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Treatment - Acne

How you treat your acne depends on how bad it is. It can take a few months before your symptoms get better.

Go to your pharmacist or GP

If you have a few blackheads, whiteheads and spots, talk to your pharmacist. They can give you medicines to treat it that you do not need a prescription for.

They may give you gels or creams (topical treatments) with benzoyl peroxide in them. Benzoyl peroxide helps you have less bacteria that cause acne.

Your GP can tell you if any medicines are covered by your medical card or under the drugs payment scheme.

Drugs Payment Scheme

Non-urgent advice: Talk to your GP if:

  • gels or creams do not help
  • acne is affecting your mental health
  • you have lots of spots or lots of big, sore papules, pustules, nodules or cysts

You need proper treatment for these so you do not get scarring.

Acne scarring

Main treatments for acne

The main treatments for acne are:

  • a mix of antibiotic tablets and topical treatments (creams, gels and ointments) if you have severe acne
  • hormonal therapies or the combined oral contraceptive pill
  • isotretinoin - you may be referred to a dermatologist who can prescribe this if your acne fails to respond to other treatment or you have scarring

It's important to be patient and keep up a treatment, even if it does not work straight away. Treatments can take up to 3 months to work, so do not expect results overnight. When they do start to work, the results are usually good.


You might want to pick or squeeze your spots. Do not - this can lead to permanent scarring.

Seeing a specialist

Your GP can refer you to an expert in treating skin conditions (dermatologist) if you have:

  • a lot of papules and pustules on your chest and back, as well as your face
  • painful nodules
  • scarring, or are at risk of scarring

Prescription medicines

Prescription medicines for acne include:

  • topical retinoids
  • topical antibiotics
  • azelaic acid
  • antibiotic tablets
  • in women, the combined oral contraceptive pill or spironolactone
  • isotretinoin tablets

Creams, gels and ointments

Topical treatments are creams, gels and ointments that you put on your skin.

Benzoyl peroxide

Benzoyl peroxide works as an antiseptic. This means you will have less bacteria on your skin.

It helps you have less whiteheads and blackheads and has an anti-inflammatory effect.

Benzoyl peroxide is usually available as a cream or gel. It's used either once or twice a day.

Wait 20 minutes after washing to put it on. Put it on all the parts of your face affected by acne. Put it on a thin layer as it may irritate your skin.

Side effects

Put on sunscreen as benzoyl peroxide makes your face more sensitive to light.

Benzoyl peroxide can bleach things. Do not get it on your hair or clothes.

Common side effects of benzoyl peroxide include:

  • dry and tense skin
  • a burning, itching or stinging sensation
  • some redness and peeling of skin

Side effects are usually mild. They should pass when your treatment stops.

Most people need treatment for at least 6 weeks to clear most or all of their acne.

Your GP may tell you to keep up some treatment to stop acne coming back.

Topical retinoids

Topical retinoids are creams and gels you can put on your skin. They work by taking away dead skin cells (exfoliating). This helps to stop them building up in hair follicles.

Tretinoin and adapalene are topical retinoids for acne. They come in a gel or cream and are usually put on once a day before you go to bed.

Wait 20 minutes after washing your face. Put it on all the parts of your face affected by acne.


Do not use topical retinoids if you are pregnant. There's a risk they might cause birth defects.

Topical antibiotics

Topical antibiotics help kill the bacteria on the skin that can infect blocked hair follicles. They are either a lotion or gel that you put on once or twice a day.

You usually take topical antibiotics for 6 to 8 weeks.

Side effects

Side effects are uncommon, but can include:

  • minor irritation of your skin
  • redness and burning of your skin
  • peeling skin
Azelaic acid

Azelaic acid is often used if the side effects of benzoyl peroxide or topical retinoids are very irritating or painful.

Azelaic acid works by getting rid of dead skin and killing bacteria. It's available as a cream or gel. It's usually put on twice a day (or once a day if your skin is very sensitive).

Side effects

The side effects of azelaic acid are usually mild and include:

  • burning or stinging skin
  • itchiness
  • dry skin
  • redness of the skin
Antibiotic tablets

If your acne is bad, antibiotic tablets are usually used with a topical treatment.

Your GP will usually tell you to take antibiotics called tetracyclines.


You cannot take tetracyclines if you're pregnant or breastfeeding.

Pregnant or breastfeeding women should take an antibiotic called erythromycin.

It usually takes about 6 weeks before you notice your acne is getting better.

How long you take antibiotic tablets for depends on how soon your acne changes after taking them. It could be 4 to 6 months.

Side effects

Tetracyclines can make your skin sensitive to sunlight and UV light.

They can also make the oral contraceptive pill less likely to work. This is for the first few weeks you are taking these antibiotics. You'll need to use a different type of contraception, such as condoms.

Hormonal therapies for women

Hormonal therapies can often be good for women with acne. Especially if the acne flares up around periods or is to do with polycystic ovary syndrome.

But the progestogen-only pill or contraceptive implant can sometimes make acne worse.

Combined oral contraceptive pill

Your GP may recommend the combined oral contraceptive pill. This is even if you are not sexually active.

This pill can often help acne in women. But it may take up to a year before you see your skin get better.


Co-cyprindiol is a hormonal treatment for bad acne that antibiotics do not work for. It helps your glands make less sebum.

You'll have to use co-cyprindiol for 2 to 6 months before you notice your acne getting much better.

Side effects

Risks and side effects of co-cyprindiol:

  • there's a small risk that you may get breast cancer in later life
  • there's very small chance you will get a blood clot - the risk is around 1 in 2,500 a year


You should not take co-cyprindiol if you're pregnant or breastfeeding - it's not thought to be safe and you may need to have a pregnancy test before treatment can begin


Isotretinoin is for severe cases of acne that other treatments have not worked on.

You take isotretinoin as a tablet. Most people take it for 6 to 9 months.

Your acne may get worse during the first 7 to 10 days. But this is normal and soon settles.

Side effects

Common side effects of isotretinoin include:

  • inflammation, dryness and cracking of the skin, lips and nostrils
  • inflammation of your eyelids (blepharitis)
  • inflammation and irritation of your eyes (conjunctivitis)

Rarer side effects of isotretinoin include:

  • inflammation of the liver (hepatitis)
  • inflammation of the pancreas (pancreatitis)
  • kidney disease

Because of the risk of these rarer side effects, you'll need a blood test before and during treatment.

Isotretinoin and birth defects

Isotretinoin will damage an unborn baby. Your dermatologist will explain the risks of taking isotretinoin if you can become pregnant.

Do not use isotretinoin if you're pregnant or you think you're pregnant.

If you can get pregnant you will need to sign a form to say that you:

  • understand the risk of birth defects
  • will use contraceptives to prevent this risk - you will do this even if you're not currently sexually active

You must have a pregnancy test before, during and after treatment.

You must use 2 methods of contraception:

  • during treatment
  • for 1 month before treatment begins
  • 1 month after treatment has finished

If you think you may have become pregnant when taking isotretinoin, contact your dermatologist immediately.

Isotretinoin is also not suitable if you're breastfeeding.

Isotretinoin and mood changes

There have been reports of people experiencing mood changes while taking isotretinoin.

There's no proof that these were because of the medicine.

Contact your GP immediately if you:

  • feel depressed
  • feel anxious
  • feel aggressive
  • have suicidal thoughts

Other treatments for acne

A few treatments for acne do not involve medicine.

These include:

Comedone extractor

This is a small pen-shaped instrument that can be used to clean out blackheads and whiteheads.

Chemical peels

A chemical solution is put onto the face, causing the skin to peel off and new skin to replace it.

Treatments for acne scarring

Treatments for acne scarring are a type of cosmetic surgery. Talk to your GP if you're thinking about having treatment. They will talk through your options with you.

It's important to be realistic about what this type of treatment can do. Treatment can help your scars look better. But it cannot get rid of them completely.

Causes of acne scarring


Dermabrasion removes your top layer of skin. There are 2 ways to do this:

  • using lasers
  • using a specially made wire brush

After the treatment, your skin will look red and sore for a few months. But as it heals you should see your scars starting to look better.

Laser treatment

Laser treatment can be used to treat mild to moderate acne scarring.

There are two types of laser treatment:

Ablative laser treatment

Lasers remove a small patch of skin around the scar. This makes a new, smooth-looking area of skin.

Non-ablative laser treatment

Lasers helps the growth of new collagen (a type of protein found in skin).

This helps to fix some of the damage from scarring, and makes it look better.

Dermal fillers

Dermal fillers are used to fill scars that have left a dip in your skin.

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 8 June 2023
Next review due: 8 June 2026

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.