Why acne flares keep returning
Acne is a disorder of the oil gland and hair follicle. It is not a hygiene problem. Four things interact. Cells fail to shed and block the follicle opening. Androgens drive sebum. Cutibacterium acnes multiplies in the blocked follicle. Inflammation then turns a blackhead or whitehead into a red spot.
That inflammation also drives scarring and lasting marks. Hormonal change can track with sebum, and acne can continue into adult life. A plan that targets one driver leaves the other three in place.
What laser pimple treatment can do
Two lasers are used for active acne. R2 Glow works on inflammatory activity in the skin, not on pigment. A 675 nm laser aims at inflammatory activity around the follicle and at its vascular component. Lasers sit alongside medical care, as set out on our acne treatment page. They do not act on androgen-driven sebum or on follicle blockage. A plan built on laser alone addresses one of the four factors.
Matching the plan to the acne
| Type | What you see | Why it matters |
|---|---|---|
| Comedonal | Blackheads and whiteheads, little redness | Blockage is the main issue |
| Papulopustular | Red spots and pustules with comedones | Inflammation is active |
| Nodulocystic | Deep, tender nodules and cysts | Most linked to scarring, so early medical care matters |
| Fungal folliculitis | Uniform, often itchy bumps on chest, back and shoulders | A yeast issue, not acne, and some antibiotics can worsen it |
Medicines stay first-line
Topical and oral agents remain the first step. They act on keratinisation, sebum, bacteria, or several of these together. Antibiotic choice needs care, because some regimens can worsen fungal folliculitis. Some need assessment and monitoring, and side effects are discussed before a course starts. Acne is managed over a period, and plans usually include a maintenance phase. Scar work comes later. Active acne is generally controlled first, because resurfacing skin with active acne may mean repeating the work.
What the consultation covers
Your doctor grades the acne, looks for its cause and checks skin type and hormonal factors. No single approach fits every presentation. Acne on the back, chest and shoulders is assessed in the same way as facial acne, with fungal folliculitis kept in mind. Your doctor then decides whether medicines alone are suitable or a combined approach makes sense, depending on the grade and the areas involved. Cost is explained at this point, as a figure given without assessment would not reflect your skin. Side effects of any medicine are discussed before you begin.
Who should wait, and the risks
Pregnancy or breastfeeding, a recent tan, photosensitising medicines, a keloid history, or recent isotretinoin, where your doctor advises on timing. Tell your doctor about all creams and medicines. Suitability is assessed in person.
Consider whether the bumps are fungal, particularly if several acne treatments have failed. Fungal folliculitis does not respond to acne therapy.
Brief redness and warmth are expected. Rebound darkening can occur if energy is too high, and blistering or crusting is rare. Risk rises in darker skin and after sun exposure.
Untreated nodulocystic acne carries a high risk of scarring. Fitzpatrick III to V skin is prone to post-inflammatory hyperpigmentation, which can persist.
What it cannot do
Laser will not switch off oil production. It will not unblock follicles. It does not remodel scars that have already formed, and those need acne scar treatment instead. It will not clear fungal folliculitis. Response depends on your acne grade, its cause, skin type, hormonal factors and how closely the plan is followed. Results vary, and no set number of sessions applies to everyone.