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What is acne?
Acne is a common skin condition that you can experience at any point in your life, and can vary in severity. Some patients develop 1 or 2 spots at a time, whereas those with extensive acne can have widespread, numerous spots on the face, back and chest.
Treatments we offer for acne depends on the severity of the condition and your personal needs. These can include:
- topical treatments to reduce bacteria on the skin surface and control oil production
- oral antibiotics or retinoids like Isotretinoin (Roaccutane) to combat severe acne
- contraceptive pills or other hormonal tablets can also be used to treat acne related to periods or conditions that cause a hormonal imbalance
You may also need treatment for acne scarring.
Our adult skin specialists at St John’s Dermatology, our private dermatology service at Guy’s Hospital, are world-renowned experts in delivering personalised, effective acne treatments – including treatment for acne scarring.
Experts in acne treatments
Our world-renowned consultants offer:
- fast and accurate diagnosis of acne
- short notice appointments
- personalised, effective acne treatments
Symptoms of acne
Several types of spots can appear with acne and you may experience more than one kind at a time.
The most common types of spots in acne are:
- blackheads – small bumps on your skin that look dark or ‘black’ and may pop out of the skin if squeezed
- papules – small red bumps that are often sore
- pustules (or whiteheads) – like papules, except they have a white dot at the centre caused by pus build-up
- nodules – large, painful bumps that develop under the skin
- cysts – a severe type of spot filled with pus and carrying a higher risk of scarring
You can develop different types of acne:
- cystic acne – causes deep nodules and cysts
- hormonal acne – overproduction of sebum drives acne. Sebum is an oily substance produced by your body to keep your skin moisturised. It is more common in women as hormonal changes affect it.
- nodular acne – a severe form of acne that causes spots and nodules under the skin
- fungal acne – caused by a sensitivity to yeast build-up in the oily parts of the skin, such as the hair follicles
Each type of acne carries a risk of scarring and skin damage, so it’s vital to seek medical advice if self-care remedies do not help or if your acne is severe and greatly disrupts your life.
If you would like to speak to one of our dermatology consultants, you can contact our team to arrange an appointment.
Causes of acne
Different factors can cause acne, but it is usually due to a combination of the following factors:
- excessive production of sebum
- blocked hair follicles
- presence of specific bacteria on the skin
- inflamed skin
Risk factors for acne
Some adults may be at a higher risk of developing acne than others and certain things can worsen or trigger acne.
Hormonal changes during pregnancy, menstrual cycles and menopause can lead to hormonal acne developing. The reason is that certain hormones increase the amount of sebum your body produces. It can also affect the lining of your hair follicle, leading to changes in skin bacteria that causes inflammation and pus and blocks your pores.
Other risk factors may include:
- a family history of acne
- wearing tight or restrictive clothing
- stress
- using oily products on the skin that block pores
- certain medications
Our dermatologists can help treat the underlying causes of acne. Get in touch with our team to book an appointment at a time that’s convenient for you.
Diagnosing acne
A physical skin examination typically diagnoses acne. Our consultants may also ask about any other symptoms you experience and whether you notice any pattern in your acne outbreaks.
We may also ask questions about:
- your menstrual cycle, pregnancy or menopause
- any stress you’re experiencing
- medications you’re taking
- any family history of acne
- at-home measures you may have tried
Often, acne does not need diagnostic tests unless our dermatologists suspect an underlying condition is causing or worsening your acne. If you would like to speak to one of our consultants about your symptoms, get in touch with our team to book an appointment.
Adult acne treatment
We provide specialist adult skin care services as part of St John’s Dermatology at Guy’s Hospital, to help you effectively manage and find relief from acne. Treatment for your acne will also depend on its severity and your unique needs.
We also provide treatments for acne scarring, find out more about scar treatments here.
Topical treatments
Topical acne treatments are lotions, gels or creams you apply directly to the skin. These may alleviate mild to moderate acne. You usually apply topical treatments to your skin after washing the affected area.
Common topical acne treatments include:
- benzoyl peroxide – an antiseptic that reduces bacteria on the skin’s surface
- topical retinoids – remove dead skin cells from your skin’s surface and prevent build-up in the hair follicles and also control oil production
- topical antibiotics – alter bacteria on the skin’s surface which may cause hair follicles to become inflamed
Oral antibiotics
You usually take oral antibiotics or antibiotic tablets alongside topical treatments to combat severe acne. Oral antibiotics may alter the bacteria on your skin and inflammation in severe forms of acne.
Contraceptive pills and spironolactone
If your acne flares up in sync with your period or is associated with a hormonal condition like polycystic ovary syndrome (PCOS), our dermatologists might advise trying the contraceptive pill or a medication named spironolactone. They may also recommend this if your acne does not respond to topical treatments and oral antibiotics.
The contraceptive pill may reduce sebum production, potentially reducing acne. It can take up to 1 year for the pill to take full effect on your acne. Spironolactone is a medication licensed for managing blood pressure which has been shown to be helpful in selected female patients who develop acne after teenage years.
Isotretinoin
Isotretinoin (also known as Roaccutane) is a medicine based on Vitamin A. It is used for severe acne with scarring, or persistent acne which has not responded to other tablet medications. It works by shrinking the oil producing glands, prevents clogging of the pores and settles inflammation of the follicles. It is usually given as a 6- to 8-month course, which is effective in the long term for most patients.
If you would like to speak to one of our dermatology specialists about treatment options for acne, contact our team to arrange an appointment.
Reviewed regularly to reflect clinical best practice
Last reviewed: 09 March 2026
Locations
Our dermatology services are available at the following locations:
Discover our dermatology experts
Acne can be a painful condition that’s difficult to manage daily. However, our experienced dermatologists provide personalised acne treatments and aftercare advice to help you effectively manage your acne.