Bacteria in the deeper part of the hair follicle and beneath the sebum blockage release chemicals which act upon the sebum and break it down to release other chemicals. These chemicals make the skin around the hair follicle red and inflamed, resulting in a pimple. In bad cases, pus may develop within the pimple. Large, painful swellings called nodules and cysts may develop and result in scarring after the condition has eventually settled. These scars can either be depressed and sunken, or bulging and hard.

There is significant scarring

Patients with mild acne usually respond well to topical treatments. These include sulphur and resorcinol preparations (e.g. acne clear cream and lotion), benzoyl peroxide containing preparations, antibiotics (erythromycin and clindamycin gel and lotions) and vitamin A derived creams or gels (adapalene and tretinoin).

If your acne becomes worse and you have a lot of inflamed spots, topical treatment alone may not be adequate. Your dermatologist will probably prescribe antibiotic tablets, such as doxycycline, erythromycin, minocycline and cotrimoxazole.

In very serious cases who do not respond to the above treatment, or in cases of severe nodulocystic acne, a tablet called isotretinoin may be given. This medication may give rise to side effects such as dry skin, cracked lips and body ache. The most serious being damage to the unborn baby if taken during pregnancy, hence it is important for women of child-bearing age to practice strict contraception while on therapy.