Acne Treatment Online — Ireland

About acne

Acne (acne vulgaris) is a common inflammatory skin condition that affects most teenagers and many adults in Ireland. It typically develops where the skin has the most oil (sebaceous) glands — the face, chest, upper back, and shoulders. Most acne is mild to moderate and responds well to topical treatment, but moderate-to-severe acne, or acne causing significant distress or scarring, warrants prompt medical assessment.

Symptoms and signs

• Non-inflammatory lesions: blackheads (open comedones) and whiteheads (closed comedones)
• Inflammatory lesions: papules (small red bumps), pustules (red bumps with pus)
• Severe forms: nodules and cysts (large, deep, painful lesions)
• Hyperpigmentation marks after lesions resolve (more common in darker skin)
• Permanent scarring — atrophic ("ice-pick") or hypertrophic

Causes and contributing factors

Acne is driven by four main factors per NICE CKS: increased sebum production (often hormonal — androgens), abnormal keratinisation blocking hair follicles, colonisation by Cutibacterium acnes bacteria, and resulting inflammation. Hormonal changes around puberty, the menstrual cycle, and polycystic ovary syndrome (PCOS) are common triggers. Family history is a significant predictor.

When to seek help

An Online Doctor consultation is appropriate for most cases of acne. Specifically, book a consultation if: acne is affecting your wellbeing or mood; over-the-counter products (benzoyl peroxide, salicylic acid) haven't worked after 8–12 weeks; you have inflammatory or cystic lesions; or you're noticing early scarring. Seek in-person review for severe nodulocystic acne, suspected acne fulminans (sudden severe inflammation with systemic symptoms), or if isotretinoin is being considered — this requires consultant-led management in Ireland.

Treatment options

Treatment per ICGP and NICE Irish-adapted guidance follows a stepped approach:

• First-line topical: a fixed-combination of topical retinoid (adapalene) and benzoyl peroxide, applied once daily
• Inflammatory acne, moderate: topical retinoid + benzoyl peroxide + topical or short-course oral antibiotic (limited to 12 weeks to reduce resistance)
• Hormonal therapy: combined oral contraceptive pill for suitable women with hormonally-driven acne
• Severe/scarring acne: referral to dermatology for consideration of oral isotretinoin (Roaccutane) — a consultant-led prescription with monitoring requirements set by HPRA

Self-care and lifestyle

Use gentle, non-comedogenic skincare. Avoid picking or squeezing lesions (worsens scarring). Sun protection is important — topical retinoids increase photosensitivity. Diet evidence is mixed; some patients find dairy or high-glycaemic foods worsen symptoms, but there's no universal "acne diet." Stress management may help. Avoid scrubbing or harsh exfoliation, which can worsen inflammation.

Frequently asked questions

How long until I see improvement?

Most treatments take 8–12 weeks to show meaningful improvement. Topical retinoids often cause initial dryness and mild irritation in the first 2–4 weeks before improving — this is expected. Don't switch treatments prematurely.

Will acne leave scars?

Untreated inflammatory acne has a higher risk of scarring. Early effective treatment, avoiding picking, and sun protection significantly reduce scarring risk. Existing scars can be improved by dermatology-led options after acne is controlled.

Does diet cause acne?

Evidence is limited. Some studies suggest a possible role for skimmed dairy and high-glycaemic-index foods, but no diet alone treats acne. Don't restrict food groups without seeing a doctor or dietitian first.

Can I get isotretinoin from an Online Doctor?

No — isotretinoin (Roaccutane) is a consultant-only prescription in Ireland with mandatory monitoring (bloods, pregnancy prevention programme). An Online Doctor can refer you to dermatology if indicated.

Sources: HSE.ie, NICE CKS Acne Vulgaris, Irish College of General Practitioners, HPRA. Information for general guidance only — not a substitute for individual medical advice.