Acne: pharmacist or Doctor?


Acne is a common skin condition that mostly affects teenagers. It can also affect people into early adulthood - especially women.

What is acne?

Acne is an infection of the pores (follicles) from which hair grows. Acne usually occurs on the face, shoulders, chest and back. 

What causes acne?

People used to think acne was caused by greasy food and poor hygiene, but this isn't true.

Acne happens when hormones cause our skin's oil-producing sebaceous glands to become overactive. Usually, these glands produce just enough oil (sebum) to condition our hair and skin.

When excess sebum mixes with dead skin cells it can form 'plugs’, which block the follicles. If the plugs are near the surface of the skin, they swell outwards, forming whiteheads. When the blocked follicle produces pigment, this leads to blackheads.

Excess oil aggravates the bacteria that usually live harmlessly on the skin. These bacteria might then cause papules and pustules (pimples and spots), nodules (swellings) or cysts (fluid-filled sacs) to form.

Are there different types of acne?

Acne is measured in terms of severity, ranging from mild, to moderate, to severe.

• Mild acne. This is mostly whiteheads and blackheads, mixed with a few pimples and spots.

• Moderate acne. Whiteheads and blackheads are more widespread, as are pimples and spots.

• Severe acne. Pimples and spots become enlarged and painful. There are also nodules or cysts. Severe acne can cause scarring

How is mild acne treated?

For mild acne, speak to your pharmacist. They will advise you on which over-the-counter spot creams, gels, and washes might work best when applied to your skin. Most non-prescription acne products contain the antibacterial agent benzoyl peroxide. This works by reducing the number of bacteria on the skin. Benzoyl peroxide can make your skin more sensitive to sunlight. So, you should avoid exposure to strong sunlight, as well as other sources of UV, such as sunbeds. Read the patient information leaflet which comes with the product for more information and for instruction on how to use your medicine.

Treatments for mild acne can take a month or more to work. If there’s no improvement after this time – or if you're worried in any way about your acne – consult your Doctor.

You should avoid picking or popping spots, as this leaves them open to infection and can slow down healing, which increases the likelihood of scarring. You should wash your hands before you touch your face.

How is moderate to severe acne treated?

If you have moderate to severe acne or mild acne unresponsive to self-care, visit your Doctor, who can prescribe from a range of acne treatments. These can include:

• Antibacterial creams

• Topical antibiotics which can be applied directly to the skin

• Oral antibiotics (severe acne)

For severe acne, your Doctor might refer you to a skin specialist, called a dermatologist, who can offer different treatments.

If you have acne scarring, which might be distressing for you, dermatologists can also advise on treatments. A range of cosmetic surgery treatments are available, including laser and abrasion treatments. 

Next steps

• Don’t pick or pop pimples and spots. This can cause infection and scarring

• For mild acne, visit your pharmacist for advice on over the counter treatments

• If your acne is mild to moderate, you can consider treatment through the Boots Acne Online Clinic

• Consult your Doctor for moderate to severe acne, or if you feel like your acne is have a big effect on your life