Health Insights · Dermatology
Acne: causes, treatments and when to see a dermatologist
Acne is a treatable medical condition, not a hygiene problem or something to be grown out of quietly. The commonest reason treatment appears to fail is stopping it too early — almost nothing works inside six weeks, and most regimens need three months before you can judge them.
Arrange prompt assessment if you have
- deep, painful lumps or nodules, or acne that is leaving scars
- a sudden severe eruption with fever, joint pain and feeling unwell — this needs urgent treatment
- acne causing significant distress, low mood or social withdrawal, whatever it looks like clinically
- acne alongside irregular periods, excess hair growth or hair thinning, which may point to an underlying hormonal cause
- acne that has not responded to two courses of appropriate treatment
Scarring is preventable but not reversible — treating early and adequately matters far more than the cosmetic appearance on any given day. Psychological impact is a legitimate reason to treat acne actively, and it does not need to correlate with severity.
What is actually happening
Hormones increase oil production, dead skin cells block the pore, and a normal skin bacterium multiplies in the blocked follicle, producing inflammation. That is why treatments target several steps at once and why none of them work overnight.
It is not caused by poor hygiene
Acne is not dirt, and washing more will not clear it — scrubbing and harsh cleansers damage the skin barrier and make things worse. Wash gently twice a day with a mild cleanser, no more. Nor is it caused by chocolate. There is modest evidence that high-glycaemic diets and skimmed milk may aggravate acne in some people, but diet is not the cause and restrictive eating is not a treatment.
Treatment, and the timescale
- Topical retinoids unblock pores and are the backbone of most regimens. They commonly cause dryness, redness and flaking for the first few weeks, and often a temporary worsening at around three to four weeks. This is expected — not a reaction, and not a reason to stop.
- Benzoyl peroxide reduces bacteria and does not cause resistance. It bleaches fabric, so use white towels and pillowcases.
- Combination products are generally more effective than single agents.
- Antibiotics, topical or oral, are used for inflammatory acne but always alongside benzoyl peroxide or a retinoid, and for a limited period — typically no more than three to six months — to limit resistance.
- Hormonal treatment, including the combined pill, is effective for many women.
- Apply treatment to the whole affected area, not as spot treatment — you are preventing the next spots, not treating today's.
Getting through the first weeks
Do
- Start a retinoid every other night and build up
- Use a simple non-comedogenic moisturiser alongside
- Use sunscreen — several treatments increase sun sensitivity
- Give each regimen a full twelve weeks
- Photograph your skin monthly, since day-to-day judgement is unreliable
Do not
- Do not pick or squeeze — this is the main cause of scarring and dark marks
- Do not scrub, or use astringents and harsh exfoliants
- Do not stop when it looks better; maintenance prevents relapse
- Do not use a friend's antibiotics or leftover creams
- Do not layer many active products at once
Marks and scars
Flat brown or red marks left after a spot are not scars. They are post-inflammatory pigment change and they fade over months, faster with sun protection. True scars are indented or raised, and they are permanent — which is the argument for treating acne properly and early rather than waiting to see.
When treatment is not enough
Acne that has not responded to two adequate courses of treatment, or that is scarring or causing significant distress, warrants a dermatology opinion. Isotretinoin is a highly effective oral treatment for severe or resistant acne, prescribed under specialist supervision with monitoring, and with strict precautions because it causes serious harm in pregnancy.
Book an appointment if over-the-counter treatments have not worked after twelve weeks, your acne is painful or scarring, it is affecting your confidence or mood, or you want to discuss isotretinoin or hormonal treatment. Our dermatology team sees patients without a referral or a wait.
Private acne treatment in London
Acne is very treatable, and getting the right treatment early reduces the risk of scarring. A private GP in East London can start effective treatment for mild-to-moderate acne, and our private dermatology clinic in London can help with stubborn, scarring or severe acne that needs specialist options. Where a spot or lump is changing, we can also arrange a skin lesion and mole check. We treat acne at our private hospital in Whitechapel, East London, with patients travelling in from Canary Wharf, the City, Aldgate and across Tower Hamlets.
Acne: when to see a private dermatologist
Can a private GP treat acne?
Yes — a GP can prescribe effective treatments for most acne and refer to dermatology if it is severe, scarring or not responding.
When should I see a dermatologist for acne?
If acne is severe, leaving scars, or not improving with standard treatment, a dermatologist can offer stronger options.
Can I be seen the same day?
Yes — same-day private appointments are available most days at our Whitechapel clinic, no referral needed.
Will treatment prevent scarring?
Treating acne early and effectively reduces the risk of scarring, which is much harder to treat once established.
Is there a private dermatologist near me for acne in East London?
Yes — our private dermatology clinic in London is on Whitechapel Road, close to Canary Wharf and the City, offering acne assessment and prescription treatment without a referral.
Can I get treatment for acne scarring?
Yes — once active acne is controlled, our skin rejuvenation service and dermatology team can advise on evidence-based options for acne scarring.
Dermatology without the wait
Same-day appointments most days, 7 days a week, 9am–7pm, on Whitechapel Road.