Acne
Acne is the most common skin condition in the UK and affects adults as well as teenagers. It happens when hair follicles become blocked with oil and dead skin cells, which allows the bacterium Cutibacterium acnes to multiply and drive inflammation.
The good news is that acne responds well to the right treatment. The frustrating part is that most people are using the wrong products, at the wrong strength, for too short a time.
What the evidence supports
UK guidance (NICE NG198) recommends topical treatments as first line for mild to moderate acne. The strongest over-the-counter option is benzoyl peroxide, which kills the bacteria involved and does not cause resistance. Start at 2.5% to 5% once daily and build up.
Adapalene, a topical retinoid, normalises how skin cells shed so pores stop blocking. In the UK it is prescription only, and NICE recommends it in fixed combination with benzoyl peroxide as a first-line option. Azelaic acid is a well-tolerated alternative that also helps with the dark marks acne leaves behind and is safe in pregnancy.
Expect 8 to 12 weeks before judging any treatment. Stopping at week 3 because nothing has changed is the single most common reason acne routines fail.
When to seek prescription treatment
See a prescriber if your acne is moderate to severe, is leaving scars, is affecting your mood, or has not improved after 12 weeks of a proper over-the-counter routine. Prescription options include combination gels, oral antibiotics used alongside a topical, hormonal treatments for women, and isotretinoin under specialist care for severe or scarring acne.
As an independent prescriber, our clinic can assess your acne online and advise on the most appropriate route, including whether a GP or dermatology referral is needed.
Building a routine that sticks
Keep it simple: a gentle cleanser, one active treatment, a non-comedogenic moisturiser and a broad-spectrum SPF every morning. Adding more products increases irritation, not results.
Our Complete Acne Guide walks through routines, a 12-week plan, purging versus reactions, scarring, body acne and hormonal acne in depth.
Read more
Ingredient guides relevant to acne vulgaris:
Common questions
- Does diet cause acne?
- UK guidance does not recommend specific diets for acne because the evidence is limited. Some studies link high glycaemic load diets and dairy with acne in some people, so it is reasonable to track your own pattern, but diet changes alone rarely clear acne.
- Should I stop wearing makeup?
- No. Choose products labelled non-comedogenic, remove makeup fully at night, and clean brushes weekly. Makeup is not a cause of acne when used this way.
- Is it normal for skin to get worse when I start treatment?
- A short period of increased breakouts can happen in the first few weeks with retinoids as blocked pores clear. Burning, swelling or a rash is not purging and means you should stop and seek advice.
Want a plan built for your skin?
A 30 minute online video consultation with a GPhC-registered pharmacist. Evidence-based advice with no product pushing. £45.
This page is educational and does not replace an individual assessment. If your skin is painful, rapidly changing, or affecting your wellbeing, speak to a pharmacist or GP.