An effective acne skincare routine is simple: a gentle cleanser, one or two proven active ingredients, a non-comedogenic moisturiser and daily SPF, used consistently for three to six months. The evidence-based actives available without prescription are salicylic acid, benzoyl peroxide, adapalene and niacinamide. If acne is moderate to severe, scarring or affecting your confidence, see your GP or a dermatologist early, because prescription treatment works best when started promptly.
This guide is written by Dr Vishal Patel at Dental & Wellness London in Islington. It covers what causes acne, how to build a routine that the skin will tolerate, a realistic timeline, and when in-clinic care such as chemical peels or medical-grade facials can help.
What causes acne
Acne is multifactorial. Excess sebum, dead skin cells that block the follicle, the skin bacterium Cutibacterium acnes and inflammation all play a part, with hormones, genetics, some medications, stress and sleep influencing how active it is. That is why a routine targets more than one factor at once. Our page on acne explains the clinical picture in more detail.
Acne types
- Comedonal: blackheads and whiteheads, usually on the forehead, nose and chin.
- Inflammatory papular and pustular: red, tender spots, some with a white head.
- Nodular and cystic: deep, painful lumps that can scar. These need medical assessment rather than skincare alone.
The routine
Morning
- Gentle, fragrance-free cleanser.
- Niacinamide serum (2–5%) to calm redness and regulate oil.
- Light, non-comedogenic moisturiser.
- Broad-spectrum SPF 30 or higher.
Evening
- The same gentle cleanser.
- One active: adapalene gel on alternate nights to begin with, or a salicylic acid product, or benzoyl peroxide on inflamed areas.
- Moisturiser.
The active ingredients explained
- Salicylic acid is oil-soluble and clears blocked pores; see our AHA and BHA guide.
- Adapalene is a retinoid that normalises how skin cells shed and prevents new blockages. It is available over the counter in the UK at 0.1%. Avoid it in pregnancy.
- Benzoyl peroxide reduces acne bacteria and does not cause resistance. Start at 2.5–5%; it can bleach fabric.
- Niacinamide is a well-tolerated support ingredient for redness and oiliness.
Introduce one new active at a time, two to three weeks apart, so you can tell what is helping and what is irritating.
Realistic timeline
The first two to four weeks can bring purging as deeper congestion comes to the surface. Meaningful improvement usually takes eight to twelve weeks, and the full effect three to six months. Keep the routine going once skin is clear, because acne tends to return when treatment stops.
When to see your GP or a dermatologist
See your GP if spots are painful, deep or leaving marks, if acne has not improved after three months of a consistent routine, or if it is affecting your mood. Prescription options can then be discussed. Existing marks are treated once the acne is settled; our acne scarring page explains the options.
Lifestyle factors
Evidence is strongest for avoiding heavy, pore-blocking cosmetics, not picking, and managing stress and sleep. Diets high in refined sugar and, for some people, dairy may worsen acne; a nutritional therapist can help where diet seems to play a part.
Common mistakes
- Using too many actives at once and damaging the skin barrier.
- Harsh scrubs and over-cleansing.
- Stopping after two or three weeks, before the routine has had time to work.
- Skipping moisturiser and sunscreen.
Cost
- Drugstore acne routine (cleanser, niacinamide, adapalene OTC, benzoyl peroxide, moisturiser, SPF): £30-£80/month
- Mid-range routine: £80-£200/month (see our AHA and BHA exfoliation guide)
- Skin consultation at DWL: £65, redeemable in full against treatment
- Nutritional therapy alongside skin care: arranged with our nutritional therapist, fee confirmed at booking
Book a consultation
Free 20-minute discovery call. Skin consultation £65, redeemable in full against treatment, includes an acne-specific protocol. In-clinic options include chemical peels.
See related: Acne, acne scarring.
