Skin Condition · Kensington, London

Home / Acne

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.

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

0 +

Procedures

0 +

Satisfaction

0 %

On this page:

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.

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.

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

Medical-Grade Skincare

Best for: mild acne and long-term maintenance

Read about Medical-Grade Skincare

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.

About the Treatment

What Is Botox® and How Does It Work?

A plain medical explanation of what Botox is, which lines it changes, and why placement matters far more than the brand on the vial.

Botox® is a brand of botulinum toxin type A, a purified protein that temporarily relaxes the small facial muscles responsible for dynamic wrinkles — the lines made by frowning, squinting and raising the brows. With that repeated movement softened, the skin above rests and expression lines gradually smooth while natural movement is kept. The treatment is also known generically as anti-wrinkle injections.

Why expression lines form, and what Botox changes

Dynamic wrinkles — forehead lines, the vertical frown lines between the brows and crow’s feet at the outer corners of the eyes — form because the same muscles fold the same skin thousands of times a day. The crease starts as something you only see when you move. Over years it stays visible when you stop.

Botox works by a different mechanism from filler. Filler adds volume beneath the skin; anti-wrinkle injections reduce the strength of specific muscle contractions, so the skin above can relax and recover. Placed carefully, they soften the lines that exist and may help slow deeper creases from becoming etched. Outcomes differ from person to person, and a line already fixed at rest may need a different approach — see how wrinkles are assessed for that distinction.

Why a doctor plans and performs your Botox treatment

The result of a Botox treatment depends far more on the injector than on the product. Muscle strength, natural asymmetry, brow position, skin quality, previous treatment history and the balance between one area and the next all change how a plan should be dosed and where each injection should sit. Two people asking for the same thing rarely need the same treatment.

There is a legal dimension too. Botulinum toxin is prescription-only in the UK, which means a prescriber must assess you face to face before it can be prescribed for you. At Faciem the same person does both: Dr Prasad assesses, prescribes, plans and injects, with 20 years’ experience behind that judgement. Nothing is delegated, and you will be told honestly when treatment is not the right answer.

What Botox treatment feels like

Anti-wrinkle treatment is a series of very small injections with an ultra-fine needle into precisely selected muscles. Most people describe quick, small pinches rather than pain, and the injecting itself is usually finished within minutes. The appointment as a whole runs 20–30 minutes, most of which is assessment and planning.

Afterwards there is little to see. Mild redness or small bumps at the injection points are common and settle quickly. Most people return to work the same day and to normal activities immediately, with simple aftercare guidance to protect the result. What takes time is the effect itself, which builds over the following days instead of appearing as you leave. If you have something in the diary, plan around that gap: a first appointment is best not booked in the week of an event.

Botox is a brand name: what that means for your treatment

“Anti-wrinkle injections” is the general name for the treatment. Botox® is the best-known brand of botulinum toxin type A, made by Allergan and regulated in the UK by the MHRA; other licensed brands of the same class of medicine exist, and they are not interchangeable in dosing terms.

At Faciem the product used is a licensed botulinum toxin type A, prescribed by Dr Prasad following your face-to-face consultation. Knowing exactly what is being injected, by whom and under whose prescription is something every patient should be able to ask of any clinic and get a straight answer to. If a clinic will not name the product or the prescriber, that is the answer.

The medicine also cannot legally be advertised to the public in the UK, which is why clinics often describe the treatment generically as anti-wrinkle injections. That restricts promotion, not information: at consultation you can ask anything you like about what is being used.

What else Botox is used for, beyond expression lines

Although Botox is best known as an upper-face treatment, the same medicine may be considered — after assessment — for jawline slimming, masseter tension and teeth grinding, chin dimpling, downturned mouth corners, neck bands and excessive sweating. These are clinically distinct from smoothing a forehead, and some are treated more for function than for appearance.

Each has its own considerations, and none is offered on request without an examination first. Jaw work is discussed further on our jawline contouring page, and underarm, hand or facial sweating on our excessive sweating treatment page. Suitability is confirmed at consultation, because responses differ between individuals and not every presentation behaves the same way. Jaw and neck work in particular is planned differently from upper-face anti-wrinkle treatment, so what it involves and what it costs are set out at consultation, before anything is agreed.

Choosing the Right Treatment

Botox® vs Dermal Fillers: What’s the Difference?

Botox and dermal fillers are the two most requested injectable treatments in London, and they answer different problems. Botox — anti-wrinkle injections — relaxes the muscles that fold the skin; dermal fillers replace volume that has been lost. Which one a concern calls for is often the opposite of what people expect, and some faces benefit from both. Use the comparison below as a starting point; your consultation settles it.

Comparison of Botox (anti-wrinkle injections) and dermal fillers
	Botox	Dermal Fillers
How it works	Temporarily relaxes the muscles that cause dynamic expression lines	Adds hyaluronic acid volume beneath the skin to restore structure and smooth static folds
Best for	Forehead lines, frown lines, crow’s feet, jaw slimming and teeth grinding	Volume loss in cheeks and lips, nasolabial folds and deeper static lines
Results appear	From a few days, with full effect in 10–14 days	Immediately, settling over one to two weeks
Results last	Around 3–4 months	Typically 6–18 months, depending on product and area
Downtime	Minimal — most people return to work the same day	Minimal, though mild swelling or bruising can occur
Ideal candidate	Someone whose lines appear or deepen when they make an expression	Someone with lines and hollows visible even when the face is at rest

Both are medical treatments and individual responses differ. At consultation Dr Prasad says which of the two your face actually calls for — if either — and when dermal fillers for volume loss or a medical-grade skincare plan would do more for you than an anti-wrinkle injection into muscle.

Botox Prices London

How Much Does Botox® Cost in London?

Botox treatment at Faciem starts from £150 per area. Your final price depends on how many areas are treated and the dose your plan requires, and both are confirmed in writing at your consultation before any treatment takes place. There are no surprises on the day and no pressure to proceed.

Some candid advice on comparing anti-wrinkle injection prices in London. Reputable clinics tend to cluster in a similar range, because a proper service carries real costs: a registered prescriber, a genuine consultation, a licensed medicine and a clinical setting. A price well below that range usually means one of those four is missing.

We would rather you chose carefully than chose us quickly. If you want to talk something through before booking, you can contact the clinic directly, and a consultation carries no obligation to go ahead.

Treatment	Price
Botox, one area	From £150
Additional areas	Quoted at consultation
Jaw slimming and jaw tension	Quoted at consultation
Consultation	Varies by appointment type, confirmed when you book

Benefits of Botox Treatment at Faciem

Why Patients Choose Faciem for Botox® in London

Botox is one of the most requested treatments in Kensington because it is quick, non-surgical and, done well, genuinely subtle. Done poorly, an anti-wrinkle injection is obvious for three months. Almost all of that difference sits in the assessment and the dosing, which is why both are done by a doctor here.

Softens frown lines, forehead lines and crow’s feet without surgery
Botox prescribed, planned and performed by Dr Prasad, a GMC-registered doctor
Dosing and placement matched to your muscles, so the result still looks like you
Short anti-wrinkle appointments with little to no downtime for most patients
Consultation-first advice, with clear anti-wrinkle injection pricing agreed before treatment
Kensington Church St clinic, minutes from High Street Kensington station

Experience & Expertise

Your Botox Is Prescribed and Performed by the Same Doctor

With an injectable treatment, the outcome is decided by who holds the syringe. Reading muscle strength, allowing for asymmetry that was there long before treatment, judging what a lifted brow will do to the eye beneath it, knowing which areas to leave alone — none of that comes from the product. It comes from anatomy, from experience, and from a willingness to inject less than was asked for.

At Faciem Dermatology & Medical Clinic your anti-wrinkle treatment is assessed, prescribed, planned and injected by Dr Prasad herself; it is not delegated to a non-medical injector. That means a genuine medical consultation before anything is prescribed, honest advice on suitability and alternatives, and a clinician trained to recognise facial anatomy, to manage the uncommon complications and to say no when the answer is no.

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 · ZO Skin Health UK Faculty & Trainer
Clinic operated by Derma Medical UK Ltd — registered with the Care Quality Commission (CQC) for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury (Location ID 1-25573003746)
Face-to-face medical consultation and facial assessment before every treatment, as UK prescribing rules require
20 years’ experience in dermatology and aesthetic medicine, with every treatment planned and performed personally

Patient Reviews

Rated Excellent by Patients on Google

Your Journey, Our Promise

What Happens at a Botox® Appointment

A Botox appointment at Faciem takes 20–30 minutes, and the majority of that is spent before a needle is opened. These are the four stages of an anti-wrinkle appointment, from first assessment to review.

STEP 01

Consultation

Dr Prasad watches how your forehead, brow and eye muscles actually move, reviews your medical history and any previous injectable treatment, and tells you whether the lines that bother you are the sort that respond to anti-wrinkle injections. Because botulinum toxin is prescription-only, this face-to-face assessment is a legal requirement as well as a clinical one.

STEP 02

Personalised Plan

You are shown which areas are proposed, the dose intended for each, and the price of that exact combination — before anything is prescribed. If skincare, filler or simply doing nothing would suit you better, you are told so at this point.

STEP 03

Treatment

The mapped points are injected in sequence with an ultra-fine needle. Most patients describe brief pinches, the injecting is over within minutes, and there is nothing to recover from before you leave the clinic.

STEP 04

Aftercare & Review

You go home with aftercare advice for the first 24–48 hours and a clear idea of the timeline: changes from around day three, the settled result at 10–14 days. A review can be arranged to fine-tune the plan; when it takes place, and any charge for it, is confirmed at your appointment.

Side Effects & Safety

How Safe Is Botox®? An Honest Answer

Botox has a long, well-documented record when prescribed and administered correctly, and botulinum toxin, the medicine behind every anti-wrinkle injection, has been licensed for cosmetic use for over two decades. How safe your treatment is depends on who is treating you and what they knew about your history first. Here is what any clinic should tell you before treating you, including this one.

Common, temporary effects

Uncommon effects

Who Botox is not for

Botox Aftercare

How to Care for Your Skin After Botox®

Good aftercare protects the result of your Botox treatment, and the recovery arc after an anti-wrinkle injection is short and predictable. The first four hours carry the strictest rules, the first 24 to 48 hours carry the rest, the earliest softening shows from around day three, and the settled result arrives at 10 to 14 days. You will receive personalised guidance on the day; these are the general principles most patients follow.

Do

Stay upright for at least four hours, avoiding bending forward at the waist
Leave the treated area free of make-up for the rest of the day, roughly 12 hours
Frown, raise the brows and smile a few times in the first hour after treatment
Wait the full 10–14 days for the result to settle before judging it or booking a review
Plan your next treatment at around the 3–4 month mark, before movement has fully returned

Avoid

Rubbing, massaging or pressing the treated area for 24 hours, cleansing brushes included
Vigorous exercise, saunas, steam rooms and hot yoga for 24–48 hours
Lying flat, lying face-down or having a head or facial massage for the first four hours
Alcohol for 24 hours after treatment, which lowers the chance of bruising
Facials, facial massage, microneedling and other facial treatments for two weeks

General guidance only: it does not replace the aftercare instructions Dr Prasad gives you for your own treatment. Mild redness or small bumps at the injection points are common and usually settle within about half an hour, and pinpoint bruising, if it appears, fades over a few days. Contact the clinic if anything unexpected appears, rather than waiting it out.

Botox FAQs

Your Questions, Answered

Cost, timing, safety and how natural the result looks — the questions below come up in almost every Botox consultation. If yours is not here, bring it with you and Dr Prasad will answer it in person.

How much does Botox cost in London?

Botox at Faciem starts from £150 per area. The final cost depends on how many areas are treated and the dose your plan requires, and it is confirmed in writing at consultation, so you know exactly what is recommended and why before going ahead. Jaw slimming and jaw tension treatment is quoted separately, because it is planned and dosed differently.

How long does Botox take to work?

Botox typically starts to show within three to fourteen days, with the full result usually settled by day 10 to 14. How quickly you see a change depends on the area treated, the dose used and the strength of the underlying muscle. Wait the full two weeks before judging the outcome or asking for an adjustment.

How long does Botox last?

Botox results usually last around three to four months, though this varies. Metabolism, muscle strength, lifestyle and the area treated all influence how long the effect is maintained — masseter and jaw-slimming treatment can need shorter intervals. If you stop having treatment, your muscles and lines gradually return to the state they were in before; they do not become worse. The interval that suits you is agreed at review once Dr Prasad has seen how your muscles responded the first time.

Does Botox hurt?

Botox is usually described as a brief pinch at each point rather than pain. It is given with an ultra-fine needle, each injection lasts a second or two, and the injecting part of the appointment is over in a few minutes, so no anaesthetic is normally needed. Ice can be used on the day if you would find it easier. If you are anxious about needles, raise it at consultation so it can be planned for, not on the day once you are in the chair.

Will I still look natural after Botox?

When Botox is planned conservatively and with a good understanding of facial anatomy, the result is a fresher, softer appearance rather than a fixed one. At Faciem the plan is built to keep your natural expression while reducing the lines you dislike, which is one reason Dr Prasad will sometimes recommend a smaller dose than you asked for. Individual responses differ.

Who should not have Botox?

Botox is not suitable during pregnancy or breastfeeding, for people with certain neuromuscular conditions, or where there is an infection at the treatment site. Other medical history can also make treatment inadvisable, which is why Dr Prasad reviews it before prescribing. If treatment is not right for you, she will say so and discuss what else might help.

How soon can I go back to work or to an event after Botox?

Most people go back to work straight after Botox, on the same day. The appointment runs 20–30 minutes and there is little to see afterwards beyond mild redness or small bumps at the injection points, which usually settle within about half an hour. Events are a different question, because the effect builds rather than appears: leave at least a fortnight, ideally two to three weeks, between a first treatment and a wedding, a photograph or anything you want to look settled for.

Can men have anti-wrinkle injections?

Yes — anti-wrinkle injections suit men and women, and the plan is tailored to the individual, taking account of facial structure, muscle strength and the kind of result wanted. Male facial muscles are often stronger, which changes the dose and the placement, not the principle behind them. How much movement you want kept is part of the plan and is agreed before treatment.

Do anti-wrinkle injections prevent wrinkles?

Anti-wrinkle injections may reduce the repetitive muscle movement that contributes to dynamic lines, which is why some people choose to start before creases become established. Skin ageing is also driven by sun exposure, genetics and skincare habits, so prevention is never one treatment alone; a fuller plan is discussed at consultation.

Can I wear make-up after Botox?

Leave the treated area free of make-up for the rest of the day after Botox, roughly 12 hours, and apply it again the following morning. The reason is the pressure rather than the product: rubbing and massaging the area in the first 24 hours can move the medicine away from the muscle it was placed in, so use fingertips or a clean brush with a light touch rather than a sponge or a cleansing device. Exercise, saunas and steam rooms wait 24 to 48 hours.

Is Botox the same as anti-wrinkle injections?

Yes. “Anti-wrinkle injections” is the general name for the treatment, and Botox® is the best-known licensed brand of botulinum toxin type A used to perform it. Faciem stocks the three established, licensed botulinum toxins — Botox®, Azzalure® and Bocouture® — each with long-standing international safety data, and does not use newer toxins still awaiting comparable evidence. Which product suits your treatment is decided with Dr Prasad at consultation.

Why do I need a consultation before Botox?

Botox is botulinum toxin type A, a prescription-only medicine in the UK, so a prescriber must assess you face to face before it can be prescribed for you. Beyond the legal requirement, the consultation is where your anatomy, medical history and goals are assessed — and that assessment is what determines the dose, the placement and whether treatment is advisable at all.

Botox® in Kensington, London

A Doctor-Led Clinic in the Heart of Kensington

Faciem Dermatology & Medical Clinic sits on Kensington Church St, a few minutes’ walk from High Street Kensington station and roughly ten from Notting Hill Gate. Most patients come from the streets around it — Chelsea, South Kensington, Notting Hill, Knightsbridge, Holland Park — and others travel in from further across London for their anti-wrinkle injections for the same reason: one doctor prescribes, plans and injects.

Botox appointments run 20–30 minutes and the clinic is open Monday to Saturday, 10am–7pm, which makes a lunchtime or early-evening slot workable around most jobs. Kensington council underground parking is available nearby. One piece of timing advice: because the effect builds over 10–14 days, book at least a fortnight ahead of a wedding, a photograph or anything else you would like to look settled for.

Comparing clinics? Ask three questions wherever you go. Who prescribes the medicine, and will you meet them face to face before treatment? Which licensed product will be used, named rather than described only as premium? And what exactly does the quoted price cover? A clinic working properly answers all three without hesitation — and a prescriber should be registered with the GMC, NMC or GDC. Those are the standards this clinic holds itself to.

Still unsure whether Botox is the right starting point? A consultation carries no obligation to proceed. Dr Prasad will assess your skin and your expression lines, explain the alternatives including doing nothing for now, and give you a straight recommendation.

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
Appointments: 20–30 minutes, bookable online
Consultation-first — no treatment without medical assessment
Serving Kensington, Chelsea, Notting Hill & Central London

Continue Exploring

Related Treatments & Reading

All Aesthetic Treatments

Explore the full range of doctor-led skin and aesthetic treatments available at Faciem, from injectables to medical-grade skincare.

View treatments →

Skin Health Blog

Expert articles from the Faciem team on skin ageing, treatment advice and how to get the best from your skincare.

Read the blog →

Faciem Dermatology & Medical Clinic · Kensington

Have Your Face Assessed Before Botox Is Prescribed

Book a Botox consultation with Dr Prasad to find out how your muscles move, which areas would respond and what a plan would cost — with no obligation to go ahead. If you would like to hear from people treated here first, read our patient reviews.

Prefer to talk? +44 20 7131 3539