Common questions and answers about acne treatments including:

Creams and tablets, myths and facts, our clinic, and roaccutane treatment for acne.

Creams and tablets for Acne

 

Almost everyone will grow out of acne, but we cannot give an exact date as to when you should stop acne treatment. If you are using acne treatment creams, your acne should start to improve within 6 weeks. Cream and antibiotic treatments can be continued for several months. In severe cases of acne a course of Roaccutane tablets may last for 6-9 months. Hormonal acne may need control for several years. Diet related acne can be improved within weeks, and maintaining a sensible diet for life can keep you blemish free!

Our Specialists can tailor a treatment program based upon lifestyle factors such as sunexposure, and pregnancy plans.

In many cases of acne in females, the pill can be an effective treatment. If your acne tends to flare with your period cycles, you may want to consider the following types of oral contraceptive pills-  Diane, Brenda, Estelle, Yaz, or Yasmin. It may take up to 3 months before you notice maximal anti-acne effects on the pill.

Discuss with your GP the safety profile of the pill and how it can reduce your acne outbreaks. Other forms of contraception such as the Depo injection can worsen acne.

More on hormonal treatments for acne

Various prescription creams are available for acne patients. These treatments are safe, effective and cost effective. In fact one of the best cream treatments for acne is listed on the PBS and is subsidised by the Government. For more details on what prescription creams to use, speak to your GP or make a booking to see our Specialists.

Our prescription creams most frequently used at the Acne Specialist Clinics include

  • Topical antibiotics
  • Topical Vitamin A Creams
  • Benzoyl Peroxide and Vitamin A creams
  • Compounded acne creams for treating bacne
  • AHA and BHA lotions and creams

Several classes of tablets can be used to treat acne, and they all work in a different way.

Antibiotics are frequently prescribed by GPs and Specialists. Antibiotics work by reducing inflammation as well as reducing the number of bacteria in the acne lesions. Antibiotics take 6-10 weeks to start working and can be safely used for up to 12-18 months. Most specialists will try to limit courses to less than 6 months.

Vitamin A can be prescribed in a capsule, and this is commonly known as Roaccutane or Oratane. Specialists may consider this tablet if your acne is severe, scarring, or if other treatments don't work. Most patients will need a course lasting between 6-12 months.

Female patients may benefit from tablets that control hormones. These tablets such as the pill and anti-hormones can improve hormonal acne.

More on Tablets for acne

Myths & Facts

 

Absolutely. In fact even the most severe forms of acne can be effectively treated and cured. Our specialists use scientifically proven medications with a long safety record. Dermatologists at the Acne Specialist Clinics employ a vast array of methods to treat and cure acne including creams, tablets, chemical peels, and acne light phototherapy. We can also prevent or treat any scarring associated with acne and pimples.  Our Specialist group treats all forms of acne including childhood acne, teenage acne as well as adult onset acne. Our expertise coupled in the very latest in technology ensures that every case of acne can be sorted!

This myth is true! Research has shown that acne can be related to diet in some but not all patients. Eating a healthy well balanced diet, low in sugar can reduce acne counts in some patients. Several US studies have shown a correlation with milk and dairy products, however the jury is still out on this one.

A sensible diet guide endorsed by the Australian College of Dermatologist can be the first step to eating healthy to keep your zits at bay.

Download the acne free diet guide

Acne is due to a blockage of oil glands. Oils glands or sebaceous glands are located in higher numbers on the face, back and shoulders, areas mainly affected by acne. Once the oil glands are blocked, a blackhead forms. Blackheads can evolve into pustules, or zits.

The severity of acne is dependent on genetics, hormonal factors, stress, and in some cases diet. If there is a family history of acne, this may increase your likelihood of developing acne.

Developing a simple, non abrasive and gentle skin care regime is important in all cases of acne, no matter how mild or severe. Get into the habit of looking after your skin.

Simple tips for acne prone skin include -

  • Washing your face in the morning and evening, and not more often. Pat your face dry, and don’t rub
  • Don't squeeze your pimples as this can increase the chances of acne scars
  • Wait at least 15 minutes after face washing before applying any prescription creams
  • Avoid applying creams to sensitive areas, such as the angles of the mouth, or around the eyes
  • Always start with a small amount of cream, applied every second night and increase if you do not have any skin irritation

Keeping a simple and cost effective skin care regime forms the absolute basis of acne treatment. Dermatologists at Brisbane’s Acne Specialist Clinics endorse the following products.

Cleansers

Simple cleansers that do not irritate your skin are the best. Brands like Cetaphil, QV Wash, Neutrogena.

Make up

Look for the word Non Comedogenic. Use make up that won’t block your pores. Mineral make up is both talc and paraben free.

Sunscreen

Best sunscreen is La Roche Posay, oil free, light, super protective and won’t clog your pores.

Toners

Toners strip the skin of oils and do not play a role in the management of acne. Avoid alcohol based products at all costs!

Moisturiser

We endorse the Cetaphil and La Roche Posay range of products.

Most people grow out of teenage acne (however if you acne is severe it may persist into adult life). Adult acne is more persistent, and can have a significant hormonal component to it. Factors such as stress play an important role in adult acne.

Adult acne can be defined as acne over the age of 25, and often presents as painful deep cysts along the chin and jawline areas. Some people pick at these lesions as they are blind ending. It is important treat adult acne as this type of acne tends to cause scarring.  

Anti hormone treatments or a low dose of isotretinoin can be extremely effective in treating this form of acne.

Other Acne Treatments

 

Yes, in some subtypes of acne, chemical peels can be an excellent method to clear up acne! Comedomal acne or white head- black head acne seems to respond best. In some cases, one to two sessions of our Specialist strength chemical peels can markedly improve acne in one session. We use a combination of chemical peels including both Sal Acid Peel and the Glycolic AHA peel at the Acne Specialist Clinic, Westside Dermatology.

Proactive is a good treatment for some patients, but may not work so well in others. Inflammatory papular and pustular acne lesions respond best to Benzoyl Peroxide (Proactive), another cheaper but stronger option is BENZAC AC wash.

If you have scarring acne, you should consider visiting a Specialist for more effective treatments.

Acne light treatments is a form of low-level laser therapy and has been used for the treatment of mild acne and very mild early acne scars. This treatment delivers medically measured doses of LED light to the skin, and target both bacteria and early scarring.

Blue light works best to temporarily destroy bacteria, whist red light penetrates to the deeper layers of the skin to help remodel collagen. Low-level laser phototherapy is only effective if acne scars are mild, red, and if treatment is initiated early.

Dermatologists at the Acne Specialist Clinics use several forms of phototherapy, including Blue light, Red light, Photodynamic therapy and BBL Blue Filtered light. Phototherapy is a safe method of treating acne in pregnancy or in women who are breastfeeding. We do not advocate this as a sole method of acne treatment as it only produces a temporary reduction in acne lesions.

No it won’t. At best this treatment can reduce the amount of bacteria on your skin, but this treatment will not cure the underlying process of acne. This treatment is used by various cosmetic centers and beauty clinics, and can improve inflammatory acne, but your acne will most likely return if you stop treatment.

Note: Specialists also use this treatment in patients who cannot tolerate other treatments or would like a more natural approach to treating acne. Omnilux is ideal as adjunctive treatment for acne in pregnancy.

More information on The Clear Skin Program for acne and acne scars

Other Popular Questions

 

Some acne scar treatments are possible if you have active acne. Our specialists will always encourage patients to have active acne treated at the same time or prior to undertaking scar revision. Vitally important as this can prevent further scarring. Patients who are on Roaccutane// Oratane are excluded form treatments such as laser and chemical peels as the risks associated with these procedures.

Chemical peels can reduce acne lesions and treat mild scars, especially if acne is of the blackhead subtype.

For cases of moderate to severe scarring, RadioFrequency treatments can prove highly effective, especially during the early phase of acne scars

More on Radiofrequency treatment of acne scars

Scar treatments such as Laser Resurfacing, Fractional laser and chemical peels are contraindicated in patients on Roaccutane/ Oratane. This is due to the fact that your skin will take a longer time to heal following these treatments. There is also a risk of scarring following more aggressive treatments as above.

In a group of patients who are on low dose Roaccutane, a new form of acne treatment called RF or RadioFrequency can be used in conjunction with this drug. RF does not involve laser or chemicals, but uses radiowave energy to remodel scars. Your Dermatologist will inform you regarding the suitability of this program.

More on the Acne Free RF program

Dermapen is a form of skin needling that can help improve skin texture, and mild forms of acne scarring. This works by providing hundreds of tiny holes thru the skin’s surface, in turn breaking down acne scars. Medical Dermapen treatment can be effective in the treatment of rolling and atrophic scars, however laser treatments with FRAXEL, and Fractional Lasers are usually much more effective.

Dermapen fractional resurfacing can also be used to treat acne. Using the same method of fractional treatments, needling can be used to deliver active acne-fighting creams into the deeper layers of the skin. This form of acne treatment uses very fine needles that only penetrate 0.2 mm into the upper layers of the skin. We then use a vitamin A cream immediately after treatment. Dermapen-A treatments can improve skin texture, mild scarring and decrease acne breakouts. In some cases we add OMNILUX RED PHOTOTHERAPY (not BLUE) as this increases healing time and decreases downtime.

More on Dermapen for acne scars

Yes! PCOS or polycystic ovarian syndrome is a very common hormone and metabolic disorder that affects up to 10% of Brisbane women. In fact half a million Australian women have either diagnosed or undiagnosed polycystic ovaries.

PCOS can be associated with cysts in the ovaries, weight gain, menstrual irregularities, infertility, mood changes and skin changes. Hormonal imbalances, including excess androgens account for some of these symptoms.

Skin changes associated with PCOS include acne, excessive hair (hirsuitism), skin tags, and skin discolouration. Acne associated with PCOS often occurs around the jawline area, chin and cheeks. Excessive hair growth may also occur on the upper lip, face and body.

Specialist Dermatologists will work in with your GP and Endocrinologist to manage the skin related changes of PCOS. As a guide we often use anti-hormone treatments, Vitamin A creams or tablets, and laser treatments to help with skin issues relating to PCOS. Our Westside Laser Dermatology also provides hair removal in PCOS patients.

More on hormone control of acne

Some patients do notice an improvement in their acne with light. The effects are usually short lived, and is due to the effects of UV light (especially the blue wavelengths and red wavelengths).

Light can temporarily destroy the bacteria associated with acne lesions. This forms the basis behind OMNILUX Blue and Red Light Phototherapy for acne.

Phototherapy for acne should always be combined with medical therapy to address the underlying cause of acne.

Medically prescribed phototherapy is safe, however we don’t endorse solarium use as this form of treatment can be associated with skin cancer and premature wrinkling.

More on acne treatment with Omnilux

Enlarged skin pores are more common in patients with acne prone or oily skin. The first step of pore control is to reduce any underlying cause, such as acne or blackheads. Once underlying factors are controlled, Specialists can place you on a pore reduction program.

Shallow depth enlarged pores can be treated with AHA chemical peels and Vitamin A creams. Mid to deep enlarged facial pores are best treated with TCA Cross Chemical peels and lasers.

More on treating enlarged pores and reducing pore size

Excessively oily skin can occur as a stand-alone condition or occur with blackheads and acne. This condition is known as seborrhoea and usually starts around puberty, a time when hormones called androgens increase in levels. Oily skin usually affects the forehead, nose, cheeks and temples, areas of high concentrations of oil glands.

A simple skin care program can mop up excess oil on the skin, and protect the upper layers. Specialists often use anti-hormone tablets or a very low dose of Vitamin A to decrease oil production. Oily skin treatments have a 99% success rate.

More on oily skin and blackhead treatments

Contrary to commercials on TV and magazines, acne does take time to clear up. Because effective treatments are aimed at curing acne, it may take up to 8 weeks before a treatment makes a difference. Some forms of acne, such as blackhead acne can clear up quickly with chemical peels, whilst other forms of acne such as trunkal ance/ bacne will take longer to improve.

In some cases, acne may flair up during pregnancy. Acne in pregnancy most often occurs in the first 3-4 months of pregnancy, and usually improves in the last trimester. Post delivery, acne may improve with breast-feeding!

The most common scenario we encounter is that acne has been kept under control prior to pregnancy with the oral contraceptive pill. The pill, such as Diane, Yaz, Yasmin, Estelle or Juliette, keeps hormones in check, however when females cease the pill to get pregnant…acne hits!

Treating acne in pregnancy can be very tricky as we need to take into consideration the safety profile of medications and the potential effects of acne medication on the unborn baby. The retinoid class of drug (this includes Differin,  Epiduo, and Roaccutane) are absolutely contraindicated in pregnancy. High does can cause birth defects. Many other antibiotics such as the tetracycline group are also contraindicated in pregnancy.

Acne treatments with proven safety record in pregnancy include- Erythomycin, topical clindamycin (Clindatech), Duac Gel and Benzoyl Peroxide (Benzac AC wash, and Proactive).

Brisbane’s Acne Clinic also manages acne in pregnancy with a few other safe but highly effective treatments. OMNILUX Blue and Red light phototherapy can be safely used in pregnancy. These treatments do not cure acne, but can provide a level of remission. Additionally gentle fruit acid peels are safe in pregnancy.

More on treating acne in pregnancy

Hormonal acne occurs in two situations- first of all during the early teenage years. This first stage of hormonal acne is due to androgens which stimulate the oil gland to produce more oil. The second stage of hormonal acne usually occurs later in life, and can present in the late 20s through to the early 40s. This type of acne is called adult female jawline acne. This type of acne is usually deep, and presents as blind ending pimples that worsen with stress.

The severity of hormonal acne can vary from a few small red pimples on the chin to deeper scarring cyst. More severe cases of hormonal acne can also affect the chest, back and shoulders.

Treatment options include -

  • The oral contraceptive pill: Estelle, Diane, Brenda, Yaz or Yasmin
  • An anti-hormone tablet such as Spironolactone
  • A course of Roaccutane

Our Specialists will decide as to what is the best treatment option for you, and this will depend on your pregnancy plans, and lifestyle factors.

More on hormonal control for acne

The daily use of a high factor SPF should be part of your skin care regime, including acne treatments. Sunscreen can protect you from the harmful UV rays, but can also decrease the incidence of certain types of scarring, especially in darker skin patients. Choosing a right sunscreen is important as most sunscreens are greasy and can block your pores. The Acne Specialist Clinic endorses ‘La Roche Posay’. It’s light, non-greasy and is the number one sunscreen of choice for Specialist clinics Worldwide.

Comedomal acne is also known as Blackhead acne and is one of the easiest forms of acne to treat. In fact with a chemical peel as much as 50-80% can be improved over a matter of a week or two.

Blackheads are due to keratin build up- essentially skin-cells plugging up your oil gland. Treatments are aimed at unplugging this build up, then preventing the keratin plug from reforming.

Treatments include -

  • Chemical peels with sal acid or glycolic acid
  • Vitamin A creams
  • Or gentle extractions under local anaesthetic creams

Specialists at Brisbane’s Acne Specialist Clinic not only will find a solution to treat blackheads, but will also devise a program to ensure they won’t come back!

More on chemical peels for acne

Roaccutane treatment of Acne

 

Side effects are seen in all patients on Roaccutane however the question is how do we manage the side effects and what do we look for?

The most common side effect, seen in all cases of patients, include drying of the lips and skin. Using a simple moisturiser such as chap-stick or Paw-Paw ointment several times a day can reduce the dryness associated with Roaccutane. You will need to moisturise your skin daily, especially if you are prone to eczema.

Other side effects (less common) include mood changes, muscle aches and pains, and ingrown toe nails.

For a complete list of side effects we advise patients to read the product information provided with the prescription.

More on Roaccutane treatment for acne

Absolutely! Roaccutane or Oratane is only indicated for severe or scarring acne, or if everything else fails! Our Specialists are equipped with the knowledge to treat all forms of acne, including hormonal acne, adult acne, and acne in children.

In many cases we use a combination of prescription creams, tablets, phototherapy and chemical peels to treat acne without the need for Roaccutane.

Acne scar treatments such as chemical peels and lasers are not allowed in patients on Roaccutane, however our Specialist now combine a non-laser method of scar revision called RF RadioFrequency treatment, along side low doses of Roaccutane. This treatment is so successful it has been presented in National Laser conferences and will be published in International journals. RadioFrequency is a gentle method of scar remodelling, with little or no downtime. Unlike laser methods of scar revision, radiofrequency uses non-harmful radiowaves to break down collagen scars by gently heating up the dermal layers of skin.

More on the Acne Free RF Program

A course of Roaccutane/ Oratane is highly variable, and will depend on several factors including the type of acne, your side effect profile and your weight. As a guide, most patients will need to undergo a 6-8 month course, back acne patients / bacne patients will need at least 12 months.

Most Specialists now elect to use a low-dose isotretinoin regime as this has a much better side effect profile- the flip side is that patients may need to be on Roaccutane a few months longer to reach remission.

Roaccutane or Oratane is subsidised by the PBS under Specialist prescriptions. On average patients pay less than a dollar a day to be on this medication. In fact with the Government subsidy, Australia provides the cheapest avenue for isotretinoin therapy anywhere in the World.

Roaccutane or Oratane works in over 99% of cases. Most patients need only one course of this drug. A course of treatment is usually 6-8 months long.  Patients on a lower dose, will have an extended course. Roaccutane is extremely effective in treating all forms of acne, including hormonal acne, picking acne, cystic acne, bacne, adult acne, PCOS associated acne and even comedomal (blackhead) acne.

More on Roaccutane treatment for acne

Roaccutane or Oratane is also known as Isotretinoin and it is a form of Vitamin A. This tablet has been used for the treatment of severe cystic acne for the past 30 years and has received lots of publicity- both good and bad.

This drug is restricted for use in Australia, and can only be prescribed by Specialists. Isotretinoin is the most effective method of treating acne, however we reserve its use for cases of severe acne, scarring acne or acne that does not respond to ‘conventional methods.’

This drug treats the 4 scientific causes of acne including-

  1. Decreasing acne causing bacteria
  2. Decreasing inflammation (Zits and pustules)
  3. Decreasing oil production
  4. Decreasing black heads and white heads (keratin plugs)

One course of treatment will cure 80% of cases. This means that once you finish the course of treatment, your acne will not recur.

20% of patients may need a second or third course of Roaccutane.

Predictive factors for a second course of Roaccutane include-

  • Very severe acne
  • A family history of acne
  • Back acne, trunkal acne
  • Patients who do not complete a prescribed course
  • Early onset acne
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