Acne is one of the most common skin conditions in the UK, and it can be stubborn to clear. Most people find the right acne treatment comes down to a combination of products, once they understand which ingredients suit their skin.
This guide explains how the main topical treatments work, what to expect from each one, and when it's worth speaking to your GP.
Most acne treatments need around 12 weeks of daily use before you can judge them. Patience is part of the treatment.
What causes acne?
Acne vulgaris starts when hair follicles get blocked with excess oil (sebum) and dead skin cells. That creates the perfect conditions for a skin bacterium called Cutibacterium acnes to multiply and trigger inflammation.
Hormonal changes are a major driver. That's why breakouts are so closely linked to puberty, periods, pregnancy and conditions such as polycystic ovary syndrome (PCOS).1
This hormonal link matters for teenage acne treatment. But it's just as important for adult and hormonal acne, which can appear for the first time in your twenties or thirties. Genetics play a part too, which is why acne often runs in families.
Because these causes overlap, most effective treatments target one or more of them directly. They unblock pores, slow oil production, reduce acne-causing bacteria or calm inflammation.
What acne treatments are available in the UK?
There's no single best acne treatment in the UK that suits everyone. The right choice depends on whether your acne is mostly blackheads and whiteheads, inflamed spots, or a mix of both.
As a general guide, NICE recommends a combination product as the first-line treatment for most people with mild to moderate acne, rather than a single ingredient on its own.1 Severe acne, with painful nodules or cysts, is more likely to need input from a GP or dermatologist alongside anything you use on your skin.
Topical retinoids
Differin contains adapalene, a retinoid-like ingredient that comes as a gel and a cream. It speeds up skin cell turnover, which helps unblock pores and stop new spots forming.2
You apply it once a day, usually in the evening. Adapalene is also one half of the combination treatment NICE recommends as a first-line option.1
Combination gels
Pairing a retinoid with benzoyl peroxide tackles more than one cause of acne at once. Epiduo and the generic adapalene and benzoyl peroxide gel both combine adapalene with benzoyl peroxide.
Benzoyl peroxide works as an antiseptic, reducing bacteria on your skin's surface, and it has an anti-inflammatory effect of its own.3 NICE recommends this fixed combination as a first-line treatment for mild to moderate acne, and it's one of the most widely used prescription combinations.1
Antibacterial gels
Duac combines benzoyl peroxide with clindamycin, an antibiotic you apply to the skin. It's generally used for spots with more visible inflammation.
Do not let benzoyl peroxide touch towels, pillowcases or coloured clothes until it's fully dry. It can bleach fabric and hair.
Cleansers
A gentle, non-drying cleanser won't clear acne on its own. But it supports whichever active treatment you're using.
Products such as the Cetaphil Gentle Cleanser are designed not to strip your skin. That matters, because over-washing or scrubbing can make irritation from active treatments worse.
When treatment needs to go further
Persistent or cystic acne usually needs more than topical products. A GP may prescribe oral antibiotics alongside a topical treatment. For women, the combined contraceptive pill can also work as a hormonal acne treatment, by reducing the hormonal drive behind breakouts.3
These options sit outside Pharmica's online range and need a face-to-face or GP consultation.
How long do acne treatments take to work?
This is one of the most common questions about any acne treatment. The honest answer? Longer than most people expect.
Topical treatments such as Differin, Epiduo and Duac usually need 8 to 12 weeks of consistent daily use before you see a real improvement. It's also common for your skin to look a little worse in the first couple of weeks, as blockages under the surface come up.1
Hormonal treatments, including the combined pill, can take much longer. It can sometimes be up to a year before you see the full effect.3
Switching products too early is one of the most common reasons an acne treatment seems to fail, when really it just hasn't had time to work.
What side effects can acne treatments cause?
Topical acne treatments are generally well tolerated. But some irritation is common, especially in the first few weeks:
- Dryness and skin irritation - common (affects up to 1 in 10 people) with retinoids and benzoyl peroxide. A fragrance-free moisturiser, applied a little while after your treatment, can help.
- Redness and a burning feeling - common, especially when you first start. Using it on alternate nights to begin with, then building up to daily use, can help.
- Sunburn or sun sensitivity - uncommon (affects up to 1 in 100 people) but reported with adapalene. Wearing a daily SPF is still a good idea while you're using any topical retinoid.
- Bleaching of hair or fabric - a known property of benzoyl peroxide, rather than a skin side effect.
Skin blistering, swelling or a severe reaction? Stop using the treatment and get medical advice.
Topical retinoids such as adapalene must not be used if you're pregnant or planning a pregnancy. Speak to a pharmacist about suitable alternatives if this applies to you.2
When should you see a GP about acne?
Speak to a GP or dermatologist if:
- Your acne hasn't improved after two full 12-week courses of topical treatment
- You have nodules, cysts, or acne that's starting to scar
- Acne is affecting your mental health or self-confidence
- You suspect an underlying hormonal cause, such as PCOS
A GP can prescribe oral antibiotics or hormonal treatments, or refer you to a dermatologist for options such as isotretinoin for more severe or scarring acne.4
Frequently asked questions
How long does acne treatment take to work?
Most topical treatments, including Differin, Epiduo and Duac, need 8 to 12 weeks of consistent
daily use before you see a real improvement. It's common for skin to look slightly worse in the
first couple of weeks as blockages come to the surface, so try not to judge a treatment too early.
Can Differin (adapalene) make acne worse before it gets better?
Yes, and this is expected. Adapalene speeds up skin cell turnover, so in the first few weeks it
can bring underlying blockages to the surface before skin starts to clear. Mild redness, dryness
or a short-lived flare are common early on and usually settle with continued use.
What's the difference between Epiduo and Duac?
Epiduo combines adapalene (a retinoid) with benzoyl peroxide, while Duac combines benzoyl peroxide
with the antibiotic clindamycin. Epiduo tends to suit a broader mix of blackheads, whiteheads and
inflamed spots, while Duac is generally used for more visibly inflamed, bacterial-driven breakouts.
Is benzoyl peroxide safe to use every day?
For most people, yes, though it's best to start on alternate days or with short-contact use
(washing it off after an hour) to reduce irritation, then build up to daily use as your skin
tolerates it. It can bleach hair and fabric, so let it dry fully before it touches towels or clothing.
What is the best acne treatment UK pharmacies offer without a prescription?
Topical retinoids such as Differin and combination gels such as Epiduo are among the most
effective over-the-counter and pharmacy options for mild to moderate acne, though which one
suits you best depends on your acne type and how sensitive your skin is.
Can I use adapalene during pregnancy?
No. Topical retinoids, including adapalene, are contraindicated during pregnancy and when
planning a pregnancy. Speak to a pharmacist or GP about pregnancy-safe alternatives.
Does Duac help with acne scars?
Duac treats active, inflamed acne rather than existing scarring. Treating breakouts early and
consistently reduces the risk of new scars forming, but established scarring usually needs a
separate approach from a dermatologist.
When should I see a GP instead of using over-the-counter treatment?
See a GP if your acne hasn't improved after two full 12-week courses of treatment, if you have
nodules, cysts or scarring, if it's affecting your mental health, or if you suspect a hormonal
cause such as PCOS.
References
- National Institute for Health and Care Excellence. Acne vulgaris: management. NICE guideline NG198; 2021. nice.org.uk
- Electronic Medicines Compendium. Differin Gel Summary of Product Characteristics. eMC. medicines.org.uk/emc
- NHS. Acne - Treatment. nhs.uk
- GPnotebook. Referral criteria from primary care: acne vulgaris. gpnotebook.com
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.