Acne Treatment in Ireland: From OTC to Prescription Options

Acne is one of the most common skin conditions in Ireland, affecting approximately 80% of people at some point between the ages of 11 and 30. While often associated with teenagers, acne can persist well into adulthood, causing not only physical discomfort but also significant emotional distress and loss of confidence.

The good news is that acne is highly treatable. Whether you are dealing with occasional breakouts or persistent, stubborn acne, there are effective options — from over-the-counter products to prescription medications. This guide walks through them in the order most people should try them, and explains when it is worth involving a GP. (If your skin problem is itchy and dry rather than spotty, it may be eczema instead.)

What Causes Acne?

Understanding what causes acne is the first step toward effective treatment. Acne develops when hair follicles become clogged with oil (sebum) and dead skin cells, creating an environment where bacteria can thrive.

The Four Key Factors

1. Excess Sebum Production

Sebaceous glands attached to hair follicles produce sebum, an oily substance that normally keeps skin moisturised. During puberty, hormonal changes stimulate these glands to produce more sebum. When too much sebum is produced, it can combine with dead skin cells to block pores.

2. Abnormal Skin Cell Shedding

Normally, dead skin cells are shed gradually and replaced by new cells. In acne-prone skin, these cells can clump together and combine with sebum to form plugs that block the follicle opening.

3. Bacteria (Cutibacterium acnes)

The bacterium Cutibacterium acnes (formerly known as Propionibacterium acnes) lives naturally on the skin. When follicles become blocked, these bacteria multiply rapidly in the sebum-rich environment, triggering inflammation and the formation of pus-filled spots.

4. Inflammation

The body's immune response to bacterial overgrowth and blocked pores leads to inflammation, causing the redness, swelling, and pain associated with inflammatory acne.

Hormonal Influences

Hormones play a significant role in acne development:

• Androgens: These hormones (including testosterone) increase during puberty in both males and females, stimulating sebaceous glands to enlarge and produce more sebum
• Menstrual cycle: Many women experience acne flare-ups around their period due to hormonal fluctuations
• Polycystic ovary syndrome (PCOS): This hormonal condition is associated with increased androgen levels and persistent acne
• Pregnancy and menopause: Hormonal changes during these times can trigger or worsen acne

Other Contributing Factors

• Genetics: If your parents had acne, you are more likely to develop it
• Diet: High-glycaemic foods and dairy may worsen acne in some people
• Stress: While stress does not cause acne directly, it can worsen existing breakouts
• Certain medications: Corticosteroids, lithium, and some hormonal treatments can trigger acne
• Cosmetics: Oil-based makeup and skincare products can clog pores
• Friction: Pressure from helmets, tight clothing, or phone screens can worsen acne in affected areas

Types of Acne

Acne presents in several forms, ranging from mild to severe. Understanding your acne type helps determine the most appropriate treatment.

Non-Inflammatory (Comedonal) Acne

Comedonal acne consists of clogged pores without significant inflammation:

Blackheads (Open Comedones)

• Open pores clogged with sebum and dead skin cells
• Dark appearance due to oxidation when exposed to air
• Not caused by dirt despite the dark colour
• Common on the nose, forehead, and chin

Whiteheads (Closed Comedones)

• Closed pores with trapped sebum and skin cells beneath the surface
• Appear as small, flesh-coloured or white bumps
• Cannot be squeezed out like blackheads
• Can progress to inflammatory acne if bacteria invade

Inflammatory Acne

When bacteria multiply in clogged pores, the immune system responds with inflammation:

Papules

• Small, red, raised bumps
• Tender to the touch
• No visible pus
• Early stage of inflammatory acne

Pustules

• Similar to papules but with a white or yellow pus-filled centre
• The classic "spot" or "pimple"
• Red and inflamed at the base
• More likely to leave marks if squeezed

Severe Acne

Nodules

• Large, painful, solid lumps deep beneath the skin surface
• Develop when clogged pores become severely irritated
• Do not contain pus initially
• Can persist for weeks or months
• High risk of scarring

Cysts (Cystic Acne)

• Large, pus-filled lumps similar to boils
• The most severe form of acne
• Very painful and deep within the skin
• Highest risk of permanent scarring
• Requires prescription treatment

Over-the-Counter (OTC) Treatments

For mild to moderate acne, over-the-counter treatments available from Irish pharmacies can be highly effective. These products target different aspects of acne formation.

Benzoyl Peroxide

Benzoyl peroxide is one of the most effective OTC acne treatments and has been used for decades.

How it works:

• Kills acne-causing bacteria (C. acnes)
• Helps unclog pores by promoting skin cell turnover
• Reduces inflammation
• Works quickly, often showing results within 5-7 days

Available strengths: 2.5%, 5%, and 10%

Tips for use:

• Start with the lowest strength (2.5%) to minimise irritation
• Apply once daily, increasing to twice daily if tolerated
• Can bleach fabrics, so use white towels and pillowcases
• Use an oil-free moisturiser to counteract dryness
• Apply sunscreen as it can increase sun sensitivity

Products available in Ireland: Acnecide, PanOxyl, Brevoxyl

Salicylic Acid

Salicylic acid is a beta-hydroxy acid (BHA) that penetrates oil-filled pores.

How it works:

• Exfoliates inside the pore, helping to unclog blockages
• Reduces excess oil
• Mildly anti-inflammatory
• Particularly effective for blackheads and whiteheads

Available strengths: 0.5% to 2%

Tips for use:

• Ideal for comedonal (non-inflammatory) acne
• Can be used in cleansers, toners, or leave-on treatments
• Generally well-tolerated with less irritation than benzoyl peroxide
• Often combined with other ingredients in acne products

Products available in Ireland: La Roche-Posay Effaclar, CeraVe Renewing SA Cleanser, The Ordinary Salicylic Acid

Niacinamide

Niacinamide (vitamin B3) is a versatile ingredient that has gained popularity for acne treatment.

How it works:

• Regulates sebum production
• Anti-inflammatory properties help reduce redness
• Strengthens the skin barrier
• Can help fade post-acne marks (hyperpigmentation)
• Does not cause irritation like acids

Available strengths: 2% to 10%

Tips for use:

• Suitable for all skin types, including sensitive skin
• Can be combined with other acne treatments
• Best applied after cleansing, before moisturiser
• Results typically seen after 4-8 weeks of consistent use

Products available in Ireland: The Ordinary Niacinamide, CeraVe PM Moisturiser, Paula's Choice Niacinamide Booster

Alpha Hydroxy Acids (AHAs)

AHAs such as glycolic acid and lactic acid are chemical exfoliants.

How they work:

• Remove dead skin cells from the surface
• Promote cell turnover
• Help prevent pore clogging
• Improve skin texture and fade acne marks

Tips for use:

• Start with lower concentrations (5-10%)
• Use in the evening as they increase sun sensitivity
• Always use sunscreen during the day
• Do not combine with retinoids on the same night

Prescription Treatments

When OTC treatments are not providing adequate results after 2-3 months, prescription medications offer more powerful options. These require a GP consultation and are available through pharmacies in Ireland.

Topical Retinoids

Retinoids are vitamin A derivatives and are considered the cornerstone of acne treatment by dermatologists.

Tretinoin

Tretinoin is a powerful prescription retinoid that has been used for acne treatment for over 50 years.

How it works:

• Increases skin cell turnover, preventing pore blockages
• Reduces comedone formation
• Has anti-inflammatory effects
• Can improve skin texture
• Takes 8-12 weeks to see significant improvement

Tips for use:

• The prescribing doctor chooses the strength, usually starting low
• Expect initial irritation, dryness, and possible "purging" (temporary worsening)
• Always use sunscreen as tretinoin increases photosensitivity
• Must not be used in pregnancy

Adapalene

Adapalene is a newer prescription retinoid that is often better tolerated than tretinoin — it has a similar mechanism but is more selective and less irritating, and is often recommended as a first-line prescription retinoid for that reason.

Topical Antibiotics

Topical antibiotics target the bacteria component of acne.

Clindamycin

Clindamycin is the most commonly prescribed topical antibiotic for acne.

How it works:

• Kills C. acnes bacteria
• Reduces inflammation
• Works best in combination with benzoyl peroxide (to prevent antibiotic resistance)

Tips for use:

• Should NOT be used as monotherapy due to resistance risk
• Always combine with benzoyl peroxide or a retinoid
• Apply to all acne-prone areas, not just individual spots
• Typical course is 8-12 weeks

Erythromycin

An alternative topical antibiotic, though less commonly used due to higher resistance rates.

Combination Topical Products

Many prescription acne treatments combine multiple active ingredients — an antibiotic with benzoyl peroxide, or a retinoid with either of those. Combination products can improve efficacy while simplifying treatment routines, and your GP will recommend one where it suits your skin.

Oral Antibiotics

For moderate to severe inflammatory acne, oral antibiotics may be prescribed.

Doxycycline

Doxycycline is the most commonly prescribed oral antibiotic for acne in Ireland.

How it works:

• Kills acne-causing bacteria throughout the body
• Has anti-inflammatory properties independent of its antibiotic action
• Reduces the population of C. acnes in sebaceous follicles

Tips for use:

• The dose and course length are set by the prescribing doctor
• Take with food to reduce stomach upset, and avoid lying down for 30 minutes after taking
• Avoid excessive sun exposure (increased photosensitivity)
• Should be used alongside topical treatments, and courses are kept time-limited to reduce the risk of antibiotic resistance
• Not suitable during pregnancy or for children under 12

Lymecycline

Lymecycline is another tetracycline antibiotic commonly used for acne. It can be taken with food, is generally well-tolerated, and carries similar precautions to doxycycline; as with doxycycline, the dose and course length are the prescriber's decision.

Combined Oral Contraceptive Pills

For women with hormonal acne, certain combined oral contraceptive pills can be highly effective.

How they work:

• Reduce androgen levels
• Decrease sebum production
• Regulate hormonal fluctuations

Suitable options: Pills containing ethinylestradiol combined with progestogens like drospirenone, norgestimate, or cyproterone acetate

Note: These require an assessment of cardiovascular risk factors and are not suitable for all women.

Isotretinoin

For severe, persistent, or scarring acne, isotretinoin is the most effective treatment available.

How it works:

• Dramatically reduces sebum production
• Shrinks sebaceous glands
• Normalises skin cell shedding
• Has anti-inflammatory effects
• Produces long-term remission in most cases

Important considerations:

• Available only from dermatologists (specialist referral required)
• Requires regular blood tests and monitoring
• Must not be used in pregnancy under any circumstances — reliable contraception is a strict requirement of treatment for anyone who could become pregnant
• Women of childbearing age must use contraception
• Side effects include dry skin, lips, and eyes; muscle aches; mood changes
• Typical course is 4-6 months

Isotretinoin should be considered when other treatments have failed or when there is significant risk of scarring.

When to See a GP

While mild acne can often be managed with OTC treatments, there are clear indicators that you should consult a doctor:

You Should See a GP If:

OTC treatments have not worked after 3 months If you have been consistently using benzoyl peroxide, salicylic acid, or other OTC products for 8-12 weeks without improvement, prescription treatments are likely needed.

You have moderate to severe acne Multiple papules, pustules, or any nodules/cysts require prescription treatment to prevent scarring.

Your acne is causing scarring Early intervention with effective treatment can prevent permanent scarring. Do not wait to seek help.

You have painful, deep spots Nodular or cystic acne is not treatable with OTC products and needs prescription medication.

Acne is affecting your mental health If acne is causing anxiety, depression, or social withdrawal, speak to a GP. Your mental wellbeing matters, and effective treatment is available.

You are an adult woman with hormonal acne Acne along the jawline and chin, worsening around periods, or associated with other hormonal symptoms may benefit from hormonal treatments.

You have tried multiple treatments without success A GP can assess your treatment history and recommend the most appropriate next steps.

How to Get Acne Treatment Online

Getting prescription acne treatment has never been more convenient. Online consultations allow you to speak with an Irish-registered GP from the comfort of your home.

Acne suits remote assessment well: the GP can see your skin on video (photos help too), ask about how long you have had it, what you have already tried, and your wider medical history, and — where prescription treatment is appropriate — send an electronic prescription to your chosen pharmacy the same day. Our acne treatment service page sets out what an online assessment covers and which treatments an Irish-registered GP can consider, and how it works explains the booking process itself.

What to Expect: Results Take Time

One of the most important things to understand about acne treatment is that results take time. This applies to both OTC and prescription treatments.

Typical Timelines

• Benzoyl peroxide: Initial improvement in 1-2 weeks; full results in 4-8 weeks
• Salicylic acid: Gradual improvement over 6-8 weeks
• Topical retinoids: Initial "purging" for 2-4 weeks; improvement starts around 6-8 weeks; significant results at 12 weeks
• Oral antibiotics: Improvement typically begins at 4-6 weeks; full course is 3-6 months
• Isotretinoin: Often initial worsening; improvement typically at 2-3 months; course lasts 4-6 months

Why Patience Matters

Acne treatments work by changing how your skin behaves at a cellular level. Skin cells take approximately 4-6 weeks to turn over, meaning any treatment needs at least this long to show meaningful results.

The "Purging" Phase

When starting retinoids, many people experience an initial worsening of acne called "purging." This occurs because:

• Retinoids speed up skin cell turnover
• Existing blocked pores are pushed to the surface faster
• Spots that would have appeared over weeks all come up at once

Purging typically lasts 2-6 weeks and is followed by significant improvement. It is a sign the treatment is working.

Stick With Your Treatment

The most common reason for treatment failure is giving up too soon. Commit to your treatment plan for at least 8-12 weeks before assessing whether it is working.

Skincare Routine Tips for Acne-Prone Skin

Alongside acne treatments, the right skincare routine can make a significant difference.

Morning Routine

• Gentle cleanser: Use a mild, non-foaming cleanser (e.g., CeraVe Hydrating Cleanser, La Roche-Posay Toleriane)
• Acne treatment (if AM application): Apply benzoyl peroxide or other treatment if instructed
• Lightweight moisturiser: Even oily skin needs moisture (e.g., CeraVe PM, Cetaphil Daily Hydrating Lotion)
• Sunscreen: SPF 30+ is essential, especially when using retinoids or antibiotics. Choose oil-free, non-comedogenic options

Evening Routine

• Double cleanse (if wearing makeup/sunscreen): Oil-based cleanser followed by gentle water-based cleanser
• Treatment application: Apply prescription treatment (retinoid, antibiotic) or OTC treatment
• Moisturiser: Apply after treatment has absorbed

General Tips

• Do not over-wash: Twice daily is enough; excessive cleansing irritates skin
• Avoid harsh scrubs: Physical exfoliation can worsen inflammation
• Choose non-comedogenic products: Look for "oil-free" and "non-comedogenic" labels
• Do not pick or squeeze: This spreads bacteria, worsens inflammation, and causes scarring
• Change pillowcases regularly: Bacteria and oil accumulate on fabric
• Keep phones clean: Phone screens harbour bacteria that can worsen acne
• Stay hydrated: Drink plenty of water for overall skin health

Frequently Asked Questions

How long does it take for acne treatment to work?

Most acne treatments take 8-12 weeks to show significant improvement. Topical retinoids may cause initial worsening before improvement. Patience and consistency are key.

Can I use benzoyl peroxide and retinoids together?

Yes, but not at the same time. Benzoyl peroxide can inactivate some retinoids. Apply benzoyl peroxide in the morning and retinoids at night, or use on alternate days.

Will my acne come back after treatment?

For some people, acne may return after stopping treatment, particularly hormonal acne. Maintenance therapy with topical retinoids can help prevent recurrence. Isotretinoin often produces long-lasting remission.

Is acne caused by poor hygiene?

No. Acne is caused by hormones, genetics, and bacteria, not by dirty skin. Over-washing can actually worsen acne by irritating the skin.

Can diet affect acne?

Some studies suggest high-glycaemic foods (sugary, processed foods) and dairy may worsen acne in some people. However, diet is not the primary cause. Focus on proven treatments rather than restrictive diets.

Is it safe to take antibiotics long-term for acne?

Oral antibiotics should typically be limited to 3-6 months to reduce the risk of antibiotic resistance. They should always be combined with topical treatments and can often be stopped while continuing topical maintenance.

Can I wear makeup if I have acne?

Yes. Choose non-comedogenic, oil-free makeup products. Always remove makeup thoroughly at night. Mineral makeup is often well-tolerated by acne-prone skin.

When should I see a dermatologist?

Your GP can manage most acne effectively. Referral to a dermatologist is typically needed for severe cystic acne, acne not responding to standard treatments, or when isotretinoin is being considered.

Is acne treatment safe during pregnancy?

Some acne treatments (retinoids, certain antibiotics, hormonal treatments) are not safe during pregnancy. If you are pregnant or planning pregnancy, consult your GP about pregnancy-safe options. Benzoyl peroxide and azelaic acid are generally considered safe.

Take Control of Your Skin

Acne can be frustrating and affect your confidence, but effective treatment is available. Whether you need guidance on OTC products or prescription-strength medications, help is at hand.

Do not let acne hold you back. With the right treatment and patience, clear skin is achievable. Most people see significant improvement within 8-12 weeks of starting appropriate treatment.

If OTC products have not worked after 8-12 weeks, or your acne is painful, cystic, or scarring, speak to a GP about prescription options. Our acne treatment service page explains how an assessment with an Irish-registered GP works.

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This article was reviewed by Dr. Junaid Akram, a General Practitioner registered with the Irish Medical Council. The information provided is for educational purposes and does not replace personalised medical advice.