Acne develops within the hair follicles and oil glands of the skin. Several factors contribute, including increased oil production, blockage of the hair follicles, changes in the normal skin bacteria and inflammation.

Hormonal changes are particularly important during puberty and can also contribute to acne in adults, particularly women. Acne can sometimes be associated with hormonal conditions such as polycystic ovary syndrome, also known as PCOS.

Genetics also play a role, with acne often running in families.

Acne is not caused by poor hygiene. Excessive washing, scrubbing and harsh skincare can irritate the skin and make acne worse.

Acne naturally fluctuates and different people have different triggers. Factors that may contribute include:

• Hormonal fluctuations, including around periods

• Stress

• Oily or occlusive skincare, makeup and hair products

• Picking or squeezing pimples

• Heat, humidity and sweating

• Friction from helmets, masks, sports equipment or clothing

• Certain medications

• Diets high in refined or high glycaemic index foods

Some people also notice an association between dairy intake and acne. Dietary triggers are individual, and restrictive diets are generally not necessary.

Acne can appear on the face, chest, shoulders and back.

It may include:

• Blackheads and whiteheads

• Red pimples and pustules

• Deep, painful nodules

• Cysts

• Red or brown marks left after pimples have healed

• Depressed or raised acne scars

Deep inflammatory acne is more likely to cause permanent scarring, which is one reason early treatment can be important.

Acne is usually diagnosed by examining the skin. Your dermatologist will assess the type and severity of your acne, whether there is scarring or pigmentation, and what treatments you have previously tried.

We may also ask about your menstrual cycle, medications, skincare routine and other symptoms. Blood tests are not usually required, but may be recommended when there are signs of an underlying hormonal condition such as PMOS (previously PCOS).

Treatment depends on the type and severity of your acne. Your dermatologist may recommend topical treatment, oral medication, hormonal treatment or a combination.

Topical treatments can include:

• Retinoids such as tretinoin, adapalene or trifarotene

• Benzoyl peroxide

• Azelaic acid

• Combination acne treatments

For more persistent or inflammatory acne, oral treatments may be appropriate. These can include antibiotics, hormonal treatments such as spironolactone in suitable women, or isotretinoin.

The aim of treatment is not just to clear existing pimples, but to prevent new acne and reduce the risk of permanent scarring.

Isotretinoin is an oral retinoid and one of the most effective treatments for persistent, severe or scarring acne. It works on several of the underlying causes of acne, including reducing oil production, preventing blocked pores and reducing inflammation.

It may be considered when:

• Acne is severe or widespread

• Acne is causing scarring

• Other treatments have not worked adequately

• Acne repeatedly returns

• Acne is having a significant impact on quality of life

Isotretinoin requires medical supervision. Your dermatologist will discuss potential side effects, monitoring and pregnancy prevention requirements before and during treatment.

Dry lips and dry skin are very common. Treatment usually continues for several months, with the dose and duration tailored to the individual.

Acne can leave permanent changes in the skin, particularly after deep inflammatory acne. The most common depressed scars are ice pick, boxcar and rolling scars.

Treatment depends on the type and depth of scarring and may involve more than one procedure. Active acne should generally be controlled before scar treatment begins.

At Mermaid Beach Dermatology, we assess your individual scars and skin type before recommending treatment. Options may include:

• Fractional CO₂ laser

• Subcision

• TCA CROSS

• Punch techniques

• Treatments for persistent redness or pigmentation

• Combination treatment approaches

Fractional CO₂ laser can be used for selected patients with depressed acne scars. It creates microscopic areas of controlled injury in the skin, stimulating collagen production and skin remodelling.

Over time, this can soften the appearance of scars and improve overall skin texture. Several treatments may be required, and improvement develops gradually over the following months.

CO₂ laser is not suitable for every scar or every skin type. Your dermatologist will consider your scar type, skin colour, pigmentation risk and previous treatments before recommending resurfacing.

The goal of acne scar treatment is improvement rather than complete removal of scars.

A simple skincare routine can make acne treatment easier to tolerate.

Use a gentle cleanser twice a day and avoid scrubbing or abrasive exfoliation. A non-comedogenic moisturiser can help protect the skin barrier, particularly when using prescription acne treatments.

Daily sunscreen is also important. We recommend a broad spectrum SPF 50+ sunscreen that is comfortable for acne-prone skin.

Avoid picking or squeezing pimples as this can increase inflammation and the risk of scarring.

A balanced diet is preferable to restrictive diets. Some people may benefit from reducing highly refined, high glycaemic index foods, but there is no single diet that works for everyone with acne.

You do not need to wait until your acne is severe before seeking specialist advice.

A dermatologist may be particularly helpful if:

• Your acne is leaving scars

• You have painful nodules or cysts

• Your acne is widespread or affecting your back or chest

• Over-the-counter treatments have not worked

• Your acne keeps returning

• Your acne started or worsened in adulthood

• You think hormones may be contributing

• You are considering isotretinoin

• Acne is affecting your confidence or quality of life

Early treatment can help reduce the risk of permanent scarring.

At Mermaid Beach Dermatology, acne is treated as a medical skin condition rather than simply a cosmetic concern.

Our dermatologists take the time to understand your acne, previous treatments, lifestyle, hormonal factors and risk of scarring before developing an individual treatment plan.

Treatment may include prescription skincare, oral medication, hormonal treatment, isotretinoin and, once active acne is controlled, treatment of acne scarring.

Our aim is to achieve long-term acne control while minimising side effects and preventing permanent scarring.

If acne is affecting your skin, confidence or quality of life, you do not have to simply wait for it to improve. A personalised dermatology assessment can help you understand your options and develop a treatment plan that is right for you.