Acne is a skin condition that occurs when hair follicles become clogged with oil (sebum), dead skin cells, and sometimes bacteria. This can result in the formation of pimples, blackheads, whiteheads, or deeper cystic lesions.
It is one of the most common skin concerns that affects both teenagers and adults. While many experience occasional breakouts, for others, acne can be persistent, affecting their confidence and quality of life.
Acne can present in a variety of forms, depending on the severity and depth of the inflammation.
These are the most basic forms of acne and are non-inflammatory. Comedones occur when pores become clogged with excess sebum and dead skin cells. Open comedones (blackheads), appear dark due to oxidation, while closed comedones (whiteheads), remain beneath the skin’s surface and appear as small flesh-coloured bumps.
Papules are small, red, inflamed bumps that occur when the walls surrounding the pores break down due to severe clogging. Papules do not contain pus and can be tender to the touch. They affect the more superficial layer of the skin.
Pustules are similar to papules but contain a visible white or yellowish centre filled with pus. These inflamed lesions form when bacteria, oil, and dead skin cells accumulate and trigger an immune response, resulting in a swollen, painful blemish.
Nodules are a more severe type of acne. They are large, firm, and painful bumps that do not contain pus and affect the deeper layer of the skin. Nodules develop when a pore becomes deeply clogged and irritated, leading to inflammation that extends below the skin surface.
Cystic acne is one of the most severe and painful forms of acne. It occurs when bacteria and oil are trapped deep inside the pores, causing large, fluid-filled cysts beneath the skin. This type of acne often leads to scarring if not treated properly and may require prescription oral medication.
This is a rare but aggressive form of acne that involves multiple inflamed nodules interconnected beneath the skin. It can result in severe scarring and is usually seen in adult males. Early treatment is recommended to reduce scarring and it often requires a multi-pronged approach involving oral isotretinoin and medical supervision.
Fungal acne, also called Malassezia folliculitis, is a skin condition caused by an overgrowth of yeast (Malassezia). They appear as a cluster of small (1-2mm), uniform red or flesh-colored pustules or papules, and are usually itchy, especially when sweating. Unlike bacterial acne, it doesn’t respond to traditional acne treatments and often requires antifungal creams, shampoos, or oral medications.
These are the most basic forms of acne and are non-inflammatory. Comedones occur when pores become clogged with excess sebum and dead skin cells. Open comedones (blackheads), appear dark due to oxidation, while closed comedones (whiteheads), remain beneath the skin’s surface and appear as small flesh-coloured bumps.
Papules are small, red, inflamed bumps that occur when the walls surrounding the pores break down due to severe clogging. Papules do not contain pus and can be tender to the touch. They affect the more superficial layer of the skin.
Pustules are similar to papules but contain a visible white or yellowish centre filled with pus. These inflamed lesions form when bacteria, oil, and dead skin cells accumulate and trigger an immune response, resulting in a swollen, painful blemish.
Nodules are a more severe type of acne. They are large, firm, and painful bumps that do not contain pus and affect the deeper layer of the skin. Nodules develop when a pore becomes deeply clogged and irritated, leading to inflammation that extends below the skin surface.
Cystic acne is one of the most severe and painful forms of acne. It occurs when bacteria and oil are trapped deep inside the pores, causing large, fluid-filled cysts beneath the skin. This type of acne often leads to scarring if not treated properly and may require prescription oral medication.
This is a rare but aggressive form of acne that involves multiple inflamed nodules interconnected beneath the skin. It can result in severe scarring and is usually seen in adult males. Early treatment is recommended to reduce scarring and it often requires a multi-pronged approach involving oral isotretinoin and medical supervision.
Fungal acne, also called Malassezia folliculitis, is a skin condition caused by an overgrowth of yeast (Malassezia). They appear as a cluster of small (1-2mm), uniform red or flesh-colored pustules or papules, and are usually itchy, especially when sweating. Unlike bacterial acne, it doesn’t respond to traditional acne treatments and often requires antifungal creams, shampoos, or oral medications.
Several factors contribute to the development of acne.
Poor hygiene, such as not regularly changing your pillowcase and touching your face throughout the day, can result in the inoculation of bacteria onto the skin.
Changes in hormones, especially during puberty, menstruation, or conditions like PCOS, can increase oil production in the skin.
Cutibacterium acnes or C acne (formerly Propionibacterium acnes or P acne) is a bacteria that thrives in blocked pores and contributes to inflammation.
Comedogenic makeup or skincare can clog pores.
A family history of acne may increase your likelihood of developing the condition.
Overactive sebaceous glands can clog pores.
Factors like a high-sugar high-dairy diet, lack of sleep, stress, and lack of hydration can exacerbate acne.
Treating acne effectively often requires a combination of approaches, from topical and oral medication to in-clinic treatments. Our doctors will assess your skin and customise a plan that best suits your skin type, acne severity, and lifestyle.
Topical treatments are often the first line of defense in managing mild acne. Some commonly recommended topical treatments include:
Benzoyl peroxide helps reduce the amount of acne-causing bacteria on the skin while also reducing excess sebum. It may be used in combination with other topical treatments to enhance efficacy.
Retinoids, such as tretinoin and adapalene, are derived from vitamin A and work by increasing skin cell turnover. Retinoids are effective for treating mild to moderate acne. It helps to unclog pores, reduce inflammation, and prevent the formation of new acne lesions.
Topical antibiotics, such as clindamycin and erythromycin, are often prescribed to help reduce bacterial growth and inflammation. These medications work by targeting the bacteria that contribute to acne flare-ups, helping to control infection and prevent the development of new acne lesions. These treatments are typically used for mild to moderate acne, and can be paired with other topical treatments.
When topical treatments alone are not sufficient, especially in moderate to severe or persistent cases, oral medications may be prescribed to manage acne more effectively. These treatments are prescribed depending on the underlying causes of the acne.
For inflammatory acne, oral antibiotics may be prescribed to reduce bacteria and calm skin inflammation. These are generally used for a short duration (typically a few weeks to a few months) and often in combination with topical treatments to prevent antibiotic resistance and improve outcomes.
In cases of hormonally driven acne, often identified in adult women with irregular menstrual cycles, hormonal therapy may be considered. Oral contraceptives or anti-androgen medications like spironolactone can help regulate hormones that trigger excessive sebum production. Hormonal acne typically worsens during menses or 1 week before menses, and the commonly affected areas include the lower face and jawline areas.
Isotretinoin is a strong oral retinoid prescribed for moderate to severe acne. It works by reducing the size and activity of the oil glands, decreasing inflammation, and preventing the clogging of pores. Isotretinoin is proven to be effective in achieving long-term acne clearance, but it must be used under close medical supervision due to its potential side effects. Patients taking isotretinoin will be required to undergo regular follow-up consultations and blood tests to monitor liver function and lipid levels.
Mild chemical peels help to exfoliate dead skin cells and clear clogged pores, reducing the frequency and severity of acne breakouts. Commonly used chemical peels include salicylic acid and glycolic acid. Read more
While commonly used for pigmentation, the Q-Switched Laser also offers benefits for acne by targeting acne-causing bacteria, reducing residual acne marks and controlling the overproduction of oil in the skin. Read more
This gentle yet effective laser targets acne-causing bacteria and reduces skin inflammation without damaging surrounding tissue. It also helps to regulate oil production, reduce redness and calm active breakouts. Read more
Corticosteroid injections are used to help reduce inflammation and shrink deep cystic acne or acne nodules. It is administered directly into the pimple and helps reduce acne inflammation, flattening and calming the acne lesion within a few days.
While not a primary treatment for acne, skin boosters can reduce the occurrence of acne by hydrating the skin, reducing excessive oil production, and improving the skin barrier. They can be easily combined with other skin treatments to help with the overall quality of the skin. Read more
While mild acne can sometimes be managed with good lifestyle habits, over-the-counter products and proper skincare, moderate to severe or persistent acne often require a formal medical evaluation and prescription medicine. A doctor can diagnose the type of acne you have and recommend safe, effective treatments tailored to your skin.
For some individuals, acne may improve with age or lifestyle changes. However, untreated acne, especially inflammatory or cystic acne, can lead to scarring and long-term skin issues. Seeking timely treatment can help prevent complications and scarring.
Facials and manual extractions may provide temporary relief for clogged pores but are not a long-term solution for active acne. In some cases, improper extractions may cause irritation or worsen scarring. Medical-grade treatments or prescription medications are typically more effective.
Isotretinoin is a well-studied medication and can be highly effective in the treatment of acne when prescribed and monitored by a qualified medical professional. Skin dryness is the most common side effect of isotretinoin. Other important potential side effects of the drug include inflammation of the liver and increased cholesterol levels. Hence, for safety, patients can expect to undergo regular blood tests and consultations during the course of the treatment. Additionally, isotretinoin is not safe for use for women who are family planning, pregnant or breastfeeding. It is important to consult your doctor to discuss the risks and precautions before starting treatment.
This depends on the type and severity of your acne as well as the treatment prescribed. Topical treatments may take 4 to 8 weeks to show improvement, while oral medications may require 2 to 3 months. In-clinic procedures may offer visible improvement with a few sessions when combined with a consistent skincare routine.
If acne has left behind textural scars or pigmentation, our team can recommend targeted treatments such as lasers or RF microneedling. Learn more about acne scar treatments here.
Take the first step towards clearer, healthier-looking skin. Schedule a personalised consultation with our medical team to discuss your acne concerns and explore the best treatment options for your skin.
This page is intended for educational purposes and does not constitute medical advice. For an accurate diagnosis and personalised treatment plan, please consult with our licensed medical professionals.
