Topical Acne Treatment
Part of the Salutem Acne Clinic. Treatment is GP-led, evidence-based and tailored to your skin. This page explains one part of the treatment pathway — your GP will advise which options suit you.
Topical treatments are the cornerstone of acne management. They suit most people with mild to moderate acne and are also used for long-term maintenance once the skin has improved. They work locally on the skin to reduce blocked pores, inflammation and acne-causing bacteria.
Improvement is gradual. Most people notice a change after 6–8 weeks, with the full benefit by 12 weeks. Some early irritation is common and manageable — it does not mean the treatment is failing.
Daily skincare routine
Good basic skincare makes acne treatments work better and reduces irritation.
Cleansing
- Cleanse twice daily
- Use a soap-free (syndet), non-comedogenic cleanser
- Apply gently with fingertips only
- Rinse with lukewarm water and pat dry
- Avoid harsh soaps, alcohol-based products, scrubs and exfoliating brushes
Examples available in Ireland: Cetaphil Gentle Skin Cleanser · CeraVe Hydrating or Foaming Cleanser · La Roche-Posay Effaclar Cleanser · Eucerin DermoPure Cleansing Gel · Dove Sensitive Skin Beauty Bar
Moisturising
Topical acne treatments often cause dryness. Moisturising does not worsen acne.
- Use a light, oil-free, non-comedogenic moisturiser
- Apply once or twice daily as needed
Examples: CeraVe Moisturising Lotion · La Roche-Posay Effaclar H or Toleriane · Eucerin DermoPure Adjunctive Soothing Cream
Sunscreen
Some acne treatments increase sun sensitivity.
- Use a non-comedogenic SPF 30+ sunscreen daily
- Gel or fluid formulations are preferred
Examples: La Roche-Posay Anthelios Oil Control · Eucerin Oil Control SPF 50+
Topical acne medications
Your GP will choose a medication based on the type of acne and how sensitive your skin is.
At a glance
| Treatment | What it does | How it is used | Notes |
|---|---|---|---|
| Benzoyl peroxide (Acnecide® 5%, Benzac® 5%) | Kills acne bacteria, reduces inflammation, prevents antibiotic resistance | Once daily (every second day at first if sensitive); wash, gel or cream | Resistance does not develop; may bleach fabrics; lower strengths work as well and are better tolerated |
| Adapalene (Differin® 0.1%) | Prevents blocked pores, reduces inflammation, improves post-acne marks | Pea-sized amount for the whole face once nightly; alternate nights for the first 2 weeks | Not used in pregnancy; central to treatment and long-term maintenance |
| Epiduo® (adapalene + benzoyl peroxide) | First-line for mixed inflammatory and comedonal acne | Thin layer once daily in the evening | Strong evidence; no antibiotic; suitable for maintenance |
| Duac® (clindamycin + benzoyl peroxide) | Short-term treatment for inflammatory acne | Once daily for a limited period | Contains an antibiotic — not for long-term use |
| Treclin® (clindamycin + tretinoin) | Alternative combination when Epiduo® is not tolerated | Once daily at night, short-term | Contains an antibiotic |
| Azelaic acid (Skinoren® 20%, Finacea® 15%) | Antibacterial, anti-inflammatory, improves pigmentation | Once or twice daily | Good for sensitive skin and in pregnancy; well tolerated |
Benzoyl peroxide (BPO)
Kills acne-causing bacteria, reduces inflammation and helps prevent antibiotic resistance. Used once daily (start every second day if your skin is sensitive) and available as washes, gels or creams. Resistance does not develop, but it may bleach towels and clothing. Lower strengths are usually just as effective and better tolerated.
Topical retinoids (adapalene)
Prevent blocked pores, reduce inflammation and improve post-acne marks and pigmentation. Apply a pea-sized amount to the whole face once nightly, on alternate nights for the first two weeks. Not used during pregnancy. Adapalene is central to both treatment and long-term maintenance.
Combination treatments
- Epiduo® (adapalene 0.1% + benzoyl peroxide 2.5%) — first-line for mixed acne; a thin layer once daily in the evening. Strong evidence base, no antibiotic, suitable for maintenance.
- Duac® (clindamycin 1% + benzoyl peroxide 5%) — short-term treatment for inflammatory acne. Contains an antibiotic, so it is used for limited periods only and is not suitable for long-term maintenance.
- Treclin® (clindamycin 1.2% + tretinoin 0.025%) — an alternative when Epiduo® is not tolerated; once daily at night, short-term.
Antibiotic principle: topical antibiotics are never used alone — they are always combined with benzoyl peroxide to reduce resistance.
Azelaic acid
Antibacterial, anti-inflammatory and mildly comedolytic, and it improves post-inflammatory pigmentation. A good choice for sensitive skin, during pregnancy or when planning pregnancy, and for people prone to pigmentation changes. Used once or twice daily and generally well tolerated.
Evening application — step by step
- Wash with a gentle cleanser
- Allow the skin to dry completely
- Apply a thin layer of your prescribed topical medication
- Apply moisturiser if needed
What to expect
- Mild irritation is common at first
- Acne may flare briefly before it improves
- Regular, consistent application is essential
- Maintenance treatment is often needed for several years
Stopping treatment early is a common cause of relapse.
When to come back for review
Book a review with your GP if:
- There is no improvement after 8–12 weeks
- Acne is causing scarring or significant distress
- You cannot tolerate the topical treatments
- Acne is extensive or nodular
Further options include oral treatments and isotretinoin (Roaccutane®).
Key messages
- Topical treatments are the foundation of acne care
- Correct skincare improves tolerance and results
- Combination treatments are often the most effective
- Consistency and patience are essential
Ready to get your acne under control? Book an acne consultation with one of our GPs — we’ll assess your skin, discuss the options and agree a treatment plan with you.
Book online Call +353 21 735 5499See also: Acne Clinic · Topical treatment · Oral treatment · Roaccutane · Fees