What is acne ?
When our hair follicles are clogged with facial oil and dead skin cells, they become prone to infection by bacteria. 
When infection and inflammation occurs, acne or pimples develop. It can affect all parts of our skin but tends to be worse on the face, back and chest where there are higher density of hair follicles.
What are some of the causes of Acne?
There are multiple causes of acne and a few factors often combine together to give rise to serious acne issues:
- Hormonal – such as During puberty and adolescence
- Menstrual related acne – acne and pimples that occur just before or in the first few days of the menstrual cycle.
- Stress – such as emotional or physiological stress.
- Genetics – your chance of developing acne is higher if you have a family history of acne.
- Diet – which are high in sugar and milk or dairy products
- Medications – such as steroids and hormonal pills etc.
Lifestyle Modifications – Do It Yourself
Adopting a Healthy lifestyle is crucial in the management of acne, and below are some of the activities you may undertake:
- Drink lots of plain water
- Avoid drinks high in sugar contents and dairy products.
- Exercise to promote blood circulation and increase sweating to help cleanse your pores and follicles the natural healthy way.
- Exercising can also help to manage your stress and improve your sleep.
- Get at least 7-8 hours of sleep so that your skin can recover better from the inflammation of the pimples.
Doctor’s recommendation for acne treatment can be subdivided into 
- Cleansers and Topical medications
- Oral medications
- Treatment in clinic
Cleansers and Topical medications
First, good cleansers are important to clear away the bacteria on the face and to get rid of excessive oil without causing too much dryness. If your face is very oily, Cleansers that contain salicylic acid may be good to remove excess sebum.
In singapore, some of the common products available that contains salicylic acid includes
- Neutrogena oil free acne wash
- COSRX salicylic acid daily gentle cleanser
- Clean and Clear Blackhead cleaning cleanser
There are many other products on the shelves of major pharmacies in Singapore. Look out for the salicylic content on the product description.
If your face belongs to the dry and sensitive type, then gentle foam cleansers may be more suitable for you. Some examples that you can find in the pharmacies in singapore are:
- Cetaphil Pro, oil removing foam wash
- Eucerin pro acne cleansing foam
The first group would be the topical antibiotics. Antibiotics help by killing the bacteria and reducing the inflammation of the pimples. 
These are doctor’s prescribed only in SIngapore. The common antibiotics available in our Singapore market are :
- Clindamycin containing creams or gel : eg. Dalacin T gel or cream
The second group would be the topical benzoyl peroxide.
Benzoyl peroxide helps in killing the bacteria. In addition, it reduces oil production and helps active pimples dry up faster and promote faster healing. Again, some of the products available in singapore includes :
- Benzac’s spot treatment water based gel
- Oxy 5 or Oxy 10 lotion
- Neutrogena On-The-spot acne treatment
The third group would be the Retinoid containing creams or gel. These are doctor-prescribed only in Singapore.
They help in reducing oil and sebum production, reducing congestion of our hair follicles and help in drying up active pimples fast.
These can be products that are retinoid-containing only like :
Or they may be combined with other medications like antibiotics or Benzoyl peroxide as mentioned above. Some examples are
- Epiduo ( Differin + benzoyl peroxide )
These are usually given when the acne condition is more severe or when lifestyle and topical treatments are not working. 
All the medications listed below are prescribed only and are not available over the counter in Singapore.
There are various oral antibiotics available to treat acne such as doxycycline, minocycline or erythromycin.
What antibiotics to give depends on your doctor’s decision. There are some side effects related to these antibiotics. Consult your doctor for more information.
In general , we would start to see results only after the 2nd month of oral antibiotics. We may need to continue the oral antibiotics for 3-4 months or longer for best clinical outcome.
Isotretinoin are powerful medications that can provide very good and effective clearance of acne.
However there are side effects associated with these medications – so a detailed consultation with your doctor is necessary before starting on it.
These medications may cause sensitivity to sun, skin dryness and peeling, liver inflammation and high triglyceride levels. Ladies who are on these medications must be reminded that these are teratogenic medications.
Oral contraceptive medications like Diane 35 are hormonal pills that are given to treat hormone related acne in females.
Again, it takes 2-3 months before these pills become effective. There are side effects to these medications therefore, detailed consultation is necessary before you are started on these medications.
Common Acne Treatment Available in Singapore Clinics
Treatments there are often prescribed in the clinics in Singapore includes
- Physical treatment
- Chemical peels
- Lasers and light treatments
Some of the physical treatments are
- Extraction facials – these are careful extraction of comedones and cleansing of face by skilled therapists. Occasionally some pustules can also be cleared through these methods.
- Aqua Peel facials – these are machine assisted facials which combine superficial oil and keratin reduction solution with hydration treatment.
In Singapore, chemical acid peels are administered by doctors in the clinic. It can help with
- Reduction of oil on the face
- Exfoliating dead skin cells
- And even help with reduction of acne scars
However these have to be done in experienced hands as burns from chemical peels is not uncommon.
Laser and Light treatment
Lasers and IPL treatments can be done by experienced doctors with the appropriate training and certification in MOH-licensed clinics. These treatments can help to reduce:
- Bacteria load
- Reduce oil production on face
- Reduce the redness and inflammation of pimples
- It can also be done to reduce the brown spots that occur after pimple healing.
There are side effects however with these treatments and consultations are vital before the start of these treatments.
By : Dr Chen Yiming- Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)
“ hair follicles are clogged https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047
“ Topical medications “ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
“ Oral medications “ https://www.webmd.com/skin-problems-and-treatments/acne/understanding-acne-treatment
“ Doctor’s recommendation “ https://www.aafp.org/afp/2012/1015/p734.html