Acne treatment (Management of acne vulgaris)

What is acne treatment?

Acne is a very common skin condition where hair follicles become blocked with oil and dead skin, leading to blackheads, whiteheads, red spots and sometimes deeper, painful lumps. It mainly affects the face, but also the chest and back. It is most common in teenagers but can affect adults too.

The aim of treatment is to control the spots, prevent new ones, and reduce the risk of permanent scarring and the distress acne can cause. Acne is not caused by poor hygiene, and it usually needs proper treatment over months rather than quick fixes.

Treatments are matched to how severe the acne is. They range from creams and gels, through antibiotic tablets and hormonal treatments, to isotretinoin (a strong tablet for severe acne) which is started only by a specialist dermatology team because of its side effects and monitoring requirements.

This guide explains the options, how long they take, and what to discuss with your clinician. It is not a substitute for personal medical advice.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Mild vs severe acne treatment

Most acne is managed in primary care. Severe, scarring or treatment-resistant acne, or major distress, should prompt referral to a dermatologist.

Preparing for your treatment

• Be ready to describe how long you have had acne, what you have already tried, and how it affects you.
• Bring a list of all your medicines, including the contraceptive pill, and any supplements.
• Tell the clinician if you could be pregnant, are planning pregnancy, or are breastfeeding, as this affects which treatments are safe.
• Mention any history of low mood, anxiety or other mental-health problems, especially if isotretinoin might be considered.
• Avoid harsh scrubbing, picking or squeezing spots, which can worsen scarring.
• Be prepared to give treatments several weeks before judging whether they work.
• Ask what to expect, including any early worsening or skin irritation.

What happens

At the appointment, the clinician asks about your acne, looks at the affected skin, and assesses how severe it is and whether it is leaving scars or affecting your wellbeing. They will ask what you have already tried.

They then suggest a treatment matched to the severity, often starting with creams or gels, adding antibiotic tablets or hormonal treatment if needed. You will usually be asked to keep using the treatment for several weeks before reviewing how it is working.

If acne is severe, scarring, or not responding, you may be referred to a dermatologist to consider isotretinoin. Your first appointment is done in person; later reviews may sometimes be done remotely if that is appropriate for you. Isotretinoin is started by a specialist with the right expertise (since January 2026 a routine second prescriber is no longer needed for people under 18, though the specialist must still have suitable experience). Before treatment starts there is a fuller discussion of benefits and risks, baseline checks, and, for anyone who could become pregnant, strict pregnancy-prevention measures. Your specialist should also ask about your mental health and any effects on sexual function before you start and at every follow-up.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The biggest specific concerns relate to particular treatments. Hormonal treatments carry a small blood-clot risk; antibiotics should not be used long-term on their own; and isotretinoin needs careful handling. If you could become pregnant, be clear about safe contraception and which treatments must be avoided in pregnancy. Tell your clinician about any mental-health history. Ask how long to wait before judging a treatment, and what to do if it does not work.

Published figures to discuss

How well acne responds, and how likely it is to relapse, varies widely by severity, type, age and treatment, so single percentages can mislead. Side-effect rates also differ between treatments. The points below describe realistic uncertainties rather than precise figures, because robust, comparable rates for individuals are limited.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no procedure to recover from. 'Afterwards' here means how your skin responds over the weeks and months of treatment, which is usually gradual.

• Dry, peeling or slightly irritated skin in the first weeks
• A possible flare or worsening before improvement
• Gradual rather than instant clearing of spots
• Needing to keep treatment going for months
• Some marks fading slowly after spots heal

Aftercare

• Use treatments exactly as directed and give them several weeks before judging them.
• Moisturise and use sun protection, as many acne treatments dry the skin and increase sun sensitivity.
• Avoid picking or squeezing spots to reduce scarring.
• Use reliable contraception if you could become pregnant and are on a treatment that requires it.
• Attend reviews and any blood tests, especially if you are on isotretinoin.
• Report low mood, anxiety or thoughts of self-harm promptly, particularly on isotretinoin.
• Tell your specialist about any sexual side effects, such as a lower sex drive or difficulty getting an erection, so they can be recorded and reviewed at each visit.
• Do not stop or share prescription treatments without advice.
• Tell your clinician if a treatment is not working so the plan can be changed.

• A clear written treatment plan and how long to use each treatment
• A non-comedogenic moisturiser and sunscreen
• A reminder of your review date
• Reliable contraception arranged if needed
• A note of which symptoms (including mood changes) to report
• Contact details for your prescriber or dermatology team

⚠ Get urgent help if…

• Low mood, anxiety, or thoughts of harming yourself — seek help straight away, especially on isotretinoin
• A possible pregnancy while taking isotretinoin or another treatment unsafe in pregnancy
• Signs of a blood clot on hormonal treatment: a swollen, painful calf, or sudden breathlessness or chest pain
• A severe skin reaction, widespread rash, blistering, or swelling of the face or lips
• Severe abdominal pain, persistent headache or visual changes on isotretinoin
• Acne becoming severe, very painful or rapidly scarring
• Signs of a serious infection while on treatment

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is clearer skin with fewer new spots and, ideally, no new scarring, achieved gradually over weeks to months. For severe acne, isotretinoin can give long-lasting clearance in many people, though acne occasionally returns and needs further treatment.

No treatment is guaranteed to clear acne completely or permanently, and results vary from person to person. Treating acne well and early matters most for preventing scars, because established scars are difficult to remove fully even with later treatment. If a treatment is not working after a fair trial, the plan should be changed rather than continued indefinitely.

Acne often settles with age, but it can persist into adult life or come and go over years, so some people need maintenance treatment. Antibiotics are used in courses rather than long-term. Isotretinoin can produce lasting improvement, but a proportion of people relapse and may need a further course or other treatment. Your clinician can give a realistic idea based on your acne.

Related tests, treatments or support

Acne treatments are often combined, for example a topical retinoid or benzoyl peroxide with an antibiotic, to work better and reduce resistance. Treatment of acne scarring is considered separately, only once active acne is controlled. For some women, hormonal treatment may be combined with topical treatments. Your clinician will explain sensible combinations.

Follow-up & long-term care

You will usually be reviewed after several weeks to check whether treatment is working and adjust it. Antibiotic and hormonal treatments are reviewed over months. Isotretinoin involves regular specialist reviews with blood tests and, where relevant, monthly pregnancy testing and mental-health checks. You should know who to contact if a treatment is not working or you have side effects.

• Continue any maintenance treatment, such as a topical retinoid, if advised to prevent relapse.
• Keep a simple, gentle skincare routine and use sun protection.
• Avoid picking or squeezing spots.
• Return if acne flares again or starts to scar.
• Keep up contraception and monitoring for as long as a treatment requires it.

Repeat, follow-on and what comes next

• Acne treatment is often adjusted, with treatments switched, combined or stepped up if the first plan does not work.
• Antibiotics are stopped after a course rather than continued long-term.
• Some people relapse after isotretinoin and need a further course or other treatment.
• Scarring is addressed separately and may need more than one treatment, with limited improvement.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear plan with realistic timescales and a defined review point.
• Proper monitoring for isotretinoin: blood tests, pregnancy prevention, and checks on mental health and sexual function before treatment and at every follow-up.
• A named contact for side effects or treatment failure.
• Advice on gentle skincare, sun protection and not picking spots.
• Honest discussion of scarring and when it can be addressed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The severity of acne and the type of treatment needed
• Whether treatment is creams, antibiotic or hormonal tablets, or specialist isotretinoin
• The clinician's fee (GP or dermatologist) and number of appointments
• Blood tests and monitoring, particularly for isotretinoin
• The cost of prescribed medicines
• Any later treatment for acne scarring, assessed separately
• Follow-up reviews over the months of treatment

• The specialist's consultation and review fees
• The cost of medicines and any monitoring blood tests
• How many follow-up appointments are included
• What is covered if treatment needs to be changed
• Whether pregnancy testing and monitoring are included for isotretinoin
• What happens, and who to contact, if you have side effects
• Whether scarring treatment is included or charged separately

On the NHS? Acne is commonly treated on the NHS, with GP-led care and referral to a dermatologist for severe, scarring or treatment-resistant acne and for isotretinoin; private care is used mainly for speed or choice of specialist.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• How severe is my acne, and is it likely to scar?
• Which treatment do you suggest first, and how long before I should see a difference?
• Are any of these treatments unsafe if I might become pregnant?
• When should I be referred to a dermatologist or considered for isotretinoin?
• What side effects should I watch for, and what should I report urgently?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for acne treatment

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Acne (treatment) NICE — Acne vulgaris: management (NG198) British Association of Dermatologists — Acne (patient leaflet) MHRA — Isotretinoin (Roaccutane): reminder of important risks and precautions GOV.UK — Isotretinoin: new safety measures including oversight for under-18s MHRA — isotretinoin: changes to prescribing guidance and additional risk-minimisation measures (Jan 2026)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.