Spots and acne
The honest order: prescription treatment first, clinic treatments for what it leaves behind.
Spots that keep coming, blackheads, whiteheads and the deeper painful lumps are all one condition, acne (acne vulgaris). It is common in the teens and keeps going, or starts again, in many adults. In women it tends to sit along the jaw and chin and flare before a period.
The thing that treats acne is medicine: a prescription cream or gel used in the evening, and for moderate or severe acne a course of prescription tablets alongside it. You can get these from your GP, or we discuss them with you at a free consultation. Clinic treatments help with congestion, redness and the marks left behind, and they sit beside the medicine rather than replacing it. This page says what causes acne, what works, what does not, and when it is a job for your GP.
What causes it
Acne starts in the pore. Oil (sebum) and dead skin cells block the opening, a bacterium that lives on everyone's skin multiplies inside, and the skin around it becomes inflamed. That gives the sequence most people recognise: blackheads and whiteheads first, then red spots, then pus-filled spots and, in some people, deep tender lumps (nodules).
Hormones drive the oil. Puberty, periods, pregnancy, stopping or starting the pill, and polycystic ovary syndrome all change it. Some medicines, steroids among them, cause spots. Thick hair products and oil-based make-up block pores along the hairline. Family history matters. Dirt does not: acne is not caused by poor washing, and scrubbing makes it worse. NICE's acne guideline (NG198, 2021, updated 2023) found no evidence for any specific diet in treating it.
What actually treats it
The first-line answer is a prescription cream or gel applied once in the evening for 12 weeks. For moderate or severe acne the same guideline adds a course of prescription acne tablets, reviewed at 12 weeks and not usually continued past 6 months. Women with hormonal acne have further prescription tablet options. The strongest treatment for severe or scarring acne is a tablet course started by a dermatology team, which your GP refers you for. We cannot name any of these medicines on a website. Where a prescription treatment is right for you, we say so and go through it with you face to face at a consultation; your GP can do the same, and the GP route is free.
Clinic treatments at Nova fit around that, not instead of it:
A Hydrofacial clears congested, blackhead-prone skin and suits acne that is mostly blocked pores rather than angry spots. We do not do it over an active flare.
A course of superficial chemical peels helps congestion, oiliness and the dull marks acne leaves. Peels are spaced out and test patched first on darker skin, because dark marks are the main risk.
LED light (blue with red) is a low-risk add-on for mild to moderate inflamed acne. The evidence is weak and we say so; it is free with any other treatment on request.
IPL does not treat active acne. It treats the flat red marks left after spots have healed, in lighter skin types.
Microneedling is for the pitted scars acne leaves, and only once the acne itself is quiet. Needling over active spots spreads the problem.
If your skin is darker (types IV to VI), acne tends to leave brown marks that outlast the spots. We start topicals low and slow, avoid high-strength benzoyl peroxide, go more gently with peels, and patch test light-based treatments or skip them.
When to see your GP
See your GP if your spots are not improving after a few months of pharmacy products; if you have many spots, deep painful lumps or any scarring; if the skin is hot, swollen and sore, which can mean infection; or if the acne is getting you down. NICE advises referral to a dermatologist when acne is causing scars or lasting dark marks, or when two full courses of treatment have not worked. Sudden explosive acne with fever and joint pain needs same-day medical help. We check for all of this at your consultation and write to your GP when needed.
What we will not do
We will not treat moderate or severe acne with facials and peels alone and let you believe it is enough. We will not put a needle, a peel or ultrasound over active pus-filled spots or nodules. We will not sell you a course while your acne is still making new scars; that is a referral, and we will tell you so. Results vary, and clinic treatments cannot be guaranteed.
Skincare at home
Keep it plain. A non-alkaline cleanser twice a day, a light moisturiser labelled non-comedogenic, and a sunscreen that does not block pores. Take make-up off every night and leave spots alone: picking is what turns a spot into a scar.
Ingredients with a track record: benzoyl peroxide at pharmacy strength (it bleaches towels, and darker skin should use the lower strengths); salicylic acid to loosen blocked pores; niacinamide to calm redness and oil; azelaic acid at the lower, non-prescription strength; a retinol at night, built up slowly. Do not use retinol or any retinoid if you are pregnant, planning a pregnancy or breastfeeding.
From the Obagi range we stock: Obagi CLENZIDERM M.D. Foaming Cleanser 1 118ml and Obagi CLENZIDERM M.D. Pore Therapy 2 148ml for the cleansing and salicylic acid steps; Obagi Hydrate Light Weightless Gel Cream 50ml as an oil-free moisturiser; Obagi Sun Shield Mineral SPF50 85g; and Obagi Retinol 0.5 28g for the night step. Skincare helps mild acne and supports treatment of the rest; it does not replace a prescription when one is needed.
Common questions
Can a clinic clear acne for good?
No. Acne is driven by hormones and oil, and nothing done in a clinic switches that off. Prescription treatment controls it, usually over 12 weeks, and relapse after stopping is common. Clinic treatments help the congestion, redness and marks around it.
Does a Hydrofacial help acne?
It helps blackhead and congestion-type acne and gives a cleaner, calmer surface for a few weeks. It is not for red, pus-filled or cystic acne, and we will not do it over a flare.
Is IPL good for acne?
Not for active acne. IPL targets the pink and red marks left once spots have healed, in lighter skin types. The spots themselves need medicine.
What about LED light for acne?
Blue and red LED is a low-risk add-on for mild to moderate inflamed acne. The published evidence is small and short term, so we offer it as a top-up, free with another treatment on request, and never as the plan on its own.
Is there a prescription treatment I can get at Nova?
Yes. Prescription creams, gels and tablets exist for acne, and we discuss them with you at a face-to-face consultation after looking at your skin. We cannot name them online. Your GP can prescribe the same options.
I have dark skin and the spots leave brown marks. What helps?
Treat the acne early, because every new spot restarts the clock on the marks. Daily sunscreen, a retinol or azelaic acid at cosmetic strength, introduced slowly, and no scrubs. Peels are done with care and a patch test; IPL is usually not the right tool for darker skin.
Can I have treatment while on acne tablets?
Some acne tablets make skin react to light or heal more slowly. Tell us everything you take. After the strongest acne tablet we wait, usually around 6 months, before microneedling or deeper peels.
Does diet cause acne?
NICE found no evidence to support a specific diet for treating acne. Eat well for other reasons; do not expect cutting out one food to clear your skin.
Related treatments
Book a free consultation. Or message us on WhatsApp: 077 21 400 600.
Nova Beauty Clinic is in East Finchley, three minutes on foot from East Finchley station on the Northern line, with a car park next door. Most people who come to us about their skin live in Hampstead, Highgate, Muswell Hill and Finchley, and we see plenty from Hampstead Garden Suburb, Golders Green, Crouch End and Barnet.
This page is general information, not medical advice. What suits you depends on your own skin, health and history, which we go through at a free consultation before anything is booked.