Evidence-based information and tools for managing acne, based on Australian Therapeutic Guidelines.
A simple, jargon-free guide to understanding your skin, with lifestyle tips and information on treatment options.
A comprehensive decision tool based on the latest guidelines to assist with diagnosis and treatment pathways.
Clear, Simple Information to Help You Manage Your Skin
Acne is a very common skin condition that causes pimples and other spots, usually on the face, neck, back, and chest. It happens when tiny holes in the skin, called hair follicles, get blocked. It's not your fault and it's not caused by being dirty.
Your skin is covered in tiny tunnels called hair follicles. Each one contains:
The oil travels up the follicle and out through a pore. Acne starts when this process goes wrong.
These are simple things you can do every day to help manage your acne and support your treatment.
Acne treatments work by targeting different parts of the process, like unblocking pores, reducing oil, fighting bacteria, or calming inflammation. Here are the main types your doctor might discuss.
These are treatments you can buy at a pharmacy. They often contain ingredients like benzoyl peroxide (which is anti-bacterial) or salicylic acid (which helps unblock pores). They are a good starting point for mild acne.
These are powerful Vitamin A derivatives that are very effective at unblocking pores and preventing new ones from forming. They are applied to the whole area affected by acne. Your doctor might prescribe brands like Tretinoin (Retrieve), Adapalene (Differin), or Trifarotene (Aklief).
Used mainly to reduce the redness and inflammation of acne, rather than just for killing bacteria. They are often used for a limited time to get inflammatory acne under control.
For females whose acne is linked to hormonal cycles, certain types of the Combined Oral Contraceptive Pill (COCP) or a medication called spironolactone can be very effective by reducing the effect of hormones on oil production.
For severe, scarring, or persistent acne, a GP may refer you to a dermatologist. They can prescribe oral isotretinoin (a powerful oral retinoid), which is highly effective. They can also discuss other options like light therapies or chemical peels, although evidence for these is not as strong.
Important Note on Scarring
If your acne is leaving scars, even if it seems mild, it is important to treat it effectively to prevent permanent marks. Don't hesitate to ask your GP if a referral to a dermatologist would be beneficial for you.
Based on the latest Australian Therapeutic Guidelines
Acne is a chronic inflammatory disease of the pilosebaceous unit, common in adolescents and young adults. It is usually caused by an increased sensitivity to circulating androgens. Key skin changes include increased sebum production, formation of keratin plugs (hypercornification), colonisation by Cutibacterium acnes, and inflammation.
The pathogenesis of acne involves four key factors:
It's important to manage patient expectations, explaining that acne is a chronic condition. Be sensitive to its profound negative emotional and social effects, which can include low self-esteem, depression, and social withdrawal.
The key diagnostic feature of acne is the presence of comedones (blackheads/whiteheads). If comedones are absent, consider these alternative diagnoses.
When to consider:
When to consider:
When to consider:
When to consider:
It is crucial to identify and modify or remove any contributing factors before or during treatment.
Acne can be aggravated by systemic drugs or topical products. Ensure skincare, cosmetics, and sunscreens are noncomedogenic ("oil-free").
In some patients, high glycaemic index foods (refined carbs, sugar) and dairy products (including whey protein) can exacerbate acne.
Exposure to comedogenic substances or environments can aggravate acne.
Assess the impact of acne on the patient's quality of life. Refer to a counsellor or psychologist if appropriate. The emotional state is an important factor in choosing therapy.
This tool is intended for use by a healthcare practitioner to help guide treatment decisions based on the provided therapeutic guidelines.
| Brand Name | Active Ingredient | Generation | General Profile | Common Side Effects | Approx. Price/Gram |
|---|---|---|---|---|---|
| Retrieve | Tretinoin | 1st | A well-researched and highly effective retinoid. | Can be more irritating, with potential for dryness, redness, and peeling, especially initially. | ~$1.40/g |
| Differin | Adapalene | 3rd | Known for being a gentler, more tolerable option. Suitable for sensitive skin. | Generally better tolerated with a lower risk of significant irritation. | ~$2.00/g |
| Aklief | Trifarotene | 4th | The newest generation, selectively targets the most common retinoid receptor in the skin. | Designed to be targeted and is generally well-tolerated. | ~$1.04/g |