Acne

Certain groups are more likely to experience acne, or more severe forms of it:

• Teenagers and young adults — hormonal changes during puberty make this the peak period for acne, though it affects people of all ages
• Women in their 20s, 30s, and 40s — hormonal or "adult" acne is common in women, often flaring around the menstrual cycle and along the jawline
• People with a family history of acne — genetics play a meaningful role in both the likelihood and severity of acne
• People with hormonal conditions — such as polycystic ovary syndrome
• People using certain medications or skincare products — some products and medications can trigger or worsen breakouts

‍

Treatment is tailored to the type and severity of acne, and often combines more than one approach:

• Topical retinoids — vitamin A-derived creams that unclog pores and prevent new comedones from forming, considered a cornerstone of most acne treatment plans
• Benzoyl peroxide — reduces the bacteria associated with acne and helps clear blocked pores, available over the counter and in prescription strengths
• Topical antibiotics — used to reduce inflammation and bacterial activity, generally in combination with benzoyl peroxide or a retinoid to reduce the risk of antibiotic resistance
• Azelaic acid — a topical treatment that reduces inflammation and can also help with the pigmentation acne sometimes leaves behind
• Oral antibiotics — used for a limited course in more inflammatory or widespread acne, alongside topical treatment
• Hormonal treatments — such as the combined oral contraceptive pill or spironolactone, particularly useful for hormonal acne in women
• Isotretinoin — an oral retinoid used for severe, cystic, or scarring acne that hasn't responded to other treatments, requiring close medical supervision due to its potency and side-effect profile

Most treatments take six to eight weeks to show visible improvement, and a full response can take several months, so your dermatologist will usually review and adjust your plan rather than expecting immediate results. A good skincare routine — gentle cleansing and non-comedogenic, oil-free products — supports whichever treatment plan you're on, but on its own is rarely enough for anything beyond very mild acne.

‍

Despite the name, fungal acne isn't acne at all — and it doesn't respond to acne treatment, which is why the distinction matters. It's actually a yeast overgrowth in the hair follicles, medically known as Malassezia (or Pityrosporum) folliculitis, caused by an overgrowth of yeast that naturally lives on everyone's skin.

Fungal acne tends to look different from true acne on close inspection: it typically presents as small, uniform, itchy red bumps rather than the mixed lesion types (blackheads, larger inflamed pimples, cysts) seen in true acne, and it commonly appears on the chest, back, and shoulders, though it can affect the face too. It's often worse with heat, humidity, sweating, and occlusive skincare or clothing.

Because fungal acne is caused by yeast rather than bacteria, standard acne treatments — particularly antibiotics — don't help and can sometimes make it worse by disrupting the balance of organisms on the skin. It's treated with antifungal medication instead, which is why an accurate diagnosis matters before starting treatment.

‍

Acne scarring is treated differently to active acne, and treatment is usually considered once breakouts are under control. Options depend on the type and severity of scarring and can include:

• Laser resurfacing — carbon dioxide or erbium lasers that resurface the skin and stimulate new collagen, used for scarring that is severely disfiguring
• Physical therapy — subcision, TCA cross and dermal fillers can be used to improve the appearance of acne scarring.
• Other in-clinic procedures — including techniques to release tethered, depressed scars, chemical peels, and skin needling, chosen based on the specific pattern of scarring

Because eligible treatments for severe acne scarring are more involved procedures with specific clinical criteria, they're best discussed directly with your dermatologist, who can assess your scarring and recommend the most appropriate option.

‍