Adult Acne Treatment & Skincare Guide

Legal Disclaimer (Adults 18+, Non-Prescription, Australia)

This policy provides evidence-based cosmetic-class information for adults (18+) with mild–moderate acne and is not a substitute for medical advice, diagnosis, investigation or treatment by a GP or dermatologist. ⁷ ⁹ It is written to comply with Australian advertising and cosmetic-product rules so that information about cleansers, cosmetic-class actives and supportive treatments remains within non-therapeutic scope and does not promote prescription-only medicines or make restricted health claims. ¹ ³

Patients with severe, painful, rapidly worsening, nodulocystic, scarring, systemic or pregnancy-related acne must be referred to a medical practitioner, as this falls outside non-prescription care. ⁷ ⁹ Nothing in this document authorises non-medical staff to diagnose acne, change prescription medicines, interpret pathology or manage systemic disease; all staff must comply with AHPRA, TGA, AICIS and ACCC requirements when discussing products or services with patients or online. ¹ ² ³ ⁶

1. Purpose

The purpose of this policy is to give adult patients a clear, plain-English guide to what acne is, why it happens, what tends to worsen it, and which non-prescription treatments have the strongest evidence so they can build a sensible routine and know when to seek medical help. ⁷ ⁸ It also provides a consistent framework for clinicians and cosmetic staff to explain acne support options while staying within Australian cosmetic, advertising and consumer law, especially around the distinction between “cosmetic” and “therapeutic” claims. ¹ ³ ⁴

2. Scope & Exclusions

This policy covers adult, non-prescription, cosmetic-class management of mild to moderate acne using: gentle cleansers, moisturisers, benzoyl peroxide, cosmetic-class retinoids (retinol/retinal), azelaic acid, niacinamide, salicylic acid, clay/sulfur masks and cosmetic LED (blue/red) as supportive care. ⁵ ⁷ ¹⁴ It applies to products correctly regulated as cosmetics under AICIS and not as therapeutic goods, and to information that avoids making therapeutic claims reserved for TGA-regulated medicines. ³ ⁵

It excludes prescription retinoids, oral antibiotics, oral isotretinoin, hormonal therapies, spironolactone, pathology work-up, diagnosis of endocrine or systemic disease, and any prescribing or deprescribing decisions, which must be managed by registered medical practitioners according to RACGP and specialist guidance. ⁹ ¹⁰ ¹³ Children and adolescents are outside scope for this adult-only guide and should follow age-specific paediatric or GP advice. ⁴ ¹¹

3. Regulatory & Advertising Compliance (AHPRA / TGA / AICIS / ACCC)

All information given to patients, on the website or social media, must comply with AHPRA’s Guidelines for advertising a regulated health service, including avoiding misleading claims, guaranteed outcomes, or use of clinical testimonials about regulated health services. ¹ ² Acne-related content must not promote prescription-only medicines or use therapeutic language implying diagnosis, prevention or cure of disease when discussing cosmetic-class products. ¹ ³

The TGA and NHMRC clearly distinguish cosmetic from therapeutic goods by ingredients, intended purpose and claims, and anti-acne cosmetics can only make limited claims about cleansing, exfoliating or improving the appearance of spots, not treating acne as a disease. ³ ⁴ AICIS regulates the chemicals in anti-acne skin-care products that are excluded goods and prohibits scheduled substances in products sold solely as cosmetics, while the ACCC requires that all performance and “results” claims are truthful, evidence-based and not misleading. ⁵ ⁶

4. Understanding Acne — Patient-Friendly Overview

4.1 What Is Acne?

Acne is a common chronic inflammatory skin condition where hair follicles and oil glands become clogged and inflamed, leading to blackheads, whiteheads, red bumps, pustules and sometimes deeper lumps on the face, neck, chest, shoulders and back. ⁷ ¹¹ ¹³ It is extremely common in adolescence but many adults continue to have flare-ups into their 30s, 40s and beyond. ⁷ ¹² While acne is not dangerous, ongoing or severe acne can cause physical scarring and significant impact on self-esteem and mental health if not managed appropriately. ⁹

4.2 How Acne Develops (Pathophysiology in Simple Terms)

Acne is driven by four main processes: increased oil (sebum) production, sticky dead skin cells that block pores, overgrowth of acne-related bacteria in the follicles, and inflammation in and around the hair follicle unit. ⁹ ¹³ Hormones, genetics and environmental factors influence these processes, which is why some people are highly acne-prone even with good hygiene and reasonable lifestyles. ⁹ ¹³

When a pore becomes blocked, it forms a microcomedone which can evolve into a whitehead or blackhead; if the follicle wall breaks and inflammation spreads, red papules, pustules and deeper nodules can appear. ⁹ ¹³ These inflammatory lesions are more likely to leave marks or scars if they are picked, squeezed or left untreated. ¹¹ ¹³

5. Types of Acne (Adults)

5.1 Comedonal Acne (Blackheads & Whiteheads)

Comedonal acne is dominated by blackheads and whiteheads and is most visible across the T-zone, cheeks and jawline. ⁷ ¹³ It is usually mild to moderate and responds well to non-prescription exfoliants such as salicylic acid, benzoyl peroxide and cosmetic-class retinoids, which help keep pores clear and reduce formation of new comedones over time. ⁸ ¹⁴

5.2 Inflammatory Acne (Red Bumps & Pustules)

Inflammatory acne features red, tender bumps and pustules caused by deeper inflammation and involvement of acne-related bacteria. ⁹ ¹¹ ¹³ Mild to moderate inflammatory acne may improve with combinations of benzoyl peroxide, salicylic acid and retinol, but more pronounced or widespread disease often needs medical review, especially where scarring, distress or failure of over-the-counter care is evident. ⁸ ⁹

5.3 Nodulocystic Acne (Severe / Scarring-Prone)

Nodulocystic acne consists of deep, painful lumps and cyst-like lesions and is strongly associated with permanent scarring and psychosocial harm. ⁹ ¹³ This pattern almost always requires prescription-only therapies, including oral isotretinoin under specialist supervision, and is not suitable for cosmetic-class management; early GP or dermatologist referral is critical. ⁹ ¹⁰

6. Common Triggers & Worsening Factors

Acne can be aggravated by hormonal changes, menstrual cycles, stress, sleep disturbance, heavy or occlusive cosmetics, friction from masks or helmets, sweat, high humidity and irregular skincare routines. ⁷ ¹¹ ¹³ Some people also notice flares with high-glycaemic diets, sugary drinks or whey-protein supplements, although dietary effects vary and should be approached with moderation rather than extreme restriction. ⁸ ¹³

Picking or squeezing pimples significantly increases the risk of pigmentation and scarring, especially in medium-to-darker skin types, and can prolong the life of a breakout. ¹¹ ¹³ Adult acne can also be triggered or worsened by smoking, certain medicines, cosmetic occlusion or occupational exposures, which may need to be reviewed with a GP. ⁸ ⁹

7. Acne Treatment Hierarchy — From Strongest Evidence to Supportive

7.1 How to Read This Section

Tier 1 treatments are the backbone and are recommended for most adults with mild–moderate acne if tolerated. ⁷ ⁸ Tier 2 treatments are powerful add-ons that are usually combined with Tier 1 for best results, while Tier 3 options support the barrier and tolerance, and Tier 4 options are adjuncts that should not replace higher-tier therapies. ⁷ ⁹

7.2 TIER 1 — Strongest Evidence, First-Line

7.2.1 Benzoyl Peroxide (BPO) — Core Non-Prescription Treatment

Benzoyl peroxide is one of the most proven over-the-counter treatments for mild–moderate acne worldwide. ⁸ ⁹ It reduces acne bacteria, inflammation and formation of new inflammatory lesions when used consistently over several weeks. ⁸ ¹⁴

Benzoyl peroxide acts like a disinfectant plus mild peel inside the pore by releasing oxygen, which kills acne-associated bacteria, and by loosening keratin plugs that block follicles. ⁸ ¹⁴ It is especially effective for inflammatory papules and pustules and can also help mixed acne with both inflamed lesions and comedones. ⁷ ⁸

Most adults do best starting with low strength around 2.5% rather than jumping straight to higher concentrations, which can be unnecessarily irritating. ⁸ ¹⁴ A pea-sized amount is usually enough for each facial region, applied thinly over acne-prone areas rather than just individual spots. ⁷ ⁸

Starting every second night for 1–2 weeks allows the skin to adapt and reduces irritation compared with daily use from day one. ⁸ ¹⁴ Pairing benzoyl peroxide with a non-comedogenic moisturiser reduces dryness and improves comfort and adherence. ⁷ ⁸

Using very high strengths or thick layers from the outset almost always leads to irritation and may cause patients to abandon effective treatment. ⁸ ⁹ Applying benzoyl peroxide twice daily immediately without a build-up period greatly increases dryness, burning and peeling, particularly in fair or sensitive skin. ⁸ ¹⁴

Benzoyl peroxide can bleach towels, pillowcases and clothing, so patients should be clearly warned before starting. ⁷ ⁸ Mild dryness, tightness and light flaking in the first weeks are common and usually improve with moisturiser and gradual dose escalation, while severe burning, intense redness, swelling or blistering suggests intolerance and warrants stopping and seeking medical advice. ⁷ ¹¹

7.3 TIER 2 — Strong Evidence, Excellent Adjuncts

7.3.1 Azelaic Acid (10–20%)

Azelaic acid is useful for people who have both active acne and post-inflammatory hyperpigmentation or redness, because it acts on inflammation, bacteria and pigment pathways. ⁷ ¹³ It offers anti-inflammatory, mild antibacterial and pigment-modulating effects in one cosmetic-class ingredient and is generally well tolerated. ¹³ ¹⁴

Azelaic acid calms inflammation around pustules and papules, reducing redness and discomfort. ¹³ ¹⁴ It also interferes with abnormal pigment production in healing lesions, helping brown and red marks fade more evenly over time, particularly when combined with sunscreen. ¹³ ¹⁴

Azelaic acid is particularly suited to adults whose main concerns are ongoing breakouts plus obvious brown or reddish marks that linger after pimples, as well as those with sensitive or rosacea-prone skin who cannot tolerate aggressive acids. ⁷ ¹³ ¹⁸ It is often easiest to use as a morning treatment before moisturiser and sunscreen, though it can also be used on non-retinoid nights in the evening. ⁷ ¹³ ¹⁴

A thin layer should be applied over acne-prone areas rather than just dotted on single lesions to treat both visible and developing lesions. ¹³ ¹⁴ Mild tingling or stinging when first applied is common and usually settles within a few minutes, especially if followed by moisturiser. ¹³ ¹⁴

If significant burning or persistent irritation occurs, reducing frequency or pairing with a richer moisturiser can help, and stopping is appropriate if symptoms continue. ⁷ ¹¹ Although azelaic acid is often considered suitable in pregnancy at cosmetic strengths, all pregnant or breastfeeding adults should confirm product use with a GP or pharmacist. ⁸ ⁹

7.3.2 Salicylic Acid (BHA)

Salicylic acid is a well-established over-the-counter treatment for comedonal acne and oily skin. ⁷ ¹³ Its oil-soluble nature allows it to penetrate into pores and dissolve sebum and compacted dead skin, making it particularly effective for blackheads and closed comedones. ¹³ ¹⁴

Salicylic acid helps loosen and clear out plugs that cause visible blackheads and rough, bumpy texture when used regularly at tolerable strengths. ⁷ ¹³ ¹⁴ It is best suited to oily or combination skin with visible congestion on the nose, chin, forehead or jawline, rather than very dry or sensitive skin. ⁷ ¹³

Sensitive patients often do better starting with a wash-off cleanser containing salicylic acid before progressing to leave-on toners or serums. ⁷ ¹³ Leave-on products should usually be introduced two or three nights per week on different nights to strong retinoids and increased only if the skin remains comfortable. ⁸ ¹⁴

Over-use, especially alongside other actives, can cause redness, stinging and peeling, particularly around the eyes, mouth and neck. ⁷ ¹¹ People with very dry, eczema-prone or sensitive skin may only tolerate occasional use or may not tolerate salicylic acid at all, and large-area high-strength leave-on use in pregnancy should be discussed with a GP or pharmacist. ⁸ ⁹

7.4 TIER 3 — Supportive, Barrier & Tolerance

7.4.1 Niacinamide (Vitamin B3)

Niacinamide supports the skin barrier and reduces background redness, making it easier to tolerate stronger actives such as benzoyl peroxide and retinoids. ⁷ ¹³ It may also modestly reduce sebum production and improve overall skin quality without significant irritation. ¹³ ¹⁴

Niacinamide enhances ceramide production and barrier function, helping the skin resist dryness and irritation from other treatments. ¹³ ¹⁴ It has anti-inflammatory properties that can reduce low-grade redness and blotchiness in acne-prone skin when used consistently. ⁷ ¹³

Niacinamide is suitable for almost all acne patients, particularly those using benzoyl peroxide or retinoids, and for sensitive, combination or redness-prone skin types needing a gentle, well-tolerated active. ⁷ ⁸ ¹¹ It is commonly used once or twice daily after cleansing and before moisturiser, with concentrations around 2–5% usually effective and well tolerated. ⁷ ¹³ ¹⁴

Side effects are uncommon but can include transient flushing or mild tingling in very sensitive individuals, which usually improves with continued use or lower frequency. ⁷ ¹¹

7.4.2 Basic Cleansers & Moisturisers (Non-Comedogenic)

Gentle cleansers and non-comedogenic moisturisers do not treat acne directly but make it possible to continue effective treatments without destroying the barrier. ⁷ ¹¹ Without this support, even correctly chosen actives can become intolerable and lead to treatment failure and poor adherence. ⁸ ¹¹

Cleansers should be soap-free, pH-balanced and non-scrubbing, helping remove oil, dirt and sunscreen without stripping the skin. ⁷ ¹¹ Moisturisers should be labelled non-comedogenic or oil-free, with light gel or cream textures that hydrate without clogging pores. ⁷ ¹¹

Cleansing twice daily is usually enough for most adults, as more frequent washing increases dryness and irritation without additional benefit. ⁷ ¹¹ Moisturiser should be used at least once daily, and more often if there is visible dryness or irritation from actives, to maintain comfort and barrier integrity. ⁷ ⁸

7.5 TIER 4 — Adjunctive / Lower Evidence

7.5.1 Clay & Sulfur Masks

Clay masks can temporarily reduce surface oil and shine by absorbing sebum from the outer layer of skin. ¹¹ ¹⁴ Sulfur-containing masks can provide mild antibacterial and anti-inflammatory effects but are not as well studied as benzoyl peroxide or retinoids. ¹⁰ ¹⁴

They can be useful as once-or-twice weekly extras for very oily skin or for patients who enjoy mask rituals, especially applied to oily zones such as the T-zone. ¹¹ ¹⁴ Most adults do well limiting these products to once or twice per week to avoid dryness and irritation and should apply moisturiser afterwards to protect the barrier. ⁷ ¹¹ ¹⁴

Clay and sulfur masks do not address deeper drivers like microcomedones or hormonal influences, so they should never replace Tier 1–2 treatments in evidence-based acne care. ⁹ ¹⁴

7.5.2 Cosmetic LED (Blue & Red Light)

Blue LED can reduce populations of acne-related bacteria in the skin when delivered at appropriate intensities and schedules, while red LED may reduce inflammation and help healing and redness. ⁹ ¹⁴ Cosmetic LED has evidence for improving mild acne but is generally less effective than systemic or combination medical therapies for moderate–severe disease. ⁹ ¹⁵

Benefits are greatest when LED is used as an adjunct to topical routines rather than as a standalone cure, and it may be considered for patients with mild acne who already have a consistent topical regimen and want an additional non-invasive option. ⁹ ¹⁴ It can be useful in clinics that already have devices and protocols aligned with evidence-based parameters. ⁹ ¹⁵

Marketing claims for LED devices must comply with TGA and ACCC requirements, avoiding unsubstantiated cure language or therapeutic claims beyond the evidence base. ¹ ³ ⁶ LED should not delay referral in patients with severe, scarring or psychologically distressing acne where isotretinoin or other systemic therapies may be indicated. ⁹ ¹⁰

8. Simple Acne Routine Templates (What To Actually Do)

8.1 Morning Routine (AM) – “Protect & Calm”

The aim of the morning routine is to prepare the skin, calm inflammation and prevent marks and UV-driven damage throughout the day. ⁷ ⁸ A simple, repeatable set of steps is usually more effective than complex routines that are hard to sustain. ⁷ ⁸

A typical morning routine begins with a gentle gel or cream cleanser that is soap-free and pH-balanced, used for 20–30 seconds with lukewarm water to remove overnight oil and product residue without stripping the barrier. ⁷ ¹¹ After cleansing, a niacinamide serum can be applied over the whole face to support the barrier and reduce redness, and a thin layer of azelaic acid may be added on acne-prone areas to calm inflammation and pigment if tolerated. ⁷ ¹³

A light, non-comedogenic cream or gel moisturiser should then be applied to reduce dryness and irritation from any overnight actives. ⁷ ¹¹ The final and non-negotiable step is a broad-spectrum SPF 50+ sunscreen labelled non-comedogenic, used every morning all year round, with approximately half a teaspoon for the face and neck and reapplication with prolonged outdoor exposure. ³ ⁷

Very oily skin often does best with gel or fluid sunscreens and very lightweight gel moisturisers to reduce shine without compromising protection. ⁷ ¹¹ Dry or sensitive skin may require slightly creamier moisturisers and very gentle, non-foaming cleansers to avoid additional irritation. ⁷ ¹¹

8.2 Evening Routine (PM) – “Treat & Repair”

The aim of the evening routine is to use core acne treatments while giving the skin time overnight to recover and repair. ⁸ ⁹ A consistent but not overly complicated routine is more sustainable and reduces the risk of over-treating and barrier damage. ⁸ ¹¹

Most adults begin with a gentle cleanser to remove makeup, sunscreen and daily build-up; double cleansing may be appropriate if heavy or water-resistant products are used. ⁷ ¹¹ After cleansing, the main treatment step is introduced, with rotation between retinoids, benzoyl peroxide and salicylic acid to balance effectiveness and tolerability. ⁸ ⁹ ¹⁴

For example, on one night a pea-sized amount of retinol or retinal can be applied across the face to prevent clogged pores and improve texture, while on the next night a thin layer of benzoyl peroxide can be used on acne-prone areas to target bacteria and inflammation. ⁸ ⁹ ¹³ ¹⁴ On another night, the patient may rest from strong actives and use only niacinamide and moisturiser to support the barrier, and on a further night a salicylic-acid product may be used if congestion is a major problem and the skin tolerates it. ⁷ ⁸ ¹³ ¹⁴

In all cases, a non-comedogenic moisturiser should be applied after actives to reduce dryness and improve comfort and adherence. ⁷ ⁸ ¹¹ If skin becomes irritated, salicylic acid is often the first active to reduce or stop, retinoid frequency can be lowered to once or twice per week, and patients can revert temporarily to cleanser, moisturiser and niacinamide alone until the barrier recovers. ⁷ ⁸ ¹¹ ¹⁴

9. Safety, Red Flags & When To Stop Products

9.1 Normal vs Not Normal

Adjustment to new actives commonly includes slight dryness or tightness, especially around the mouth and cheeks, in the first few weeks of treatment. ⁸ ¹⁴ Fine flaking around the nose or chin that improves with moisturiser and slower titration of actives is usually acceptable and not a reason to stop treatment entirely. ⁷ ¹¹

Mild tingling for a few minutes after applying active products such as azelaic acid or retinoids is also common and generally settles quickly as the skin adapts. ¹³ ¹⁴ However, intense burning that persists beyond a few minutes, increasing with each application, is not normal and may indicate intolerance, overuse or contact dermatitis. ⁷ ¹¹

Swelling of eyelids, lips or face, difficulty breathing, or widespread hives suggests a possible allergic reaction and requires urgent cessation of products and prompt medical assessment. ⁷ ¹¹ Blistering, oozing or broken skin in treated areas also indicates severe irritation or allergy and must be managed as an adverse event rather than normal purging. ⁷ ¹¹

A rapid surge of deep, painful nodules or cysts that is out of proportion to previous acne patterns is a red flag for severe inflammatory acne and should prompt early medical review, particularly if scarring is developing. ⁹ ¹⁷

9.2 “Too Much Product” Warning Signs

Warning signs that a routine is too aggressive include skin that looks constantly red, shiny and tight even without actives applied that day. ⁷ ¹¹ Stinging or burning with plain water or simple moisturiser is another indicator of barrier damage rather than normal adjustment. ⁷ ¹¹

New breakouts occurring alongside obvious irritation and peeling often mean that the barrier has been compromised and that multiple actives are being overused. ⁸ ¹⁴ In this situation, all strong actives such as benzoyl peroxide, retinoids and salicylic acid should be stopped for several days while the patient focuses on gentle cleanser, moisturiser and sunscreen only. ⁷ ¹¹

Once the skin feels comfortable again, a single active can be reintroduced at low frequency while avoiding the temptation to restart several new products at once, with gradual titration guided by tolerance rather than urgency. ⁸ ¹⁴

10. When To See a GP or Dermatologist (Non-Negotiable)

Patients should stop relying solely on self-management and see a GP or dermatologist if acne is severe, painful, cystic or nodular, with deep lumps that risk scarring. ⁹ ¹⁶ Visible new or worsening scars or areas of persistent thickening on the face or trunk are further indications for medical review and possible systemic therapy. ⁸ ⁹

Acne that is not improving after 8–12 weeks of consistent, sensible non-prescription treatment should also be reviewed clinically, as this may indicate the need for prescription options or investigation of hormonal or other systemic drivers. ⁸ ⁹ Acne that appears suddenly in adulthood without a clear trigger or that worsens rapidly over a short period can be a clue to hormonal, medication-related or systemic causes and should not be ignored. ⁹ ¹⁷

Other reasons to seek medical input include irregular periods, new facial or body hair growth, or weight changes that could suggest androgen excess or other endocrine issues, as well as acne that clearly started or worsened after a prescription medication and has not settled. ⁹ ¹⁰ ¹⁷ Significant impact on mood, self-esteem or social functioning due to acne is itself a valid reason to seek help, as early treatment can reduce psychological harm. ⁹ ¹⁷

GPs can manage many cases with topical and systemic therapies according to RACGP guidance and will refer to dermatologists when isotretinoin or more complex treatments are needed. ⁹ ¹⁰

11. Patient Q&A (15 Questions)

Q1. Why does acne take so long to improve?

Acne lesions start forming deep in the pores weeks before they appear on the skin’s surface, so treatments are always working on both old and developing lesions. ⁹ ¹⁷ Most people need at least 8–12 weeks of consistent treatment before a fair assessment is possible, and stopping early is a major reason therapies seem to fail. ⁸ ⁹

Q2. Can skincare alone fix all acne?

For mild–moderate acne, a structured routine using benzoyl peroxide, retinoids, gentle cleanser, moisturiser and sunscreen can achieve excellent control for many adults. ⁷ ⁸ For severe, cystic, scarring or clearly hormonal acne, skincare helps but is rarely enough, and prescription medications from a GP or dermatologist are usually required. ⁹ ¹⁰

Q3. Does diet really matter for acne?

Studies suggest that high-glycaemic diets and some dairy patterns can worsen acne in a subset of people, although responses are individual. ⁸ ¹⁷ A balanced, lower-glycaemic eating pattern with fewer sugary drinks and ultra-processed foods is sensible, but diet should be viewed as a support strategy alongside, not instead of, evidence-based treatment. ⁷ ⁹

Q4. Should I squeeze or pop my pimples?

Squeezing often pushes inflammation deeper into the skin, leading to more swelling, pain and a higher chance of dark marks or scars, especially in darker skin types. ¹¹ ¹⁸ It is safer to allow pimples to resolve with benzoyl peroxide, retinoids and azelaic acid rather than forcibly emptying them. ⁸ ¹⁴

Q5. Can sunscreen make acne worse?

Heavy, occlusive sunscreens can worsen acne in some people, but modern non-comedogenic gel and fluid SPF 50+ formulations are designed for acne-prone skin. ⁷ ⁸ Avoiding sunscreen leads to more redness, darker post-inflammatory marks and accelerated photoageing, so choosing the right sunscreen is essential rather than skipping it. ⁷ ¹³

Q6. Is acne caused by poor hygiene?

Acne is not caused by dirt; it arises from hormonal changes, excess sebum, follicular blockage and inflammation. ⁷ ¹⁷ Over-washing and harsh scrubbing can strip the barrier, making acne more inflamed and sensitive instead of clearer. ⁷ ¹¹

Q7. Can stress make acne worse?

Stress hormones can increase oil production, disrupt sleep and alter immune responses, all of which can contribute to more frequent or persistent breakouts. ⁸ ¹⁷ Combining good skincare with better sleep, basic stress management and reduced picking usually produces better results than focusing on products alone. ⁷ ¹²

Q8. Are natural or “chemical-free” products better for acne?

All skincare products are made of chemicals, including those labelled “natural”, and natural ingredients can be irritating or untested just as synthetic ones can. ⁵ ⁶ The most reliable improvement comes from ingredients with solid clinical evidence in acne such as benzoyl peroxide, retinoids, azelaic acid, salicylic acid and niacinamide. ⁸ ¹³

Q9. Can moisturiser make acne worse?

Heavy, occlusive moisturisers can aggravate breakouts, but non-comedogenic, lightweight moisturisers are protective and help the skin tolerate active treatments. ⁷ ¹¹ When patients avoid moisturiser completely, the barrier often becomes dry and inflamed, which can trigger more discomfort and potentially more breakouts. ⁸ ¹⁴

Q10. Why do dark marks stay after pimples disappear?

The dark or reddish marks that linger after acne are called post-inflammatory hyperpigmentation and arise from the skin’s pigment cells reacting to inflammation. ¹¹ ¹⁸ Strict sunscreen use plus ingredients such as azelaic acid and retinoids usually help these marks fade faster than if the skin is left untreated. ⁷ ¹³

Q11. Can acne continue into adulthood?

Adult acne is common and may either persist from teenage years or arise later in life due to hormonal changes, stress, smoking or cosmetic occlusion. ⁸ ¹² It can still be treated effectively, and adults should not assume that acne is something they missed the boat on in adolescence. ⁷ ⁹

Q12. Does makeup always make acne worse?

Makeup does not automatically worsen acne if non-comedogenic, oil-free products are chosen and removed thoroughly each night. ⁷ ¹¹ Problems tend to occur when thick, long-wear or occlusive products are left on for prolonged periods or not fully cleansed away. ⁸ ¹⁴

Q13. Why does acne sometimes come back after it gets better?

Acne is a chronic, relapsing condition, so flares are common when all active treatment is stopped as soon as the skin looks clear. ⁸ ⁹ A lower-intensity maintenance plan, such as retinoids or salicylic acid a few nights per week, helps reduce the frequency and severity of relapses. ⁹ ¹⁴

Q14. How do I know if a product is irritating my skin vs just “adjusting”?

Adjustment is characterised by mild dryness, light flaking and tolerable tightness that settle with moisturiser and reduced frequency. ⁸ ¹⁴ True irritation shows as ongoing burning, marked redness, swelling, cracking or pain, and should prompt stopping or major simplification of the routine and medical review if severe. ⁷ ¹¹

Q15. When should I stop self-managing and see a doctor?

You should seek medical review if acne is severe, painful, scarring, rapidly worsening or not improving despite 8–12 weeks of consistent non-prescription treatment. ⁸ ⁹ Medical review is also essential in pregnancy, with sudden adult-onset acne, when acne is linked to new medicines, or when it is clearly affecting mood or quality of life. ⁹ ¹⁷

13. Version Control & Review

This policy will be reviewed at least every two years, or earlier if Australian advertising, cosmetic, AICIS or acne-management guidelines are updated, to ensure ongoing clinical accuracy and regulatory compliance. ¹ ³ ⁵ ⁹

Sources

AHPRA. 2024. Advertising guidelines for regulated health services. Australian Health Practitioner Regulation Agency. Available at: https://www.ahpra.gov.au/Resources/Advertising-hub/Advertising-guidelines-and-other-guidance/Advertising-guidelines.aspx ↩
AHPRA. 2024. Advertising hub – laws, guidance and resources. Australian Health Practitioner Regulation Agency. Available at: https://www.ahpra.gov.au/Resources/Advertising-hub.aspx ↩
Therapeutic Goods Administration. 2024. Determining if your product is a cosmetic or therapeutic good. Australian Government Department of Health and Aged Care. Available at: https://www.tga.gov.au/resources/guidance/determining-if-your-product-cosmetic-or-therapeutic-good ↩
NHMRC. 2020. Factsheet: Cosmetics and therapeutics. National Health and Medical Research Council. Available at: https://www.nhmrc.gov.au/sites/default/files/documents/attachments/Factsheet-Cosmetics-and-therapeutics.pdf ↩
AICIS. 2023. Anti-dandruff and anti-acne skin-care products. Australian Industrial Chemicals Introduction Scheme. Available at: https://www.industrialchemicals.gov.au/cosmetics-and-soap/anti-dandruff-and-anti-acne-skin-care-products ↩
ACCC. 2021. False or misleading claims. Australian Competition and Consumer Commission. Available at: https://www.accc.gov.au/consumers/advertising-and-promotions/false-or-misleading-claims ↩
Healthdirect Australia. 2025. Acne – treatments, causes and prevention. Available at: https://www.healthdirect.gov.au/acne ↩
Healthdirect Australia. 2025. Acne treatments. Available at: https://www.healthdirect.gov.au/acne-treatments ↩
RACGP. 2010. Acne – best practice management. Australian Family Physician / RACGP. Available at: https://www.racgp.org.au/afp/2010/september/acne-best-practice-management ↩
RACGP. 2017. Acne in adolescents. Australian Family Physician. Available at: https://www.racgp.org.au/afp/2017/december/acne-in-adolescents ↩
Sydney Children’s Hospitals Network. 2024. Acne factsheet. Available at: https://www.schn.health.nsw.gov.au/acne-factsheet ↩
Healthdirect / All About Acne. 2024. All About Acne – partner resource. Available at: https://www.healthdirect.gov.au/partners/all-about-acne ↩
Better Health Channel. 2024. Acne. Victorian Department of Health. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/acne ↩
DermNet NZ. 2024. Acne treatment (acne management). DermNet New Zealand. Available at: https://dermnetnz.org/topics/acne-treatment ↩

Disclaimer for Newcastle Cosmetic Doctor Policies & Procedures

The policies and procedures contained within this document are the exclusive property of Newcastle Cosmetic Doctor and are provided for internal clinical governance and educational purposes only. These materials represent the internal operational framework, safety standards, and evidence-based protocols developed and implemented by Dr. Bart John Scanlon and the Newcastle Cosmetic Doctor team. They are designed specifically for use within Newcastle Cosmetic Doctor and reflect our clinic’s own professional standards, risk assessments, and compliance obligations under Australian law and regulatory authorities. External individuals, practitioners, or organisations must not copy, reproduce, distribute, or rely upon these materials, in whole or in part, for their own clinical, commercial, or educational use without prior written consent from Newcastle Cosmetic Doctor. These materials do not constitute medical, legal, or professional advice and are not intended to be adopted as official protocols or procedures by any other entity. Any external use or adaptation must be independently reviewed and modified to meet the relevant laws, guidelines, and standards applicable to the user’s own jurisdiction, scope of practice, and facility operations. Newcastle Cosmetic Doctor and Dr. Bart Scanlon accept no liability for any loss, injury, or damage arising from the unauthorised use, reliance upon, or misinterpretation of this material.