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Acne is not a 'teenage problem' or a passing phase; it appears at different ages and in various forms, and winter, stress, and changes in routine often worsen it. There are several underlying causes: genetics, hormones, excess sebum, clogged follicles, bacterial inflammation, as well as cosmetics or habits. Therefore, universal solutions rarely work. In this guide, we go throughtherapies that have actual evidence – from topical and systemic medications to clinical procedures and care that aids in treatment. At Priska Med Polyclinic, we developan individual plan: precise diagnostics, clear steps, and progress tracking to ensure lasting results tailored to your skin.
Why do acne occur?
Acne develops when there is an increase insebum production, and the exit channels of the follicles (pores) becomeclogged with thickened keratinized cells. In such a 'plug',Cutibacterium acnes (C. acnes) proliferates easily and triggers aninflammatory response: from blackheads and small pimples to painful, deep cysts. This process is influenced bygenetics (hereditary predisposition to comedone formation),hormonal changes (puberty, menstrual cycle, PCOS, stress hormones), as well ascosmetics or products that clog pores, improper skin cleansing, andstress that increases inflammation and sebum secretion.
That's why 'the same product for everyone' rarely succeeds. Different types of acne (comedonal vs. inflammatory, superficial vs. deep), differentskin sensitivities, phototype, the presence ofscars or post-inflammatory spots, as well as lifestyle habits (sports, work, makeup use) requirean individually tailored plan. In practice, this means combining proper care, targeted local therapy, and, if necessary, systemic medications or clinical interventions at a pace and intensity adapted precisely to your skin.
Types of acne and when to react
Acne is clinically classified as mild, moderate, and severe, and by shape as comedonal (blackheads and small irregularities), papulopustular (red, inflammatory lesions with possible pus tips), and nodulocystic, which affect deeper layers of the skin and are more prone to scarring. Mild acne often responds well to a properly structured home routine and targeted local therapy, while moderate and severe cases typically require a combination of topical and systemic medications, alongside possible clinical treatments.
You should contact a dermatologistimmediately when cystic acne is present, when scars begin to form, if the lesions are painful and deep, or when acne significantly affects self-esteem and daily functioning. Quick assessment is important also if anOTC regimen without a prescription fails after 6-8 weeks of consistent use. During pregnancy and breastfeeding, an individualized, safe treatment plan is essential – therefore, early dermatological consultation is recommended to select effective, yet appropriate treatment options.
Acne therapy
Topical therapy (for mild to moderate cases)
The foundation of successful initial acne treatment is properly guidedtopical therapy. The most evidence supportsretinoids (adapalene, tretinoin). They act comedolytically (preventing and 'unclogging' comedones) and anti-inflammatory, targeting both cause and consequence. In the first few weeks, mild redness, tightness, or peeling is expected, indicating that the skin is adjusting. The solution isgradual introduction (e.g., every 2-3 nights, then more frequently), applying to completely dry skin, and using the 'sandwich' method (moisturizer – retinoid – cream). The first stable results can realistically be expected in6-12 weeks with regular application.
Benzoyl peroxide (BPO) has strongantibacterial action without developing resistance, hence it is a common partner in combinations. We use it alone or with a retinoid (e.g., BPO in the morning, retinoid in the evening). It can bleach fabric and mildly dry out the skin, so it is always paired withnon-comedogenic hydration and careful selection of bedding/towels. The role of BPO is also crucial when introducingtopical antibiotics like clindamycin or erythromycin: they arenever used alone andare always combined with BPO to reduce the risk of resistance. The duration of such a regimen is limited (typically 6-12 weeks), after which therapy shifts to maintenance without antibiotics.
From other active ingredients,azelaic acid (15-20%) is beneficial for sensitive andpost-inflammatory hyperpigmented skin, has mild antibacterial and comedolytic effects, and is thefirst choice in pregnancy/breastfeeding.Salicylic acid (BHA) helps keratolytically in pores and is good in lower concentrations for oily skin, whileniacinamide reduces inflammation, regulates sebum, and strengthens the skin barrier – it is an excellent 'team player' with retinoid/BPO. Inpregnancy and breastfeedingretinoids are avoided,and the use of BPO and salicylic acid in larger areas/concentrations is decidedafter consulting with a dermatologist; azelaic acid is generally a safe option.How to arrange everything in a routine? One practical schedule is:
in the morning gentle gel cleanser + niacinamide or light moisturizer +DAILY SPF 30+;in the evening cleansing + retinoid (or azelaic if pregnant/breastfeeding) + cream. If the skin is reactive, introduce the retinoid 2-3 times a week and gradually increase the frequency. The key to success is not 'magic products', butconsistency andadjusting the intensity according to skin tolerance, with control after 6-8 weeks to specify the plan.Systemic therapy (moderate to severe cases)
In moderate to severe acne, a
systemic approach with properly guided topical therapy is often necessary.Antibiotics (most commonly doxycycline or minocycline) are used for a limited time, typically 6-12 weeks, alwaysin combination with topical benzoyl peroxide and/or retinoid to reduce the risk of bacterial resistance and maintain effect after stopping antibiotics. It is important to adhere to dosing and sun protection advice, and if needed, to introduce supportive measures for digestion.In women with clinical signs of hormonally induced acne,
hormonal therapy. Combined oral contraceptives with antiandrogenic progestin can reduce sebum secretion and inflammation, and the decision is made after an examination and assessment of contraindications. Spironolactone is another option for women, especially for persistent mandibular acne; it is applied under supervision and potassium control as needed, and is combined with local therapy. For all hormonal options, an individualized approach is necessary and, if needed, coordination with a gynecologist.For
severe, scarring or therapy-resistant acne the gold standard is isotretinoin. It is a medication with very high efficacy that requires strict supervision: initial and periodic laboratory checks (liver enzymes, lipids), detailed education about side effects (e.g. dryness of skin and mucous membranes) and mandatory contraception due to teratogenicity. Therapy usually lasts several months with a cumulative dose tailored to the patient, and control examinations serve for precise titration and monitoring tolerance. During isotretinoin, vitamin A supplements, aggressive peels, and wax depilation should be avoided, and regular photoprotection and targeted skin barrier care are recommended.At Priska Med Polyclinic, we create the systemic therapy plan
individually with clear instructions, progress monitoring, and coordination of local care, in order to achieve lasting, safe, and controlled results.Office treatments
Chemical peels
(salicylic, glycolic, TCA acid) are performed in series and target comedones, inflammatory lesions, and post-inflammatory hyperpigmentation. The intensity is chosen according to skin type and severity of acne: milder concentrations for oily and sensitive skin, stronger protocols for scars and deeper changes. The key to success is a combination with a properly structured home routine (retinoid/BPO or azelaic as planned), along with mandatory photoprotection and short breaks from irritants a few days after treatment.Mechanical cleaning/extractions of comedones
are done purposefully, under sterile conditions and with skin preparation to minimize trauma and the risk of hyperpigmentation. This procedure serves as a supplement to medical therapy and not as a standalone solution – proper timing with retinoids and keratolytics significantly improves the outcome.LED/laser and light therapies
are used as an adjunct in inflammatory acne and erythema. The evidence is moderate, but in well-selected patients, they can reduce redness and inflammatory activity between checks. The results are gradual and expected over multiple sessions, always in parallel with the basic therapy.Intralesional corticosteroids
quickly reduce pain and volume of individual cystic lesions, which is useful before an important event or in case of pronounced pain. The application is local and targeted, reducing the risk of atrophy and hypopigmentation.For
acne scars the plan is individual, according to morphology (rolling, boxcar, ice-pick). We usually combine microneedling, subcision, TCA CROSS for very narrow, deep scars, and fractional laser for texture and thickening; occasionally and hyaluronic fillers for indented scars. Therapies are scheduled in cycles with realistic expectations, photographic documentation, and strict photoprotection.What often doesn't work (or is overrated)
“Natural” home recipes like lemon, baking soda, or undiluted essential oils often irritate the skin and worsen inflammation. Aggressive scrubs damage the barrier and spread lesions, and
local antibiotic without benzoyl peroxide quickly loses effectiveness due to resistance. It is equally harmful to constantly change products before giving them 6-8 weeks and popping pimples, increasing the risk of scars and post-inflammatory hyperpigmentation. What about diet? In some patients, a diet with lower glycemic load and moderation in intake of certain dairy products can be beneficial, but it is individual and an addition to therapy, not a substitute for a dermatologically guided evidence-based treatment plan.Skin care that supports therapy
The success of acne treatment relies on a consistent, simple routine. In the morning, use a gentle gel cleanser, then a non-comedogenic moisturizer and mandatory daily SPF 30+ or higher. In the evening, cleanse your face again and apply the prescribed retinoid as planned; over it, apply a light moisturizer to reduce dryness, and if the skin is sensitive, start less frequently and gradually increase the frequency.
Soothing irritations should be done by gradually introducing active ingredients, using a “sandwich” method (cream – retinoid – cream) and taking short breaks when the skin is significantly irritated. Avoid aggressive scrubs and too many products at once; the skin barrier benefits more from regular, moderate care than from intensive “shock” treatments.
Regarding makeup and sports, choose non-comedogenic formulations and thoroughly clean your face immediately after sweating. Remove makeup with a gentle cleanser, then wash your face with a gel cleanser and rehydrate. Regularity, simplicity, and photoprotection are key to the cooperation between skin care and medical therapy and achieving faster, more stable results.
Acne treatment plan at Priska Med Polyclinic
During the first examination, we conduct
precise diagnostics: we analyze the type of acne, the condition and type of skin, care habits, and possible triggers. Based on this, you will receive a plan with clear steps and expected timetable, with a check after 6-8 weeks. This is followed by therapy personalization – we combine targeted local and, if necessary, systemic therapy with office procedures based on indication and skin tolerance. During treatment, we rely on monitoring and adjustment: regular check-ups, documenting progress with before/after photographs (with consent) and clear instructions for home care ensure that every change is timely and aligned with the goal – calming inflammation, preventing new lesions, and gradually reducing scars.Conclusion
Acne can be resolved when a
personalized, evidence-based plan is applied and when we give the skin time to respond to therapy. With the right combination of local and systemic medications, targeted office procedures, and consistent care, visible changes are expected within 6-12 weeks, with further improvement with regular checks. Do not postpone the start of treatment and trust the experts completely.Schedule a dermatological examination at Priska Med Polyclinic – quick, professional, and without a waiting list:
📞 021 44 33 44
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poliklinika@priska-med.com📝
Directly via the contact formdermatological-treatments-for-acne--it-really-works