Background and treatment At what stage should I consult a doctor?

Acne doctor examining skin
A doctor will know which treatment is best for your acne-prone skin

Do I really need to go to the doctor? Can’t I just buy an acne treatment cream at the pharmacy?

Most people with acne have asked themselves these questions. We’ve caught up with acne specialist Dr Markus Reinholz who gives his expert advice on when to consult your doctor.

Acne specialist Dr Markus Reinholz
Dr med. Markus Reinholz, dermatologist and acne specialist

The Challenge Acne team
Surely if someone only has a few spots here and there they don’t need to see a doctor?

Dr Reinholz

When it comes to acne my motto is “hit hard and hit early”. I believe that treating symptoms early and effectively is the best way to prevent the scarring that this inflammatory disease so often leaves behind. Even a few papules and pustules can lead to scarring. It’s not just severe symptoms that respond well to treatment. 

Mild forms of acne such as Acne Comedonica − where blackheads are the primary symptom − also heals faster. In fact, left untreated, blackheads are one of the first things to cause scarring as patients often pick them and fiddle with the surrounding skin so they worsen and papules form. This can lead to Acne Excoriée. You can read more about the different types of acne here.

Acne treatment from a doctor
Acne normally responds well to medical treatment

“I know fiddling with your skin sounds harmless but it’s not: it exacerbates symptoms of mild acne, spreads bacteria and can cause complications.”

Dr med. Markus Reinholz, Dermatologist

The Challenge Acne team
Can’t I just buy some acne treatment products over the counter at the pharmacy?

Dr Reinholz
In my experience, going it alone without a proper diagnosis or expert advice often leads to a delay in people getting the treatment their skin needs. So, as a dermatologist, I don’t recommend it. Pharmacists, however, can be a great source of advice for skin concerns and will be able to recommend over-the-counter medication and skincare products to start using before you meet with a doctor (either a general doctor or skin specialist known as a dermatologist). And an effective skincare routine is an important step in the right direction. Find out more in the ideal skincare products and routine for acne-prone skin.

The Challenge Acne team
Is it mostly teenagers who come to you for advice or do you advise lots of adults too?
Dr Reinholz
Most of my patients are between 12 and 30, but people of any age can get acne and the spectrum ranges from neonatal acne, through puberty and drug-induced acne and on to adult acne (also known as Acne Tarda).

The Challenge Acne team

What would you say to someone who is reluctant to seek medical advice?

Dr Reinholz
Acne doesn’t just affect people physically, it can have a considerable psychological impact too. Living with acne can be stressful and sufferers often experience low self-esteem and their confidence is further knocked by social stigmatization. Only effective treatment can really change all this, so I would encourage them to seek expert advice as soon as possible. Early treatment is also the only way to prevent scarring.

The Challenge Acne team
How does a consultation actually work?

Dr Reinholz
It starts with a detailed medical history. We discuss how long they’ve had acne for, how severe it is and the measures they’ve already taken to treat their skin. This is followed by a skin inspection which normally focusses on the face, neck, upper arms, shoulders and back. The skin expert will then make a diagnosis and treatment recommendation suitable for that person and their skin. 

Acne doctor examines skin closely
Your doctor will examine your skin closely in order to recommend the best treatment for your skin.

The Challenge Acne Team
What treatment options are available? What can you prescribe or do to help?

Dr Reinholz
The basis of any acne treatment is to ensure that the patient has a good understanding of the disease and their skin condition. I give people a fact sheet full of medical information and easy to follow advice and dos and don’ts to help improve their skin.

There are three main pillars to acne treatment: 
1. Acne medication in the form of topical creams and gels or oral tablets or capsules.
2. Dermo-cosmetic skincare - gentle cleansing and effective moisturisation as part of your daily routine.
3. Professional facial treatments conducted by a dermatologist.

You can find out more about medical treatment options in acne medication: what are the most common treatments?  And acne treatments and their possible side effects.

Acne treatment from doctor: facial
Medical facials are used to support acne therapy

The Challenge Acne Team
What is the hardest thing about treating acne?

Dr Reinholz
Treatment can take some time, so keeping the patient optimistic and their spirits up can be one of the biggest challenges. Both topical and systemic treatments (they type you take orally) can sometimes cause skin condition to deteriorate in the short-term and patients can experience skin irritation and dehydration. A large part of my role is to encourage them to persevere with the treatment. It’s also difficult to stop people from fiddling with their skin, but it’s important that the only person who manipulates your blemishes is a professional who does so in the sterile conditions of a clinic.

The Challenge Acne Team
And finally, if you could give just one piece of advice to someone with acne what would it be?

Dr Reinholz
Can I have two?! If so. Number one. Consult your doctor or dermatologist as soon as possible to get on top of your symptoms and prevent long-term consequences such as scarring. And two. Stick with your treatment − even when results seem to take longer than you’d like. Oh, and don’t fiddle with your spots. Keep your hands away from your face. Sorry, I think that’s actually three things!

The Challenge Acne Team
No problem. Thanks so much for your time and your advice Dr Reinholz.

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