Acne treatment

Assessment

Treatment depends on the type of lesions present, the severity, the distribution and whether scarring is occurring. Comedonal, inflammatory, nodulocystic and hormonal patterns need different approaches.

Adult-onset acne, particularly along the jawline in women, warrants assessment for a hormonal driver — including polycystic ovary syndrome. Where indicated, blood tests are arranged. Acne that appeared abruptly, or is accompanied by other features, is investigated rather than simply creamed.

Some conditions are mistaken for acne, including rosacea, folliculitis, perioral dermatitis and drug-induced eruptions. Treating the wrong diagnosis is the commonest reason for failure.

Treatment options

Topical therapy may include retinoids, benzoyl peroxide, azelaic acid and topical antibiotics in combination. Oral options include antibiotics used for a defined course, combined hormonal contraception where appropriate, and anti-androgen therapy such as spironolactone for hormonally driven acne.

Isotretinoin is highly effective for severe or scarring acne but requires specialist prescribing, contraception and monitoring arrangements. Where you need it, you will be told and referred appropriately rather than kept on treatments that will not be enough.

Preventing scarring

This is the reason not to wait. Inflammatory and nodular acne scars, and scarring is far harder and more expensive to treat than the acne that caused it. Early effective treatment is the single best scar prevention available.

Timeframes

Most acne treatments take eight to twelve weeks to show their real effect, and some cause an initial worsening. Knowing this in advance is what stops people abandoning a treatment that was about to work.

Risks and limitations

No treatment is without risk, and you are entitled to the full picture before you decide rather than a summary afterwards. These are discussed with you individually at consultation, in the context of your own history.

• Dryness, peeling and irritation from topical retinoids and benzoyl peroxide
• Increased sun sensitivity
• An initial flare before improvement
• Antibiotic-related side effects and the need to limit duration
• Specific risks associated with hormonal therapy, discussed individually
• Scarring from acne itself if treatment is delayed

Where you would be seen

Consultations and minor skin surgery take place at CLNQ Manchester on the ground floor of the South Tower at Deansgate Square, and at CLNQ Knutsford on King Street in Cheshire. Patients travel from across Greater Manchester and Cheshire — Altrincham, Hale, Bowdon, Wilmslow, Alderley Edge and Didsbury are all within easy reach of one or other site.

Where a lesion needs a theatre rather than a treatment room, the procedure is arranged at Deansgate Hospital, a CQC-registered private hospital a few minutes away in Manchester city centre. Any specimen requiring histology goes to a UK histopathology laboratory and the result is discussed with you directly.

• CLNQ Manchester — Deansgate Square 11 Owen Street, Manchester M15 4YB Ground floor of the South Tower at Deansgate Square, Manchester city centre.
• CLNQ Knutsford — Cheshire 49-51 King Street, Knutsford WA16 6DX King Street, Knutsford, serving Cheshire and the surrounding area.
• Deansgate Hospital Madison House, 37 Little Peter Street, Manchester M15 4QJ CQC-registered private hospital in Manchester city centre, for procedures needing a theatre.

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