Understanding Acne

Dr Catherine Fernando

IYASU Healthcare

East Lothian's Private GP Service

Explains how lifestyle and medical therapy can help acne.

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What is acne?

Acne is a long-lasting skin condition that causes:

• blackheads and whiteheads

• small red bumps

• pus-filled spots

• deeper, painful lumps

It usually appears on the face, chest, and back.

Acne is very common—most people get it at some point, usually starting in the teenage years. For many, it improves by their early 20s, but some adults continue to have acne later in life.

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Who gets acne?

• About 85% of people aged 12–24 experience acne.

• Teen boys tend to have more severe acne.

• In adults, acne is more common in women.

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Why does acne happen?

Acne develops when:

1. Hormones (especially during puberty) tell the skin to produce more oil.

2. Pores become blocked, forming blackheads and whiteheads.

3. Bacteria on the skin can then cause inflammation, leading to red or painful spots.

Acne is not caused by poor hygiene, and it’s not your fault.

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Looking After Your Skin

Good daily skin care can make a big difference. Try to:

✅ Use a gentle cleanser once or twice a day
✅ Choose oil-free or “non-comedogenic” (non-pore-blocking) products
✅ Avoid harsh scrubs, toners, or heavily fragranced products
✅ Keep hair products away from the skin
✅ Do not squeeze or pick spots—this increases the risk of scarring

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What about diet?

Some people notice that sugary or highly processed foods make acne worse.
There’s no proven “acne diet”, so the safest advice is to:

• eat a balanced diet

• include fruits, vegetables, and whole grains

• avoid extreme dieting

If you’re worried about food or eating habits, speak to a healthcare professional.

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Other Causes to Be Aware Of

Sometimes acne-like symptoms have another explanation. Speak to a doctor if:

• periods are irregular

• there is unwanted hair growth

• new acne appears after starting a medication

• you are using steroids or testosterone

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How Severe Is Your Acne?

Doctors consider:

• the number of spots

• whether there are deep, painful lumps

• whether scarring is starting

 

When acne needs urgent help

Rarely, acne can suddenly become very painful with sores, fever, or joint pain.
This is an emergency—seek same-day medical care.

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Emotional Wellbeing Matters

Acne can affect confidence at any age. Even mild acne may lead to:

• low mood

• anxiety

• poor self-esteem

• social withdrawal

Tell your doctor if you are struggling—they can offer support and referrals.

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Treatment Options

Most acne can be managed starting in primary care (your GP).

Common treatments include:

Topical treatments (creams and gels): including ingredients such as

• retinoids

• benzoyl peroxide

• azelaic acid

• antibiotics

• anti-androgens

These ingredients can reduce the number of acne lesions because they help to reduce sebum, unblock pores are reduce inflammation. However, they may cause dryness and irritation fo the skin, especially in the first few weeks of use.

Oral Antibiotics may be used for more widespread or severe acne, but only for limited periods to prevent resistance.

Hormonal treatments (for women only) may help, especially if acne flares before periods.

Isotretinoin is a specialist medication for severe or scarring acne.
It is prescribed only by a consultant dermatologist, so unfortunately we cannot prescribe this treatment at IYASU Healthcare. It requires careful monitoring.

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What to expect

• treatments take 6–8 weeks to start working

• your GP will review progress after about 12 weeks​

 

The Bottom Line

Acne is common and treatable.
You are not alone—and help is available. At IYASU Healthcare we specialise in seeing people with dermatological conditions.Everyone deserves access to accurate diagnosis, supportive care, and effective treatment. If you are struggling with acne, make an appointment to see Dr Catherine Fernando at IYASU Healthcare.