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The most advanced acne treatments

Jul 30, 2023

Acne is not just a problem for teenagers. It is also an issue for perimenopausal women, when old acne scars vie with new spots for prominence (along with the wrinkles, pigmentation and open pores). But it's not all doom and gloom. A new crop of highly effective treatments have been developed, promising clearer and brighter skin.

This is not a fluffy facial, rather it is a serious problem-solving endeavour. Dr Stefanie Williams is one of the UK's most revered dermatologists and has designed this treatment for male and female skin prone to breakouts. This facial can help with mild to severe acne because the products can be tailored in strength. The skin is thoroughly cleansed and pores gently purged with a Hydrafacial machine, which uses suction and a mixture of glycolic and salicylic acids simultaneously sprayed on the skin to soften the keratin plugs that clog pores.

Next the therapist uses a fine needle to scratch the surface of comedones (small, skin-coloured bumps) before performing manual extractions. A selection of face masks are then applied to different areas of the face — oily T-zones may get a clearing clay mask whereas a vitamin C-powered formula is favoured for cheeks to help lighten pigmentation and scarring. Lymphatic drainage massage follows to help to reduce lymph fluid congestion — particularly helpful for people with rosacea, which can cause swelling in the face around the nose and cheeks.

Finally, red and blue LED light is used to calm inflammation and reduce unwanted bacteria. For best results, a course of six treatments is recommended at monthly intervals. £415;

The aesthetics industry is abuzz with excitement as Aviclear, the first FDA-approved laser to selectively destroy sebocytes (sebum-producing cells), arrives in UK clinics this spring. Using a laser wavelength (1726n metresm), the laser reduces the production of sebum and hence the proliferation of the bacteria linked to the development of acne.

This provides a safe and effective treatment for mild, moderate and severe acne in any skin type, which doctors have suggested can be as effective as oral isotretinoin (better known as Roaccutane). In a clinical trial published in 2022, participants typically saw a 56 per cent improvement in the severity of their acne after a course of AviClear and adverse effects were mild.

The treatment involves three 30-minute sessions done at four-week intervals. Patients are recommended to avoid aerobic exercise, saunas and heavy make-up for 24 hours prior to treatment. From £3,000 for a course of three sessions;

An extremely adaptable technology, BBL — which stands for broadband light — uses light therapy like IPL (intense pulsed light) with different wavelengths to offer a range of targeted treatments for active acne, acne scarring, spider veins and inflammation all in the same session. The BBL laser not only treats active acne through controlled trauma, targeting sebaceous glands and bacteria on the face using the light therapy, but also promotes new collagen production in skin cells, helping to minimise the appearance of scarring.

The joy of this treatment is there is little downtime. Some people may experience pinkness and heat on the face, which usually disappears after 24 hours, and skin can feel a little dry for a few days afterwards, but it will soon reveal a much improved texture. Our tester reported that after three sessions her acne scars were hugely improved and noted a polished skin texture with fewer spots and faded freckles. It's recommended to avoid retinol-based products or sunshine holidays in the two weeks before or after BBL treatment because it makes skin more sensitive to UV light.

Improvements are noticeable after one treatment, but for long-term results experts suggest three sessions spaced about four weeks apart. Top-up treatments every couple of months after this are also recommended. From £450 per session;

The facialist Teresa Tarmey, who operates out of a zen-like space in Notting Hill, has been in the skin-perfecting business for 25 years. Her Advanced Acne Treatment includes a deep cleanse, lactic acid peel, extraction, laser, microneedling and LED light therapy, all focused on reducing inflammation, getting rid of spots and improving the general appearance of skin. This is ideal for younger people and women of a certain age, though Tarmey suggests swapping the microneedling for more impactful fractional radio frequency because this can help with wrinkles, acne scarring and general rejuvenation all in one go.

Tarmey applies a numbing cream before firing up the device, which causes controlled bursts of heat through the epidermis, promoting the creation of new tissue. It is not too uncomfortable, a bit like someone pressing something slightly sharp on your skin that delivers a tiny crackle of energy. Prepare to look blotchy afterwards, but it is nothing some oxygenetix foundation can't cover up. The redness should not last more than 48 hours, although you may have a bit of crustiness for a few days.

SPF 50 must be used in the weeks following the treatment and four sessions are advised. Further Tarmey tips for those with breakouts include avoiding cleansing oils and balms, because these clog the pores. A good retinol (Tarmey's own brand comes highly recommended) can also help. £195;

For undoing the sins of picking spots (acne scarring and blotchy marks) and helping with issues like broken capillaries, thread veins, mottled and crepey skin, the M22 is an effective skin resurfacer. Using a combination of IPL to tackle blotchiness/discolouration and active acne, followed up with ResurFX resurfacing laser to treat the skin tone, texture and scarring, M22 can also help to improve appearance of large pores.

This treatment has two parts — first, the IPL is fired over the face, giving a sharp pinging sensation rather like a hot rubber band slapping the skin, before the therapist changes to ResurFX laser that sizzles slightly as it moves across the face, while blowing cool air to aid any discomfort. The skin may feel slightly hot and look flushed for a few hours after the treatment, and even feel a little rough and itchy for a few days, but it should soon calm down.

It's best to avoid any "active" skincare for about four days after the treatment (for example, cleansers with glycolic acid, products with alpha hydroxy acids, beta acids, retinols or any kind of exfoliator). Just stick to simple soothing products and apply a good SPF every day.

The procedure takes about 45 minutes and most people need a course of three or four treatments spaced one month apart. From £250;

The affable Dr Penelope Tympanidis is one of a handful of experts in the UK qualified to perform acne scar subcision, a highly specialised technique that involves using a special tool that incorporates both a needle and fine blade that is inserted under the skin and used to create a controllable trauma to undermine acne scar. The procedure, which is performed under local anaesthetic, aims to stimulate type 11 collagen production (a very thick collagen that lifts the skin to smooth and flatten pitted scars). One cheek takes about 40 minutes to treat, whereas a full-face treatment takes an hour.

The results are permanent, but it's important to prepare yourself for the fact that there will be significant bruising and swelling before skin improves — healing can take between one and two weeks. Usually one treatment is all that's needed, but in severe cases treatment can be repeated a couple of months later. From £400;