Do you need topical prescriptions to treat your acne?

The question we’re often asked by acne sufferers is: “Should I be using a prescribed topical cream?”. There are cases where we’ll recommend you see a dermatologist to prescribe a topical cream, but in many instances, we’re confident that a growing personalised skincare routine (when advised by a professional such as an aesthetician or dermatologist) can be an equally, if not more, effective and inexpensive solution for achieving clearer skin.

When should you seek medical help for your acne? 

Acne can be categorised into four stages, ranging from mild to severe:

1. Mild: Small concentration of pimples and/or blackheads on the skin. 

2. Moderate: Blackheads, pustules, papules and pimples on the skin. 

3. Moderately Severe: Inflamed, red and irritated skin with pustules, papules, nodules and cysts.

4. Severe: Large, painful and deep nodules and cysts that can cause scarring and damage to the skin. 

Stages 1 and 2

When it comes to mild and moderate acne and blemishes, Renude aestheticians may provide skincare routines that include clinically proven ingredients which can address imbalances within the skin. 

Stages 3 and 4

If we believe someone is experiencing a moderately severe or severe case of acne, and stronger active ingredients like retinol won’t make any improvements to the skin, we’ll always refer them to speak to a medical specialist, such as a GP or a Dermatologist. In our experience, severe acne needs more than just skincare to see much change or improvement. 

The types of acne

There are different types of acne, and how to manage the treatment can often differ:

Acne Cosmetica: This form of acne is caused by products such as creams, hydraulics, makeup and some hair care products. This is where we would recommend looking for non-comedogenic products as a first point of call. 

Acne Mechanica: This form of acne is caused by excessive skin heat, pressure or friction. This form of acne can occur on the face but most commonly in the body. It is often referred to as sports acne since helmets, sports pads, and sweatbands are popular among young athletes. Mild acne mechanica can be handled with skincare, whereas a dermatologist can see more serious forms.

Acne Rosacea: Acne rosacea is a form of acne that mostly affects adults but can appear to become more serious in men. This form of acne causes bumpiness and pimples with rosacea, but you will also notice small blood vessels on the nose and cheeks. Stress, exposure to the sun, spicy foods or hot water will worsen your symptoms. 

Acne Vulgaris: If you break out, it’s possible that you can see acne vulgaris on your face, back, shoulders, and buttocks. It may start mild, but it may advance to harsher forms quickly. This is why dermatologists prescribe acne vulgaris care as soon as you see a breakdown.

Cystic Acne: Cystic acne occurs lower in the skin, takes weeks to heal, and may significantly harm the skin than the average pimple. Since they are so deep, topical creams and ointments might not be much of a help. Instead, you may need to seek an alternative;s oral medicine such as Accutane (isotretinoin) which needs to be prescribed by a dermatologist can help but there are side effects to consider.

Nodular Acne: Many women obtain a few nodular breakouts before their monthly cycle. But everyone, both men and women at any age, can get nodular acne. Like cystic acne, a dermatologist should look at nodular acne. You will need prescription acne treatment to keep them under control if you get nodular breakouts regularly.

Ingredients for treating acne 

Salicylic Acid: Salicylic acid (BHA) works as an exfoliating acid to dissolve the keratin that binds the outermost layers of the skin, encouraging the natural exfoliation process of the skin. Skincare products can include up to 2% salicylic acid, and one of the main benefits of salicylic acid is that it can penetrate deeper into your hair follicles than other chemical exfoliators, making a great acne treatment. 

Azelaic Acid: Azelaic acid has antibacterial properties making it a good supplementary ingredient in the treatment of acne. It has anti-inflammatory properties making it a very effective treatment for rosacea, redness, and acne inflammation, and It has mild exfoliating properties.

You’ll find up to 10% Azelaic Acid in skincare products, whereas a medical professional can prescribe up to 15/20%. In cases where someone's acne is mild or moderate, we would recommend avoiding a prescription as although it may result in the acne improving quickly, it could also have implications for the skin barrier, causing other issues such as irritation, dryness and sensitivity. Those with moderately severe or severe acne would benefit better from a prescription as skincare alone would likely not be effective.

Benzoyl Peroxide: Benzoyl peroxide works to treat and prevent acne by killing bacteria underneath the skin, as well as helping the pores shed dead skin cells and excess sebum (oil). 

The dosage and frequency of application depends on the severity of acne and skin type but It is commonly recommended to start with a 4% or 5% strength preparation to minimise the risk of skin irritation. The strength of the dosage can be increased gradually if necessary over time if needed. Common side effects of benzoyl peroxide include dry skin, itching, irritation, and redness. If these side effects occur, it is recommended to reduce the frequency of application or the time the preparation is left on the skin 

Retinoids/Retinaldehyde: The Retinoid family is the most common r ingredient for treating acne and acne scarring. At face value, it can seem complicated to understand, as there are so many derivatives available but they are all a derivative of Vitamin A - an ingredient we produce naturally which can help exfoliate the skin, removing dirt, oil, and dead skin cells from pores to prevent pimples.

The different derivatives, in order of strength, are: 

• Retinyl esters

• Retinol

• Retinaldehyde

• Retinoic acid

Even stronger retinoids can be prescribed by a Dermatologist in the UK, including Tretinoin and Isotretinoin (Accutane). Benzoyl peroxide is also available on prescription and is a separate treatment to retinoids. 

Tretinoin: Tretinoin is a prescription-strength topical cream or gel. It’s used mainly to treat acne, sun-damaged skin, and fine wrinkles. It may sound counterintuitive, but tretinoin works by irritating the skin. Tretinoin can speed up the life cycle of skin cells. It makes them divide faster and die faster, so newer, healthier cells can take their place. Before looking into Tretinoin, we would first consider whether the skin would be responsive to a Retinoid. 

Isotretinoin (Accutane):  Isotretinoin (Accutane) is an oral medication that can only be prescribed by dermatologists and is by far the most powerful treatment of acne but most dermatologists will only prescribe this in the most severe of cases, and if the acne is non-responsive to other treatments. 

Like tretinoin, isotretinoin can take several weeks to produce results, during which many people experience a temporary increase in acne symptoms. The side effects of taking this medication can also be intense. Since it is consumed orally, it affects skin across the entire body and can cause everything from dryness to itching, cracked lips, rashes, joint pain and changes in the growth of fingernails and/or toenails.

Using skincare to treat acne

When it comes to acne concerns, you may opt for a visit to the GP or Dermatologist, or explore prescription skincare brands. Yet, these options can be expensive and they don't always deliver the best results for your skin. We often receive messages from our members who've tried prescription skincare and ended up with a damaged skin barrier and their skin more irritated – not the outcome they were hoping for.

We would suggest, before diving into the costly or potentially tricky world of prescriptions, consider starting with a personalised skincare routine. It's often a first step for managing mild to moderate acne without the drawbacks of prescription products.

A proactive skincare routine can also act as a formidable shield against common skin issues, preemptively safeguarding against premature ageing, sun damage, and environmental stressors.

How to incorporate a prescription into your skincare routine 

If you already have a prescription and are looking to fit a skincare routine around it - we can help! At Renude we curate personalised routines taking your prescription into account. We would always recommend a personalised skincare routine to work with your prescription to maintain and manage your skin during potentially strong treatment. We’ll look at your routine holistically to ensure your skin looks its best whilst also treating it for your concerns. Having a personalised routine allows for the integration of specific ingredients tailored to your skin's needs

The importance of consistency in skincare 

Results in skincare are not instantaneous; they are the fruits of consistent effort but the benefits are worth it: 

• Cultivating habits through regular skincare routines sets the foundation for long-term skin health, emphasising that transformation is a gradual process.

• Skin cells undergo turnover approximately every 4-6 weeks, requiring patience and dedication to witness the full effects of a skincare routine.

• Consistency allows active ingredients to absorb deep into the skin to impact the mechanisms which results in visible change, working over at least 2-3 renewal cycles for optimal results.

While topical prescriptions have their benefits and are in some cases the best way to treat your skin, the power of a personalised skincare routine shouldn’t be underestimated or overlooked. 

By consulting with a skincare professional, you can discover the transformative effects of a well-crafted routine that goes beyond the surface, revealing the radiant, healthy skin you deserve. To get started on your skincare journey, take our skin quiz!