Skin concerns · Editorial hub · Updated weekly

Acne. The pathway your skin actually needs.

Acne is not a single condition. Hormonal, inflammatory, comedonal, cystic, each responds to a different protocol. The Glow's editors break down the evidence-based pathways, rank the products that work, and explain when a clinic is the right call.

What it is.

Acne is a chronic inflammatory condition of the pilosebaceous unit. Four mechanisms drive it: excess sebum, follicular hyperkeratinisation (skin cells blocking the follicle), Cutibacterium acnes proliferation, and inflammation. Most adult acne is hormonally driven (androgen-sensitive sebaceous glands, exacerbated by stress, sleep, and the cycle). Most teenage acne has a stronger inflammatory and comedonal component. Treatment is mechanism-specific.

What works.

The evidence-backed topical pathway, ranked from foundational to advanced. Every product link goes to the full Glow review or category ranking.

Salicylic acid 2% (BHA)

Oil-soluble, penetrates the follicle, dissolves the keratin plug. Best for comedonal acne. Paula's Choice 2% BHA Liquid is the editorial default.

Adapalene 0.1% (Differin)

Over-the-counter retinoid in Australia, originally prescription. Strongest evidence base for mild-to-moderate inflammatory and comedonal acne. AU$30-40.

Benzoyl peroxide 2.5-5%

Antimicrobial, kills C. acnes, reduces inflammation. Pair with adapalene for mechanism stacking. CeraVe Acne Foaming Cream Cleanser at 4% is well tolerated.

Azelaic acid 15-20%

Anti-inflammatory, anti-bacterial, gentle on sensitive and rosacea-prone skin. Useful when retinoids irritate.

Niacinamide 5-10%

Sebum-regulating, anti-inflammatory, well tolerated. Useful adjunct in any routine.

What doesn't.

Glow's banned list

Aggressive scrubbing or physical exfoliants on inflammatory acne. Worsens it.
Coconut oil on the face. Highly comedogenic.
Most 'detox' regimens. There is no skin detox pathway from food.
Toothpaste on pimples. The fluoride and surfactants damage the skin barrier.
Stopping all skincare to 'let skin breathe'. Skin doesn't breathe, and barrier care reduces inflammation.
Most pillowcase, towel and skincare-tool replacements without addressing the underlying drivers. Helpful at the margins, never the main lever.

When to see a clinic.

For moderate-to-severe inflammatory or cystic acne not responding to topical, prescription pathways are next. Oral antibiotics (doxycycline, minocycline) for 3-6 months. Oral isotretinoin (Roaccutane) for severe nodulocystic or treatment-resistant cases, under dermatology supervision. AviClear is the FDA-cleared 1726nm laser for moderate-to-severe acne, three sessions, no medication required. Flawless Rejuvenation runs AviClear under Dr Sean Arendse. BBL with the Forever Clear protocol can complement topical and prescription pathways for inflammatory acne. Skinologie runs the Sciton platform.

Questions, answered.

Is hormonal acne different to teenage acne?

Often, yes. Adult hormonal acne typically presents on the lower face, jawline and neck, follows the menstrual cycle, and is cystic or deep-seated. Teenage acne is more comedonal across the T-zone with inflammatory pustules. Treatment pathways overlap but adult hormonal acne often benefits from systemic intervention (anti-androgens, oral contraceptives, spironolactone) discussed with a GP.

How long does it take topical acne treatment to work?

Expect 8-12 weeks for visible improvement with topical retinoid (adapalene) or BPO. Stopping treatment reverses gains, since acne is a chronic condition, not an episode.

Is AviClear worth the cost?

AviClear is a credible FDA-cleared pathway for moderate-to-severe acne, particularly for patients who cannot or do not want to take oral isotretinoin. Three sessions typically AU$3,000-4,500 total. The evidence is good but newer than isotretinoin.

Does diet affect acne?

High-glycemic-load diets and dairy (particularly skim milk) have credible evidence as acne aggravators in some individuals. Chocolate, oily food and 'unhealthy' eating do not have a strong evidence base as direct triggers.

When should I see a dermatologist or GP about acne?

If topical adapalene plus benzoyl peroxide hasn't moved acne in 12 weeks, if scarring is occurring, or if mental health is affected. Prescription pathways and in-clinic treatment require medical input.