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Acne Q&As

Published by Bupa's health information team, December 2008.

Answers to questions about acne

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

What's the best way to apply benzoyl peroxide?

You should apply the benzoyl peroxide once or, if necessary, twice a day after washing the affected area. Benzoyl peroxide is available in several different formulations. You may find some suit you better than others.

Explanation

Although benzoyl peroxide is present in many commercial acne remedies, you can buy it on its own as a cream, a gel or a wash over-the-counter.

It's worth trying different types and seeing which works best for you. For example, you may find some formulations, such as the wash, better suited to acne on your body, while others, like the cream or gel, may be easier to apply, or more effective, on your face.

Benzoyl peroxide may cause red, irritated and scaling skin when you first use it. Irritation may be lessened by using a weaker preparation. However, as you continue to apply it regularly, your skin usually develops a tolerance to benzoyl peroxide and the irritation should improve.

Benzoyl peroxide comes in different strengths, including 2.5 percent, 4%, 5% and 10%. Some evidence suggest that the lower concentrations of benzoyl peroxide are as effective as the higher strengths, but cause less irritation.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If the skin irritation is severe, you may need to apply it less frequently. To limit skin irritation, your GP or pharmacist might recommend starting with a lower strength formulation, and gradually increase the concentration as your tolerance develops.

Further information

Sources

  • Joint Formulary Committee. British National Formulary. 55 ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008: 619
  • Acne vulgaris - management. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 8 July 2008
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I have heard oral isotretinoin (eg Roaccutane) is very effective at treating acne. Can I be prescribed it?

Acne can usually be controlled with creams, lotions, and antibiotics. However, severe acne and acne that doesn't respond to other treatments may sometimes be treated with isotretinoin.

Isotretinoin can only be prescribed by a doctor who specialises in skin disorders (dermatologist).

Explanation

Isotretinoin can be very effective at treating acne. It works by reducing the amount of oil that sebaceous glands secrete as well as modifying the skin cells to limit the blockage of pores.

However, isotretinoin has many potentially serious side-effects. These include extremely dry skin, nosebleeds, headaches, muscle aches, risk of inflamed pancreas, sweating, drowsiness, cataracts and hair loss. There have also been some reports of depression and an increase in suicidal thoughts among people who take isotretinoin, although this hasn't been proven. It can also cause severe development problems in unborn babies, so women who are taking it must not get pregnant during treatment and for at least one month after the course has finished.

Because of the side-effects, isotretinoin can only be prescribed by a dermatologist in the UK. He or she will only prescribe isotretinoin if your acne is serious enough to warrant using it.

If you're going to be treated with isotretinoin, you will need to have blood tests to check your liver function and the levels of fat in your blood before and during treatment.

Isotretinoin is only prescribed if:

  • you have severe acne, especially if it's causing nodules or cysts
  • the acne cysts have started to join together beneath the skin
  • you're scarring
  • your acne hasn't responded to previous courses of oral and topical antibiotics
  • your acne is causing you psychological problems

Talk to your doctor for more advice about isotretinoin.

Further information

Sources

  • Acne vulgaris - management. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 8 July 2008
  • Joint Formulary Committee. British National Formulary. 55 ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008: 619
  • Acne vulgaris. eMedicine. www.emedicine.com, accessed 22 July 2008
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Does sunlight help acne?

Sun exposure may well help acne in the short term, but is not likely to provide long lasting benefit and other treatments are likely to provide superior results. The association between sun exposure and skin cancer in later life limits the usefulness of this treatment.

Explanation

Some people find that sunlight improves their acne. The theory is that ultraviolet (UV) radiation in the sunlight kills the bacteria that is involved in acne and may damp down the inflammation.

Although some studies suggest that ultraviolet (UV) light therapy can slightly improve acne, they aren't conclusive and are being investigated further.

Other trials, looking at levels of acne in the summer months, have had differing results. One Saudi Arabian study found that acne improved in the summer, but it didn't take into account any other factors that may have affected acne in the volunteers.

Other trials have shown that an equal number of people get worse, improve or stay the same during summer.

Talk to your GP for more advice. You should never allow yourself to burn if you are in the sun, and should always use sunscreen. If you're using sunscreen on sites prone to acne, it's important to use non-comedogenic (or acne friendly) preparations.

Further information

Sources

  • Personal communication, Dr M Ardern-Jones, BSc, MBBS, MRCP, Dphil, Consultant Dermatologist, Southampton University NHS Trust and Spire Southampton Hospital, 20th August 2008
  • Purdy S, de Berker D. Acne. BMJ 2006; 333(7575):949-953. www.bmj.com
  • Acne vulgaris - management. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 8 July 2008
  • Acne vulgaris. eMedicine. www.emedicine.com, accessed 22 July 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: December 2008

 

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