Skin Condition · Kensington, London
Acne: Causes, Types and When to See a Doctor
Acne is a common inflammatory skin condition that develops when hair follicles become blocked with oil and dead skin cells, allowing bacteria to multiply and the surrounding skin to become inflamed. It produces blackheads, whiteheads, red papules, pustules and deeper nodules, most often on the face, chest and back.
- Doctor-led assessment
- All skin tones
- Kensington clinic
- Medically reviewed by Dr Prasad
This page reflects how acne is assessed and managed at Faciem, and is reviewed for clinical accuracy.
Last reviewed: 14 July 2026.
Patient information only. Acne varies considerably between individuals, and any treatment plan follows a face-to-face consultation with Dr Prasad.
Patients since 2019
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TL;DR
Acne is a long-term inflammatory condition of the hair follicle and its oil gland, driven by hormones, excess oil, blocked pores, bacteria and inflammation. It affects teenagers and adults, and in deeper skin tones it carries a higher risk of lasting pigmentation. Most acne improves with treatment, though results vary, and moderate or severe acne needs medical assessment, not facials alone. Doctor-led acne assessment is available at Faciem Dermatology & Medical Clinic on Kensington Church St, London, where Dr Prasad — a GMC-registered doctor with 20 years’ experience — examines your skin before any plan is agreed.
- Inflammation and blockage of the hair follicle
- Affects teenagers and adults, every skin tone
- Assessed by a doctor before any treatment
About the Condition
What Is Acne?
Acne is a long-term inflammatory condition affecting the pilosebaceous unit — the hair follicle and its attached oil gland. Excess oil and shed skin cells block the follicle, the trapped material allows bacteria to multiply, and inflammation follows. The result ranges from scattered blackheads to painful, deep-seated nodules.
What acne looks and feels like
Acne is not one type of spot. Non-inflammatory lesions — blackheads and whiteheads — are blocked follicles with little redness. Inflammatory lesions are the red papules and pus-filled pustules most people picture. Deeper still are nodules and cysts, which sit under the surface, ache rather than sting, and carry the highest risk of scarring. Most people have a mixture, and the balance shifts over time. Skin is often oily across the forehead, nose and chin, with visible pores. In adults, spots tend to cluster along the jawline and lower face; in teenagers they more often spread across the forehead and cheeks. Acne is also not limited to the face. The chest, upper back and shoulders are commonly involved, and these areas can be slower to settle because the follicles are larger and the skin is thicker.
Who tends to get acne
Acne usually begins in the teenage years, when rising androgen levels make the oil glands more active. For many people it settles in the early twenties, but a substantial number carry it into adult life or develop it for the first time in their twenties and thirties. Adult acne affects women more often than men and frequently follows a hormonal pattern, flaring in the days before a period and concentrating around the jaw, chin and neck. Family history matters: where both parents had significant acne, it is more likely to be persistent. Skin type offers no protection. Acne occurs across every skin tone, but in Black, South Asian, East Asian, Hispanic and Middle Eastern skin, inflammation is more likely to leave post-inflammatory hyperpigmentation — flat brown or grey marks that outlast the spot itself and can take six to twelve months to fade. Skin tone is described clinically on the Fitzpatrick scale, I to VI, and in Fitzpatrick IV to VI skin that pigmentation risk changes how acne is treated as much as the acne itself does: peel strength and depth are stepped up more cautiously, any light-based device has its wavelength and energy adjusted, a patch test carries more weight, and inflammation is brought down early rather than left to run its course.
Conditions that are often mistaken for acne
Several conditions produce spots that are not acne, and treating them as acne rarely works. Rosacea causes redness, flushing and papules across the central face but no blackheads, and typically starts later in life. Perioral dermatitis produces small bumps clustered around the mouth or nose, often following topical steroid use. Folliculitis is inflammation of the follicle caused by bacteria or yeast, and tends to appear as uniform, itchy bumps on the chest, back or scalp. Keratosis pilaris — rough, bobbly skin on the upper arms and thighs — is sometimes mistaken for body acne. Hidradenitis suppurativa causes painful, recurring lumps in the armpits, groin or under the breasts, and needs quite different management. Because the treatments diverge, an accurate diagnosis comes first.
Causes & Contributing Factors
What Causes Acne?
Acne is caused by four processes acting together inside the hair follicle: increased oil production, abnormal shedding of skin cells that blocks the pore, overgrowth of Cutibacterium acnes bacteria, and inflammation. Hormones drive the first of these, which is why acne so often begins at puberty and flares with hormonal change.
Hormonal activity
Androgens enlarge the oil glands and increase sebum production, which is why acne commonly starts at puberty. In adults, hormonal fluctuation around the menstrual cycle, during pregnancy, or in conditions such as polycystic ovary syndrome may drive persistent lower-face acne.
Excess oil and blocked pores
Sebum combines with dead skin cells that fail to shed normally, forming a plug inside the follicle. This blockage is the starting point for both blackheads and the inflamed spots that develop from them.
Bacterial overgrowth
Cutibacterium acnes lives harmlessly on most skin, but multiplies in the oxygen-poor environment of a blocked follicle. The immune response to it is a major contributor to redness, swelling and pus.
Genetics
A strong family history of acne is associated with earlier onset and more persistent disease. Genetics appears to influence oil gland size, how the follicle behaves, and how strongly the skin responds to inflammation.
Aggravating factors
Occlusive make-up and hair products, friction from helmets, straps or masks, picking, and some medicines including certain steroids may worsen existing acne. Evidence on diet is mixed, though high-glycaemic diets and skimmed milk have been associated with acne in some studies.
Treatments We Offer
How Acne Is Treated at Faciem
Effective acne treatment targets the processes that drive it — oil production, blockage, bacteria and inflammation — not individual spots. Depending on type and severity, Dr Prasad may combine prescription-grade skincare and in-clinic procedures with prescription medicines: for severe or resistant acne that can include low-dose oral isotretinoin, a prescription medicine started only after a detailed face-to-face consultation, and a stubborn, deeply inflamed spot can sometimes be settled quickly with an intra-lesional steroid injection. What suits you depends on your acne type, your skin tone and your scarring risk, all assessed at consultation.
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Acne Treatment Clinic
Faciem’s dedicated acne service brings assessment, prescribed treatment and in-clinic procedures into a single plan. Dr Prasad diagnoses the type and severity of your acne first, then builds the programme around it.
Best for: moderate, severe or persistent acne
Read about Acne Treatment Clinic
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Medical-Grade Skincare
Faciem’s dedicated acne service brings assessment, prescribed treatment and in-clinic procedures into a single plan. Dr Prasad diagnoses the type and severity of your acne first, then builds the programme around it.
Best for: mild acne and long-term maintenance
Read about Medical-Grade Skincare
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Chemical Peels
Peels lift away the plugs of oil and dead cells that start each spot, and can soften the pigment marks acne leaves behind. Formulation and depth are matched to your skin tone and to how inflamed your skin currently is.
Best for: congestion, texture and pigment marks
Read about Chemical Peels
Suitability and sequencing are decided at a face-to-face consultation with Dr Prasad. Outcomes differ from person to person, and if a treatment is not the right starting point for your skin, she will tell you so.
When to Seek Medical Advice
When Should You See a Doctor About Acne?
See a doctor about acne if it is leaving marks or scars, if the spots are deep or painful, if over-the-counter products have not helped after around eight weeks, or if it is affecting your mood. Early assessment matters most where scarring or pigmentation has already begun.
Worth getting checked
- Spots that are deep, painful or slow to settle, not just surface whiteheads
- Any pitting, scarring, or lasting brown or grey marks once spots clear
- Acne that has not improved after roughly eight weeks of consistent over-the-counter treatment
- Acne that is affecting your mood, your confidence or your willingness to socialise
Conditions that can look similar
- Rosacea, perioral dermatitis, folliculitis and hidradenitis suppurativa can all resemble acne but respond to different treatment. Sudden, severe acne appearing in an adult — particularly alongside irregular periods or unusual hair growth — may point to an underlying hormonal cause that should be investigated. Anything that changes rapidly, bleeds, spreads or fails to settle should be examined in person.
Self-Care & Prevention
Managing Acne Between Appointments
Home care supports acne treatment but rarely resolves moderate or severe acne on its own. The aim is to avoid making inflammation worse: cleanse gently twice daily, choose non-comedogenic products, protect the skin from sun, and resist the urge to squeeze.
Do
- Cleanse twice a day, morning and night, with a mild low-irritation cleanser — washing more often irritates the skin without clearing it
- Choose skincare and make-up labelled non-comedogenic or oil-free, and introduce one new product at a time, roughly two weeks apart
- Apply a broad-spectrum SPF 50 every morning and reapply every two hours outdoors, which helps limit post-inflammatory pigmentation
- Give any new routine eight to twelve weeks before judging it, and photograph your skin every four weeks in the same light to compare
Avoid
- Picking, squeezing or extracting spots yourself — a single squeezed lesion can leave a mark that takes six to twelve months to fade, or a permanent scar
- Scrubs, harsh exfoliants and astringent toners, and washing more than twice a day — all strip and irritate skin that is already inflamed
- Starting more than one new active ingredient at once; add one, then wait two to four weeks before introducing the next
- Heavy occlusive hair products, and helmets, straps or face masks worn against the skin for more than two hours without a break
This is general guidance and does not replace individual assessment. What suits your skin depends on your acne type, your skin tone and any other treatment you are using.
Why Patients Choose Faciem
Acne Care That Starts With a Diagnosis
Acne is common, which sometimes means it gets treated casually. It remains a medical condition, and the difference between a plan that works and one that does not usually comes down to accurate assessment.
- Assessed by Dr Prasad, a GMC-registered doctor — not a product recommendation
- Acne type, severity and scarring risk established before any treatment is chosen
- Experience across all skin tones, including the pigmentation risk in deeper skin
- Honest advice when a treatment is not appropriate, including what to consider instead
Experience & Expertise
Why Acne Should Be Assessed by a Doctor
Acne looks simple and behaves anything but. The same spots can mean very different things depending on whether they are hormonal, inflammatory, follicular or drug-related, and a treatment that helps one type can aggravate another. Assessment also matters for what acne leaves behind: scarring and post-inflammatory pigmentation are far easier to prevent than to correct, and the window for preventing them is early. Dr Prasad establishes the type and severity of your acne, your skin tone and your scarring risk before recommending anything.
- Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
- Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
- Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
- Face-to-face medical consultation and skin assessment before any acne treatment is prescribed
- 20 years’ experience in dermatology, treating acne across all ages and every skin tone
Patient Reviews
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Acne FAQs
Your Questions, Answered
Quick answers to the acne questions patients bring to us most — from hormones and make-up to what facials can and cannot do. For anything specific to your own skin, book a consultation.
What causes acne?
Acne develops when four things happen together inside a hair follicle: hormones push the oil glands to produce more sebum, dead skin cells block the pore, Cutibacterium acnes bacteria multiply in the trapped material, and the immune system responds with inflammation. Family history influences how strongly each process occurs, while friction, occlusive products and picking can aggravate spots that already exist.
Can I wear make-up if I have acne?
Yes — make-up does not have to be given up because of acne, provided it is non-comedogenic or oil-free and comes off properly. Remove it every night, ideally within an hour of getting home, and wash brushes and sponges weekly, since both hold oil and bacteria. Mineral or water-based foundations sit more lightly on inflamed skin than heavy occlusive ones. After a peel or an in-clinic procedure, leave the skin bare for the first 24 hours before returning to make-up.
What is hormonal acne?
Hormonal acne is acne driven primarily by hormonal fluctuation. It affects adult women more often than men, typically flares in the days before a period, and clusters around the jaw, chin and neck. Polycystic ovary syndrome and other hormonal conditions can sit behind it, which is why sudden or persistent lower-face acne alongside irregular periods deserves medical assessment.
Is acne scarring permanent?
True acne scarring, where collagen has been damaged, tends to be long-lasting and is treated rather than cured. The flat brown or grey marks left once spots clear are post-inflammatory pigmentation, not true scars: these usually fade over months, though fading can take considerably longer in deeper skin tones.
Can acne be treated during pregnancy or while breastfeeding?
Acne can be treated in pregnancy and while breastfeeding, but the options narrow considerably. Oral isotretinoin and topical retinoids are not used in pregnancy, and several oral antibiotics used for acne are also avoided. Pregnancy-related acne often flares in the first trimester as hormones shift, and there are topical and in-clinic approaches that remain appropriate. Tell Dr Prasad at the consultation if you are pregnant, trying to conceive or breastfeeding, so the plan is built around that from the start.
Will a facial or peel clear my acne?
A facial or the occasional peel will not control acne unless it is very mild. In-clinic treatments help clear blocked follicles, but active acne is driven by oil production, bacteria and inflammation, which need consistent daily treatment — and sometimes prescription medicine — to bring under control. Facials and peels work best inside a doctor-led plan, not as a substitute for one.
How much does acne treatment cost?
The cost of acne treatment depends on severity, on how many sessions your skin needs, and on whether prescription medicine or medical-grade products form part of the plan. Current prices for therapist-led and doctor-led acne sessions are published on our acne treatment page, and the full cost of any recommended plan is confirmed with you in writing before treatment begins.
Sources & Further Reading
- Acne — causes, symptoms and treatment — NHS
- Acne patient information leaflet — British Association of Dermatologists
- Acne vulgaris — DermNet NZ
These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan are established at consultation.
Acne in Kensington, London
A Doctor-Led Clinic in the Heart of Kensington
Acne is usually managed across several appointments — an initial assessment, then reviews as your plan takes effect — so easy access matters. Faciem Dermatology & Medical Clinic is on Kensington Church St, a few minutes on foot from High Street Kensington station and about ten from Notting Hill Gate, with Kensington council underground parking close by. The clinic is open Monday to Saturday, 10am–7pm, and sees patients from Chelsea, Notting Hill, Holland Park and across Central and West London.
Plan Your Visit
- Faciem Dermatology & Medical Clinic
- Phone: +44 20 7131 3539
- 7 Kensington Church St, London W8 4LF, United Kingdom
- Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
- Parking: Kensington council underground car park nearby
- Open Monday–Saturday, 10am–7pm · Sunday closed
- Acne consultations bookable online; treatment follows assessment
- Consultation-first — no treatment without medical assessment
- Serving Kensington, Chelsea, Notting Hill & Central London
Continue Exploring
Related Conditions & Treatments
Acne Scarring
What causes acne to leave pitted or raised scars, and why early control of active acne is the most effective prevention.
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Hyper-pigmentation
Why inflammation leaves brown or grey marks behind, particularly in deeper skin tones, and how long they take to fade.
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Oily Skin
Excess oil production is one of the four drivers of acne, and it responds to treatment in its own right.
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Faciem Dermatology & Medical Clinic · Kensington
Find Out What Is Driving Your Acne
Book a consultation with Dr Prasad to establish what type of acne you have, what is driving it, and what a realistic plan looks like for your skin.
Prefer to talk? +44 20 7131 3539