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Adult Acne: Why Am I Still Getting Pimples and Acne? | Part II

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In this three-part special, Dr. Ngui talks about Adult Acne and how to treat it.

Today, we will focus on treating acne. Read Part I here.


“Doctor, Doctor! Can I treat acne myself? When should I seek a doctor's help?"

Q: Is it necessary to see a doctor for acne problems? Aren’t over-the-counter solutions effective enough?

A: Acne is a very complex condition that varies greatly in severity and appearance. It can be as mild as a minor crop of white heads with no inflammation or it can be very severe with multiple eruption of inflamed nodules, pus filled cysts and scars covering the whole face.

Acne usually starts of mild but it can get worse very quickly over a few months. Most people don’t see the doctor for their acne. It’s common practice to use over the counter medication and cosmetic products to manage acne. Only a minority of people with acne consult their doctor for their acne problems, often waiting about a year before going for their first consultation.

In view of the fact that acne can be severe, over-the-counter solutions are far from adequate in dealing with anything more than an occasional “zit” or two. I think its alright to use over-the-counter products like cleansers and pimple spot applications initially when the person is experiencing very mild acne.

He or she should consider seeing a doctor if the acne starts to get worse and the earlier, the better. The doctor can assess the status of the acne and determine the level of treatment that is needed. The key to managing acne is early detection and aggressive intervention where appropriate in order to prevent serious effects of acne such as pigmentation changes, scarring, disfigurement and psychological disturbance.

Q: What sort of skin cleansing/maintenance regime is best suited for acne skin?

A: It’s a common misconception that just keeping the skin clean is enough to control acne. Acne per se is not just related to poor hygiene. Acne is related to excessive oil produced by the skin’s oil glands, the development of whiteheads/blackheads and subsequent inflammation of these whiteheads/blackheads due to bacterial overgrowth.

With this in mind, I would recommend a good cleanser that would effectively clean the skin and clear away surface oil but not dry the skin. Secondly, use skin products and medication to control the formation of whiteheads and inflammation. Your doctor can advise you on this.

Q: How best can I have my acne treated?

A: The principle of treatment is to control the inflammation, clear away existing whiteheads and blackheads and prevent congestion of the oil glands and pores. In addition to appropriate skin cleansing and hydration, specific anti-acne skin applications including exfoliating agents, anti-clogging agents, anti-inflammatory agents and anti-bacterial agents form the basis for daily skin management. In more severe cases, oral antibiotics like doxycycline or retinoids like isotretinoin are prescribed by the doctor. Treatment procedures like Theraclear light and vacuum suction therapy and salicylic acid skin peels are useful in expediting the clearance of acne.


About Dr. Nicholas Ngui

Dr. Nicholas Ngui is a highly experienced general practitioner with a special focus on Aesthetic Dermatology with 19 years of clinical practice experience and 12 years of pharmaceutical industry experience behind him. As a pharmaceutical medical director, he was involved in physician and patient education and clinical research with a strong emphasis on ethical practice, treatment compliance and patient safety. Dr. Ngui now practices at Neu Age Clinic in Outram and is known for specialty services in Acne & Acne Scar Treatment, Pigmentation Treatment, Anti-Aging Skin Rejuvenation, Laser Hair Removal, Tattoo Removal and Skin Tag/Mole Removal. If you have a skin-related concern and would like to find out a bit more about it, you can visit for more information.

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