Acne treatment available from your GP

Acne is a condition that affects the sebaceous glands (grease glands) mainly on the face, neck, chest and back. Sebaceous glands are the tiny pores in the skin that produce oil to protect the skin. The activity of the sebaceous glands is influenced by the male hormone testosterone (women also have small amounts of this hormone). The sebaceous glands sometimes produce too much oil and this leads to a blockage at the tip of the gland. The result is a white bump (whitehead) or a black bump (blackhead). They are called comedones. These blocked glands are much more likely to get inflamed. The inflammation is caused by bacteria which normally live harmlessly on the skin. The result is redness and swelling. The choice of treatment depends on type of acne ( comedonal-blackheads or inflammatory-red spots) and severity of acne. It is important to start early and treat long enough (before you decide to change treatment), minimum of 2 months for topical gels or creams (6 months for topical antibiotics) and 3 months for oral preparations.

Mild to moderate acne

Topical treatments are most commonly used. Comedonal acne responds well to topical retinoids (e.g. Retin-A, Isotrex) or benzoyl peroxide (e.g. Panoxyl). Comedonal and inflammatory acne respond well to azelaic acid (e.g. Skinoren). It is useful to start with lower strength. Side effects of most creams, solutions or gels include skin irritation, redness and peeling. If you reduce the frequency of application, these side effects often subside. Retinoids may increase skin sensitivity to sunlight and cause temporary pigmentation. Avoid contact with eyes, nostrils and broken skin. Retinoids must not be used during pregnancy.

Alternatively topical antibiotics can be used (e.g.Zineryt, Dalacin). Effective in mild to moderate inflammatory acne. Topical antibiotics can produce mild irritation and rarely sensitisation.

Moderate to severe acne

Oral antibiotics (tetracyclines, erythromycin, trimethoprim) Useful for inflammatory acne if topical preparations are ineffective or inappropriate. Concomitant anticomedonal treatment (e.g. with topical benzoyl peroxide) may be required. Maximum improvement usually occurs after 4-6 months. Possible side-effects: nausea, vomiting, diarrhoea, rash, headache (discuss side-effects with nurse or doctor)

Hormone treatment - specific contraceptive pill (e.g. Dianette) Useful for women who also want to receive oral contraception. Effects should be judged after at least 3 months of use. Possible side-effects are same as for other combined contraceptive pills.

Severe acne

If acne is severe or if other treatments fail, referral to dermatologist is appropriate. Severe case of acne may require treatment with a powerful oral drug isotretinoin (Roaccutane).

Further information

This article published on
01 March 2005

Next review date 3/1/2013


Skin, hair and bones
Treatment and drugs
Treatment and drugs

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Skin, hair and bones

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