blocked with sebum and dead cells and the bacteria that normally live on the skin multiply inside it.
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Medicines commonly prescribed for Acne
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CAPSULE, 100 mgActive substance: doxycyclineManufacturer: Industrial Farmaceutica Cantabria S.A.Prescription requiredDosage form: CAPSULE, 200 mgActive substance: doxycyclineManufacturer: Industrial Farmaceutica Cantabria S.A.Prescription requiredDosage form: CAPSULE, 50 mgActive substance: doxycyclineManufacturer: Industrial Farmaceutica Cantabria S.A.Prescription required
Acne develops when a hair follicle becomes blocked with sebum and dead cells and the bacteria that normally live on the skin multiply inside it. It is not caused by poor hygiene: washing more does not improve it and often makes it worse. It is the most common skin condition, it responds well to treatment, and the key is to start early, before scarring sets in.
What appears on the skin
- closed comedones — "whiteheads";
- open comedones — "blackheads"; the colour is oxidised sebum, not dirt;
- red inflamed papules;
- pustules containing pus;
- deep, painful nodules and cysts — these are what leave scars;
- red or brown marks after each lesion resolves, lasting months;
- sites: face, upper chest, back and shoulders, where the sebaceous glands are densest.
What actually influences it
- hormones: puberty, the menstrual cycle, polycystic ovary syndrome and androgens all increase sebum production;
- heredity: if parents had severe acne, the risk is higher;
- medicines: corticosteroids, anabolic steroids, lithium, some antiepileptics and contraceptives containing androgenic progestogens;
- occlusive cosmetics and greasy hair products;
- friction and pressure: helmets, straps, face masks, resting your chin on your hand;
- stress and lack of sleep;
- diet: the link is moderate but real for skimmed milk and for diets high in sugar and refined flour. Chocolate and fried food alone are not the cause.
When to see a doctor
- the lesions are deep and painful — do not wait in this case, because these are the ones that scar;
- over-the-counter products have not worked in 2–3 months;
- scars or persistent marks have already formed;
- acne is affecting your mood, relationships or work — a legitimate reason to attend;
- in a woman, acne comes with irregular periods, increased facial hair or hair loss;
- acne has appeared suddenly in adulthood;
- it started after beginning a medicine or supplement;
- there is fever, joint pain and severely inflamed lesions — severe forms needing prompt attention.
Treatment
Every acne treatment takes 8–12 weeks to show its effect. This is the first thing to understand: switching products every two weeks is the most common reason for "nothing works for me".
- topical retinoids — the foundation of treatment; they act on the follicular blockage, which is where everything starts;
- benzoyl peroxide — reduces bacteria and prevents resistance; combines well with the above;
- topical antibiotics — always alongside benzoyl peroxide, never alone;
- azelaic acid — also useful for post-inflammatory marks and safe in pregnancy;
- oral antibiotics in limited courses of around three months, for moderate inflammatory acne;
- hormonal contraceptives or anti-androgens in women with a hormonal component;
- oral isotretinoin for severe or unresponsive acne: the most effective treatment, requiring blood monitoring and reliable contraception in women because of the risk in pregnancy;
- scar treatment once acne is controlled: laser, microneedling, peels, fillers.
Daily care
- wash your face twice a day with a gentle cleanser, without scrubbing and without harsh exfoliants;
- do not use alcohol-based products or soaps that leave the skin tight: the rebound in sebum makes acne worse;
- a light oil-free moisturiser: treatments are drying, and without moisturiser people abandon them;
- a non-comedogenic sunscreen, essential with retinoids and with antibiotics;
- cosmetics labelled non-comedogenic;
- do not squeeze lesions: it is the fastest route to a mark and a scar;
- change your pillowcase often and keep greasy hair products off your forehead;
- clean your phone and do not rest it against your cheek.
Common questions
Is it because I don't wash properly? No. Over-washing irritates the skin and makes things worse.
When will I see results? From 6–8 weeks, and clearly by 12. There can be a temporary worsening at the start.
Do I need to change my diet? No strict diet is needed. Cutting sugary drinks and ultra-processed foods helps some people.
Doesn't acne just go with age? Often it does, but the scars it leaves do not. That is why it is treated.
Is isotretinoin dangerous? It has side effects and strict monitoring, but it is the most effective treatment and has been used for decades under well-established protocols.
Online consultation
In an online consultation the doctor reviews photographs, determines the severity and type of lesions, reviews your medicines and cosmetics, checks for a hormonal component in women, and sets out a regimen with realistic timescales and a review at three months.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Jul 19, 2026
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