Acne is a chronic and inflammatory condition caused by a plug of skin cells obstructing the flow of sebum (an oily substance secreted by the skin’s sebaceous glands) at the neck of the hair follicles. When sebum becomes trapped in a follicle, bacteria multiply and the follicle becomes inflamed, taking on the appearance of a spot.

Acne happens in both males and females during hormonal changes, and is more frequent in males during teens and adolescence, but more prevalent in women aged 23 and above. The condition can be aggravated by some drugs, including steroids, barbiturates, and medications used in the treatment of other health conditions such as epilepsy.

Acne occurs mainly on the face, the center of the chest, the upper back, shoulders and around the neck. The most common acne spots are open comedones (blackheads), closed comedones (whiteheads), papules, pustules, nodules (firm swellings below the skin) and cysts (larger, fluid-filled swellings in the skin).


Over-the-counter or prescribed topical treatments (applied to the skin) — such as benzyl peroxide, retinoic acid, antibiotic lotions and creams containing sulphur — act by unblocking pores and removing sebum to promote healing. If topical treatment fails, long-term therapy (lasting at least three months) using oral antibiotics or the contraceptive pill can be an option.

In the case of severe acne, the use of retinoid drugs can improve the condition, but these will not usually be prescribed until other forms of treatment have failed, and must be used cautiously because they can lead to liver damage and cannot be given to a pregnant or nursing mother.

Acne cysts can be treated by intralesional therapy (injection of drugs into the acne spot) which can help prevent scarring. For those who already carry severe acne scars, dermabrasion (removal of the top layer of affected skin under general aesthetic) is occasionally used to improve the appearance. However, you will still be left with a rough complexion and it is an extremely painful treatment that would only be considered as a last resort in extreme cases.

Some beauty spas offer a cosmetic treatment for mild acne scarring whereby collagen is injected into small acne pits to plump them out. It is reported to give perceptible results, but the effects are not permanent and so the treatment must be performed repeatedly.


Orthodox treatments are rarely prescribed on the basis of looking for an underlying cause of the condition, and therefore tend to be effective when they are being used, but not always in the long term. Complementary treatments will examine a patient’s entire lifestyle and are far more likely to help find a solution, or help best optimize management of the condition.

If patients wish to address the underlying inflammatory and hormonal imbalances which promote and aggravated the condition, then acupuncture, herbal medicine, diet changes and nutritional supplements can be of great benefit.