What it is
Acne is a disease of the oil gland and the hair follicle: blocked follicles become blackheads and whiteheads, inflamed ones become red papules and pustules, and in some people deep tender nodules and cysts. The visit starts with an examination that records which lesion types are present, how widely, and what has already been used — including creams bought without a prescription and unlabeled mixed creams. The plan is usually topical, with oral treatment added when the disease is widespread or when every lesion is leaving a mark or a scar behind it.
What this page covers
- Acne consultation, grading and baseline clinical photography
- Comedonal acne (blackheads and whiteheads)
- Inflammatory papulopustular acne
- Nodulocystic acne
- Adult female and hormonal acne, with androgen and PCOS screening where the history indicates it
- Truncal acne of the back, chest and shoulders
- Acne mechanica and folliculitis under a niqab, mask or tight scarf
- Acne excoriée (picking-driven acne)
- Pomade and cosmetic acne at the hairline and temples
- Drug-induced and steroid acne from unregulated mixed creams (الخلطات), supplements and anabolic agents
- Malassezia (pityrosporum) folliculitis, which is mistaken for acne and does not respond to acne treatment
- Gram-negative folliculitis after prolonged antibiotic use
- Topical retinoids, benzoyl peroxide, azelaic acid, clascoterone, dapsone gel and fixed combinations
- Topical and oral antibiotic courses with antibiotic stewardship
- Oral isotretinoin, with pregnancy-prevention counseling, side-effect management and laboratory monitoring
- Combined oral contraceptive and spironolactone for hormonal acne
- In-clinic comedone extraction
- Intralesional triamcinolone for a single inflamed cyst
- Superficial salicylic and mandelic peels as an acne adjunct
- Post-inflammatory hyperpigmentation (the brown marks) and post-inflammatory erythema (the red marks) after acne
- Post-acne scarring assessment and handover to the scar plan
- Skincare, cleanser, makeup and sunscreen counseling; an honest diet, dairy and supplement discussion
- Acne fulminans and acute severe flare, seen the same day
Honestly
Acne is controlled rather than cured, improvement is counted in months and an early flare of small spots is expected rather than a sign of failure; on Fitzpatrick III–VI the dark marks left behind outlast the spots by months, and no honest plan puts a date on them. Facials and in-clinic light sessions are support alongside a medical plan, not a replacement for one — a patient sold a course of facials for scarring acne loses the months that mattered.