New developments in acne treatment: what does science say?

What is acne?

Acne (acne vulgaris) is an inflammatory condition of the sebaceous glands and hair follicles. Acne often appears in areas with a high concentration of sebaceous glands, such as the face, chest, and back.

Acne can take various forms. These types of acne differ in severity and appearance, for example

• blackheads (comedones)
• red bumps (papules)
• pimples with pus (pustules)
• painful, deep-seated inflammations (nodules or cysts)

The severity varies from person to person. For some, acne remains mild and temporary, while others may develop scars or experience long-term symptoms.

How does acne develop (and why does it sometimes persist)?

Acne is usually caused by a combination of factors, such as:

• increased sebum production
• clogged pores due to the build-up of dead skin cells
• inflammatory reactions in the skin
• bacterial involvement (particularly Cutibacterium acnes, formerly Propionibacterium acnes)
• hormonal fluctuations (e.g., puberty, menstrual cycle, PCOS)

Lifestyle and environmental factors can also play a role. Think of stress, certain cosmetics, friction (such as from a face mask or helmet), or the use of oily skincare products. For some people, diet also seems to have an impact, such as consuming a lot of refined carbohydrates (like sugary snacks and soft drinks). Smoking and alcohol can also sometimes disrupt the skin and worsen acne. The effect varies from person to person.

What do guidelines say about acne treatment?

Guidelines (such as the NHG Acne Standard and dermatological guidelines) emphasise that acne is usually treatable, but it is important to tailor the treatment to:

• the type of acne (blackheads vs. inflammations)
• the severity (mild, moderate, severe)
• the risk of scarring
• the impact on daily life (e.g., self-image and quality of life)

In practice, acne treatment often consists of a combination of:

• topical treatments (such as benzoyl peroxide, azelaic acid, or a retinoid)
• antibiotics (topical or oral, usually temporary and targeted)
• systemic treatments for severe acne (such as isotretinoin)
• additional skincare and behavioural advice

International guidelines, such as those from the American Academy of Dermatology (AAD), confirm that proven treatments like benzoyl peroxide, topical retinoids, and combination therapies form an essential foundation. They also emphasise that oral antibiotics should be used judiciously and that oral isotretinoin plays a crucial role in severe acne or acne that does not respond to standard treatments.

An overview of international guidelines shows that while recommendations may differ in detail, the foundation remains the same: start with topical treatments and use antibiotics carefully.

New developments in acne treatments: what is really changing?

New developments in acne treatment broadly focus on three areas:

• reducing inflammation
• influencing bacterial activity
• addressing sebum production and clogged pores, with minimal side effects

Below are some developments that have garnered significant attention in recent years.

1) Light therapy (such as LED): promising, but not yet standard

Light therapy is often mentioned as a modern, gentle supplementary treatment. The idea is that light (e.g., LED) can influence:

• inflammatory reactions in the skin
• skin repair processes
• possibly also the activity of sebaceous glands

Some studies show improvement in mild to moderate acne, especially when different light wavelengths are combined. However, the evidence remains inconsistent because:

• research methods vary
• treatment protocols differ (frequency, intensity, duration)
• results are not always easily comparable

As a result, international guidelines continue to prioritise proven treatment options. Light and laser treatments currently have a limited role in standard care.

In practice, this means that light therapy is not a replacement for proven medications but can be an additional option in specific situations, such as when someone prefers to avoid medication or is sensitive to side effects.

2) Greater focus on responsible antibiotic use

A significant development in healthcare is the growing attention to antibiotic resistance. Antibiotics can still be used for acne, especially for moderate to severe inflammatory acne, but usually under strict conditions. The advice often includes:

• using antibiotics temporarily (no longer than necessary)
• not using them as a standalone treatment
• combining them with other treatments, such as benzoyl peroxide, to enhance effectiveness and limit resistance

This is not a new medication but rather a shift in approach: the emphasis is on targeted use and having a follow-up plan. In practice, antibiotics are more often prescribed for a limited period, with a clear evaluation point. If there is no improvement, alternative treatment strategies are considered sooner. Maintenance therapy also plays a larger role in preventing relapses.

3) More personalised treatment: skin type, age, and triggers matter more

Acne is not the same for everyone. Therefore, there is increasing emphasis on treatments tailored to the type of acne and the individual’s situation. For example, more consideration is given to:

• age (puberty acne vs. adult acne)
• the type of acne (blackheads, inflammations, deep-seated pimples)
• skin sensitivity (prone to redness, dryness, or irritation)
• the risk of scarring or pigmentation after inflammations
• possible triggers such as stress, friction, or cosmetics

This is not an entirely new treatment approach but a clear shift in how treatments are administered: plans are more often designed to be sustainable for the individual. In practice, this means treatments are usually introduced more gradually, combinations are better tailored to the skin, and there is more focus on skincare and maintenance to prevent relapses.

4) Cosmetics and skincare: fewer myths, more nuance

Many people believe that makeup always worsens acne. In reality, it depends on the product and how it is used. Non-comedogenic makeup is often fine, provided that:

• the skin is thoroughly cleansed at the end of the day
• products are not too oily or overly occlusive
• harsh scrubs or aggressive cleansers are avoided

An overly strict routine (excessive cleansing, scrubbing, or using drying products) can actually worsen acne by irritating the skin and disrupting the skin barrier.

In practice, there is now more focus on gentle skincare and restoring the skin barrier as a complement to medication. This helps make treatments more sustainable and reduces the risk of additional irritation.

What can you do yourself for acne? (practical tips)

Treatment is usually more effective when the basics are in place. These tips often help:

• Use a treatment long enough
  Many treatments only show results after 6–8 weeks.
• Avoid over-treatment
  Using too many products at once can cause irritation and worsen acne.
• Avoid popping pimples
  This increases the risk of scarring and pigmentation.
• Be cautious with deep, painful acne
  This may indicate moderate to severe acne. Medical treatment may be necessary to reduce symptoms and prevent worsening.
• Seek help if acne affects your daily life
  Seek help if acne affects your daily life Acne can be physically and mentally burdensome.

When should you consult a doctor?

Contact a doctor if:

• acne is severe or rapidly worsening
• painful, deep-seated inflammations develop
• scarring occurs
• you have been treating acne for weeks without improvement
• acne causes significant stress, embarrassment, or sadness

Conclusion: what is the most important development?

The science of acne continues to evolve, but the most significant changes currently lie in smarter treatment approaches rather than a single revolutionary new medication.

Light therapy is gaining more attention and may be interesting for some people, but guidelines still primarily focus on proven therapies. The emphasis is increasingly on personalised care, gentle treatment plans, and responsible antibiotic use.

With the right treatment, you often see improvement quickly.