Need help with your Acne?

There are four main factors which cause acne to develop:

1) Bacteria - particularly p.acnes

2) Hair follicles become clogged by oil or dead cells. 

3) Excess activity of hormones known as androgens

4) Excess oil production. 

 Acne Treatment Options

While there is no outright cure for acne, treatment is generally very effective. Your dermatologist will assess the severity of your acne to determine the most appropriate and safe treatment plan.

Treatment options may include the following:

Topical treatments (creams or gels) — applied to the skin, typically once daily, and include antimicrobials, benzoyl peroxide, and topical retinoids. These can be effective alone for mild-to-moderate acne, or combined with oral treatments for moderate-to-severe acne.

Oral antibiotics — tablets that target the bacteria (Cutibacterium acnes, formerly known as Propionibacterium acnes) that contribute to acne, and can also have an anti-inflammatory effect. The most commonly used group is tetracyclines (e.g. lymecycline, doxycycline, oxytetracycline). These are often prescribed alongside a topical treatment for moderate-to-severe acne as a first step.

Oral retinoids (isotretinoin) — for acne that hasn't responded to the treatments above, or for severe acne with a risk of long-term scarring, oral retinoid treatment may be suitable. The generic name for this medication is isotretinoin, though it's widely known by the brand name Roaccutane.

There have been media reports linking isotretinoin to mood changes; while this can occur, it is uncommon, and most patients find their mood improves as their acne clears. If you have a history of low mood, additional monitoring — potentially including psychiatric input — may be arranged during treatment.

Important safety information: isotretinoin causes serious harm to an unborn baby if taken during pregnancy. Anyone who could become pregnant must use effective contraception before, during, and for one month after treatment, and will need regular pregnancy testing throughout the course as part of the UK's mandatory Pregnancy Prevention Programme. Your dermatologist will discuss this with you in full before starting treatment.

Minor side effects are common and include dry lips, muscle aches, headaches, and occasional nosebleeds. Regular fasting blood tests are needed to monitor blood fat levels (particularly triglycerides), which can rise during treatment but return to normal afterwards — a small rise isn't a concern, but your clinician will ensure it stays within a safe range. Liver function is also monitored, though it's rarely affected; you should avoid alcohol, or limit it as much as possible, during treatment.

Isotretinoin tends to be very effective, with a typical treatment course of around 6 months, depending on dose and response. In most cases, acne clears completely by the end of the course and remains in remission afterwards. Occasionally, a second course is needed.

Blue light therapy — although not routinely used by clinicians, blue light therapy may benefit some patients. It uses a specific wavelength (405–420nm) thought to have an antimicrobial effect against the bacteria that contribute to acne.

Treatment typically involves two sessions per week over four weeks. It can be combined with a photosensitiser such as ALA, or used as a standalone treatment, including products available to purchase online. If considering an at-home device, choose one that has undergone rigorous clinical testing.

Dr Wernham offers acne treatment, including topical, oral, and light-based therapies, in Sutton Coldfield and Stafford.

 It's a common myth that eating greasy or oily food causes acne. While oil (sebum) produced by the sebaceous glands does play a role in acne, the oiliness of the food you eat has no direct effect on how much oil these glands produce, so greasy food itself is not a cause.

However, diet is not entirely unrelated to acne. Some evidence suggests that diets high in refined sugars and processed carbohydrates (a high glycaemic index diet), as well as dairy products — particularly skimmed milk — may be associated with worsening acne in some people. The research in this area is still developing, and the effect varies between individuals.

Making dietary changes is unlikely to replace the need for medical treatment if you have significant acne, but reducing high-glycaemic foods and monitoring your response to dairy may be worth considering alongside your prescribed treatment plan, particularly if you've noticed a pattern yourself.

Dr Wernham can discuss lifestyle and dietary factors as part of your acne assessment in Sutton Coldfield and Stafford.