To effectively get rid of acne, a multi-faceted clinical approach is required that targets the four primary pillars of acne pathogenesis: follicular hyperkeratinisation, excess sebum production, the proliferation of Cutibacterium acnes, and inflammation [1]. For mild to moderate cases, first-line therapy typically involves topical retinoids (such as adapalene) to prevent comedone formation and benzoyl peroxide to reduce bacterial colonisation and inflammation. When used in combination, these actives have shown a synergistic effect that significantly reduces both inflammatory and non-inflammatory lesions compared to monotherapy [2].
Consistency in a 'skincare-first' medical routine is vital for long-term resolution. This includes using a pH-balanced, non-comedogenic cleanser to maintain the skin barrier and a lightweight moisturiser to offset potential irritation from active treatments [3]. For persistent or severe cystic acne, it is essential to consult a dermatologist or GP for prescription-strength interventions, such as oral antibiotics, hormonal modulators (like spironolactone for women), or isotretinoin, which remains the gold standard for permanent remission in recalcitrant cases [4].
Acne vulgaris is a chronic inflammatory dermatosis of the pilosebaceous unit. The transition from healthy skin to an acneic state involves the disruption of the skin's microbiome and the alteration of the sebum's lipid profile, often driven by androgenic activity [1]. This biochemical shift leads to the sticking together of keratinocytes within the pore (hyperkeratinisation), creating a plug or microcomedone that traps sebum and provides an anaerobic, nutrient-rich environment for bacteria [5].
Modern dermatological science emphasises the role of the systemic inflammatory response, suggesting that inflammation is present throughout the entire life cycle of an acne lesion, even before a visible spot appears. Therefore, effective management focuses not just on 'spot treating' existing blemish sites, but on proactively modulating the entire follicular environment to prevent new lesions from forming and to minimise the risk of post-inflammatory hyperpigmentation and permanent scarring [2][6].
If you are exploring ways to manage congestion and follicular hyperkeratinisation, our Surface Purify cleanser includes Salicylic Acid to help gently clear the pores without compromising the skin's integrity. For those looking to maintain a healthy barrier during acne treatment, our Balance Biome Crème was formulated with Niacinamide and Bifida Ferment Lysate to help support the skin’s microbiome and promote a more balanced complexion.
FAQ
Which ingredients are best for hormonal acne?
Hormonal acne, often characterised by lesions along the jawline, responds well to ingredients that regulate sebum and provide anti-androgenic effects. Topical retinoids remain a cornerstone for regulating cell turnover [1]. Additionally, Salicylic Acid (a BHA) is lipophilic, allowing it to penetrate deep into the pores to dissolve excess oil and debris [3]. In clinical settings, azelaic acid is also highly favoured for its dual ability to reduce inflammation and treat the redness or 'pigment spots' left behind by hormonal flares [6].
Can diet and lifestyle help get rid of acne?
While topical treatments are primary, clinical evidence suggests that a high-glycaemic load diet can exacerbate acne by increasing insulin-like growth factor 1 (IGF-1), which stimulates sebum production [4]. Some studies also indicate a correlation between high dairy intake and acne severity in certain individuals [5]. Maintaining a low-glycaemic diet and managing stress levels may support medical treatments, though they are rarely sufficient as a sole 'cure' for moderate to severe acne [2].
How long does it take to see results from acne treatments?
Patience is critical in acne management because the follicular cycle takes approximately 4 to 8 weeks to complete [3]. Most evidence-based topical treatments require at least 8 to 12 weeks of consistent daily use before a significant clinical improvement is visible [1]. It is common to experience a 'purging' phase during the first month of retinoid use, where sub-clinical blockages move to the surface before the skin begins to clear [6].
References:
[1] Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-973. doi:10.1016/j.jaad.2015.12.037
[2] Thiboutot DM, et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. Journal of the American Academy of Dermatology. 2018;78(2):S1-S23. doi:10.1016/j.jaad.2017.09.078
[3] Del Rosso JQ. The role of skin care as an integral component in the management of acne vulgaris. Journal of Clinical and Aesthetic Dermatology. 2013;6(12):19-27.
[4] LaRosa CL, et al. Consumption of dairy in relation to acne in post-adolescent women. Journal of the American Academy of Dermatology. 2016;74(6):1097-1103. doi:10.1016/j.jaad.2016.01.034
[5] Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis. Clinical, Cosmetic and Investigational Dermatology. 2015;8:371-388. doi:10.2147/CCID.S69135
[6] Australian College of Dermatologists. Acne Vulgaris Clinical Treatment Guidelines. Australasian Journal of Dermatology. 2021;62(3):281-285. doi:10.1111/ajd.13600
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any new skincare regimen. Content reviewed by a biomedical scientist.
