How does the severity of your acne determine what treatment is suitable?

By Dr Magnus Lynch
MA(Cantab) DPhil(Oxon) MRCS FRCP
Consultant Dermatologist & Dermatological Surgeon

Mild acne will often respond to prescription topical treatments (creams and ointments) including benzoyl peroxide, topical antibiotics and topical retinoids. Over the counter products containing retinol, retinoids, AHAs, azelaic acid and salicylic acid can also be of benefit. Where topical treatments are not effective the next step would be tablet treatments such as antibiotics or the oral contraceptive pill (for women).

Moderate acne will not generally respond to over the counter products and also may not respond to prescription topical treatments on their own. It will often require tablet treatments such as antibiotics, the oral contraceptive pill (females only) spironolactone (females only) or isotretinoin (roaccutane).

Inflammatory acne affecting the chin and jawline area in women can be driven by increased levels of the male sex hormone testosterone (which is naturally present at low levels in women as well). Topical treatments tend to be less effective, however tablets which block the male sex hormone such as spironolactone or the oral contraceptive pill can be effective. This is often referred to as hormonal acne.

With severe acne there are widespread lesions and it is important to treat promptly and effectively to minimize scarring. This will almost always require a systemic (tablet) treatment

Related Articles

• How is acne classified?
• How do you know what the right treatment is for your acne?
• When should I consider isotretinoin (Roaccutane) for my acne?
• What treatments are effective for hormonal acne?

About Dr Magnus Lynch

I am a London-based Consultant Dermatologist and Dermatological Surgeon. My NHS practice is at Guy's Hospital and is focused on Mohs micrographic surgery and the treatment of complex skin cancers. My private practice additionally focuses on laser treatments, regenerative dermatology, rosacea, acne, pigmentation and scarring. I have particular expertise in the diagnosis and treatment of skin cancer, including minimally-invasive techniques, Mohs micrographic surgery, and facial reconstructive surgery. I studied at the Universities of Cambridge and Oxford, and completed my dermatology training and Mohs fellowship at the prestigious St John’s Institute of Dermatology. I graduated from medical school in 2003 and have worked exclusively in Dermatology since 2012.

I lead a research team at King’s College London investigating the molecular biology of skin cancer and skin cancer diagnostics, and I constantly aim to translate the latest findings into better patient care. You can learn more about my Research.

In recent years I have been involved in Media Appearances, including the Channel 5 series 'Skin A&E', where I perform skin surgeries and treat various skin conditions. Filming for the next series has recently completed and the series will be released later in 2025.

How I can help

I consult with private patients at several well-appointed and conveniently located sites across central London:

• London Bridge Hospital: Conveniently situated within The Shard, next to London Bridge station.
• Skin55 Ltd: Located at 55 Harley Street, this beautiful Edwardian building houses one of the largest private dermatology facilities in the UK with a comprehensive laser suite.
• OneWelbeck: Located close to Bond Street underground station. Mohs surgery, lasers, and other skin surgeries are performed in the state-of-the-art surgical suite here.

A new consultation is £250, a follow up consultation is £220. For more information on fees, please visit Prices.