Acne

What usually happens

It takes six to twelve weeks to judge anything. Nearly every acne treatment is slow, and stopping at three weeks because nothing has changed is the commonest reason treatment appears not to work. Expect to be patient, and expect us to say so.

It is not caused by poor washing, and scrubbing makes it worse. Harsh cleansing irritates skin that is already inflamed and can worsen the very thing you are trying to clear.

Treatment usually works on the blockage as well as the bacteria, which is why more than one product is often used together rather than one after another.

Scarring is the reason not to wait it out. Acne that is leaving marks deserves earlier and firmer treatment — that is the clearest argument for coming in rather than continuing to try things from the shelf.

At your appointment

We will look at the type — blackheads and whiteheads, inflamed spots, or deeper tender lumps — because the type steers the treatment more than the amount does.

We will ask what you have tried, for how long, and how you used it. Six weeks of correct use tells us far more than a drawer of things tried briefly.

We will warn you that skin often looks slightly worse before it looks better, and agree a point to review rather than leaving it open-ended.

If it is scarring, or has not responded to good treatment, that is when a referral is discussed.

Worth asking

• —How long before I should expect to see a difference?
• —How do I use these together, and in what order?
• —What should I do if it irritates my skin at first?
• —Am I at risk of scarring — and does that change the plan?