When should I see a dermatologist for recurring breakouts?

When should I book rather than keep trying products?

• You have deep, painful lumps, sometimes called nodules or cysts, or lots of spots.
• You are developing scars, or breakouts are getting worse.
• Acne or acne scars are causing ongoing distress, anxiety or low mood.
• You are unsure whether the recurring bumps are actually acne.

Do not wait for scarring before asking for help: acne scars can be permanent, and early treatment can help prevent them. You also do not need severe acne to raise its emotional impact with a doctor. Persistent distress can be a reason for specialist referral in its own right.34

How long should I try treatment first?

Improvement usually takes 6 to 8 weeks; reducing redness overnight is not the same as preventing new blemishes. If self care and acne medicines bought without a prescription have not helped after several months, contact a doctor. That waiting period is for otherwise mild acne, not a reason to postpone care for painful lumps, worsening acne or scars. Even acne that responds to treatment can flare again, so recurrence alone does not mean treatment has failed.23

Could recurring breakouts be something other than acne?

Ask for an assessment if small bumps cluster around your mouth, nose or eyes and burn or itch; perioral dermatitis can resemble acne. Breakouts with central facial redness, stinging or burning, or gritty eyes can be rosacea. Repeated deep bumps in the underarms, groin or beneath the breasts can be hidradenitis suppurativa, a condition that needs treatment to prevent worsening. These patterns are reasons to get the diagnosis checked, not to diagnose yourself.5

If acne occurs alongside irregular periods, scalp hair loss, increased facial hair or darkening and thickening skin, see a dermatologist or primary care doctor promptly. These can be signs of polycystic ovary syndrome, or PCOS, a hormonal condition that requires medical care beyond treating the breakouts.5

Contact a doctor if the affected skin becomes hot, swollen and red, which can indicate infection. Redness can be harder to see on brown and black skin. Do not treat those changes as just another routine breakout.1

What should I do while waiting?

Keep skincare gentle, rather than turning the bathroom shelf into a product launch. Wash twice daily with a gentle cleanser, remove makeup at night and choose products labelled noncomedogenic, meaning formulated not to clog pores. Avoid scrubbing, picking and squeezing: these can worsen irritation or cause scars. Follow acne product directions carefully and apply products sparingly; treatments can cause redness, dryness or excessive peeling.12

What can a dermatologist do differently?

Treatment is chosen for the types of blemishes you have, not for whichever bottle has the most ambitious name. A clinician can usually diagnose acne by examining your skin; tests are not needed in most cases. A dermatologist can identify acne lookalikes and create a treatment plan. A primary care doctor can also offer prescription treatment or refer you to a dermatologist, so you can start there if specialist care is not directly available.1235