Acne Treatment in Brighton: A Doctor’s Guide to What Actually Works

Acne is a medical condition, not a cosmetic complaint, and it is treated best when it is treated as one. If you have been cycling through skincare for two years without much progress, this guide is written for you.

Acne is not a hygiene problem

The four things driving acne are excess oil production, blocked follicles, a skin bacterium called Cutibacterium acnes and inflammation. Hormones sit behind most of it. Washing more aggressively makes it worse, not better, because a stripped skin barrier inflames more easily.

It is also not a teenage condition. Adult acne, particularly in women in their twenties and thirties along the jawline and chin, is common and is usually hormonally driven.

Working out which acne you have

• Comedonal acne: blackheads and whiteheads, little redness. Responds well to topical retinoids.

• Inflammatory acne: red papules and pustules. Usually needs a topical retinoid plus an antimicrobial approach.

• Nodulocystic acne: deep, painful lumps that last weeks and scar. This needs prescription treatment early, not another serum.

• Hormonal acne: jawline, chin and neck, often flaring in the week before a period.

• Acne scarring: the aftermath. Different problem, different treatment, and it should only be tackled once active acne is controlled.

If your acne is leaving marks that are still there six months later, that is scarring, and the priority is to stop new scars forming.

What you can do yourself

Over-the-counter treatment is genuinely useful for mild acne, if you use it properly and give it twelve weeks.

• Benzoyl peroxide reduces bacteria and does not cause resistance. Start at a low strength; it bleaches towels and pillowcases.

• Adapalene, a retinoid, is available without prescription in the UK and is the single most useful over-the-counter acne ingredient. Expect it to get worse before it gets better, at around week three to four.

• Azelaic acid is gentler, helps with post-inflammatory pigmentation and is usually safe in pregnancy, though check with your doctor.

• Salicylic acid helps unblock follicles in oily skin.

• A simple, non-comedogenic moisturiser and a daily SPF. Sun exposure darkens post-acne marks and makes them last far longer. This matters in Brighton, where people underestimate how much sun they get on the seafront in April.

What does not help: scrubs, alcohol-heavy toners, picking, and changing products every three weeks because nothing works. Acne treatment is slow. Twelve weeks is the minimum before judging anything.

When to see a doctor

Sooner than most people do. Book an appointment if your acne is scarring, is painful and deep, has not responded to three months of over-the-counter treatment, or is affecting your mood and confidence. The last of those is a legitimate medical reason on its own.

Prescription options include topical retinoids at higher strengths, topical antibiotic combinations, short courses of oral antibiotics used carefully to avoid resistance, and hormonal treatment such as the combined pill or spironolactone for suitable patients. Severe or scarring acne that has not responded to these is treated with isotretinoin, which in the UK is prescribed and monitored only by a consultant dermatologist. If that is what you need, the right answer is a referral, and we will tell you so.

You can also see your NHS GP for acne, and for severe acne that is often the most direct route to dermatology. Private assessment is useful when you want to be seen quickly, want longer appointments, or want in-clinic treatment alongside your prescription.

In-clinic treatment

Clinic treatments are an adjunct to medical management, not a replacement for it. Used in the right order, they help.

• Medical-grade chemical peels can speed up clearance of comedones and fade post-inflammatory pigmentation.

• Skin needling is for atrophic acne scarring, once active acne has settled. It is not a treatment for active spots.

• Polynucleotides and other regenerative treatments target skin quality and scarring rather than active breakouts.

• Prescription-strength topical regimens tailored to your skin, adjusted at review rather than handed over once.

Sequencing matters more than the individual treatment. Control the acne first, then treat the scarring. Treating scars while the acne is still active wastes money and can inflame the skin further.

Acne treatment in Brighton

At Dr Selvi Clinic on London Road we assess acne as a medical problem, with a doctor-led consultation, a written plan and scheduled reviews so the plan is adjusted rather than abandoned. If your acne needs specialist dermatology input, we will say so and help you get there. Contact us to arrange an appointment.