Spots and acne: what helps and when to see a doctor

Acne is extremely common in the teenage years and early twenties, and it can knock your confidence at exactly the moment you are meeting lots of new people. The good news is that there are effective treatments; the trick is using them patiently and knowing when to get medical help.

What causes acne

• Acne starts when hair follicles become blocked with oil and dead skin cells; bacteria can then cause inflammation and pus (NHS).
• Hormone changes, such as during puberty and around periods, are common triggers (NHS).
• Greasy skin and hair products can make acne worse (NHS). Keep hair oils and heavy styling products off your forehead and face.
• Friction and pressure from phones, helmets, tight collars, straps and backpacks can trigger breakouts (Mayo Clinic). Wipe your phone screen regularly.
• Stress can make acne worse (Mayo Clinic), which is why many people notice breakouts in exam season or after a move.

Daily care that helps

• Wash twice a day with a gentle cleanser and warm water, using your hands (NHS, Mayo Clinic).
• Do not pick or squeeze spots. The NHS warns this can cause scars, and picking increases the risk of scarring.
• Do not scrub, and skip harsh scrubs, astringents and masks (NHS, Mayo Clinic).
• Use non-comedogenic or water-based moisturisers, sunscreen and make-up (NHS, Mayo Clinic).
• For acne on your chest or back, wear loose, breathable clothing (NHS) and shower after sweaty workouts (Mayo Clinic).

Pharmacy products and how to use them

• A pharmacist can recommend treatments such as benzoyl peroxide or salicylic acid (NHS). Mayo Clinic also lists adapalene, glycolic acid and alpha hydroxy acids.
• Mayo Clinic notes that creams tend to irritate skin less than gels or ointments.
• Use one product consistently. Improvement can take a few weeks (Mayo Clinic), so give it time before deciding it does not work.
• Early redness, dryness and peeling are common and often ease after about a month (Mayo Clinic). If your skin becomes very sore, stop and ask the pharmacist.
• Some acne treatments make you more likely to burn, and sun can darken marks left by spots (Mayo Clinic). Use sunscreen every day, especially in the UAE.

When to see a doctor

• The NHS says see a GP if self-treatment is not helping, you have lots of spots, or your spots are deep, painful or leaving scars.
• Also see a doctor if your skin looks infected (hot, swollen and red) or if acne is affecting your mental health (NHS).
• Doctors can prescribe stronger treatments, including creams and tablets, or refer you to a dermatologist (NHS). Prescription treatments often take 4 to 8 weeks to show results (Mayo Clinic).
• Mayo Clinic says early treatment lowers the risk of scarring, so do not wait for months hoping it will pass.
• At university, start with the campus health centre or your registered GP; in the UAE, start with your family doctor or a clinic in your insurance network.

Acne and how you feel

• The NHS notes that acne can contribute to anxiety, depression and low self-esteem. That is a real reason to get treatment, not vanity.
• Unfollow accounts that make you feel worse about your skin and be wary of anyone selling a 'miracle cure'.
• Remember that most people are far more focused on themselves than on your skin.
• If low mood is lasting or getting worse, talk to someone you trust and see the Mental Health module for where to get help.