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Acne

Concerns · Skin of colour

Acne

Treating breakouts, and the marks they leave behind

Great skin is a journey, not a destination.

Dr Eckstein

Understanding your skin

What is acne?

Acne is a very common skin condition that appears as blackheads, whiteheads, and red or pus-filled spots. It can range from a few small blemishes to more severe, painful lumps under the skin that may leave scars.

Acne usually begins during puberty, but it is not only a teenage concern, and it can affect you at any stage of life.

  1. Infancy & childhood

    Acne can occasionally appear in infants and young children.

  2. Puberty

    When acne most commonly begins.

  3. Mid-twenties

    For most people, acne improves by this stage, though in some it persists for longer.

  4. Late twenties & beyond

    Acne can also appear for the first time in adulthood.

Our specialism

Acne in skin of colour

Acne is extremely common in people with skin of colour and is one of the main reasons our clients seek help for their skin. Skin of colour generally refers to individuals with medium to deep skin tones, often described medically as Fitzpatrick skin types III to VI.

This includes people from African, Caribbean, Asian, Middle Eastern, Hispanic, and mixed ethnic backgrounds. Acne affects these skin types just as frequently, if not more so, than lighter skin tones, particularly in adolescents and young adults.

The Fitzpatrick scale

Skin types I to VI

Types III to VI are where our expertise is centred, and where acne care needs particular nuance.

The science

How acne forms

The underlying causes of acne are similar in all skin colours, and are often due to several factors acting together.

  1. 01

    Excess oil

    The oil-producing glands in the skin, known as sebaceous glands, become overactive and produce too much oil.

  2. 02

    Blocked pores

    At the same time, pores become blocked with dead skin cells, forming blackheads and whiteheads.

  3. 03

    Bacteria

    The excess oil provides a breeding ground for bacteria within the blocked pore.

  4. 04

    Inflammation

    Bacteria trigger inflammation, resulting in red, swollen or pus-filled spots.

What you may notice

Affected skin may feel hot, sore or tender. Over time, acne can also leave its mark on the skin in different ways.

  • Raised scarsRaised and lumpy, known as hypertrophic or keloid scars.
  • Indented scarsPitted or sunken, known as atrophic scars.
  • DiscolourationAreas darker than the surrounding skin, especially in skin of colour, or sometimes lighter.

It is not related to hygiene

What can trigger acne?

There are a number of reasons why you may be struggling with acne. Often, several work together.

i.

Hormones

Hormonal conditions such as polycystic ovary syndrome (PCOS).

ii.

Medications

Certain medications, including steroids or hormonal contraceptives.

iii.

Products

Oily skincare products, greasy moisturisers and some hair products.

iv.

Family history

Acne often runs in families.

v.

Diet

Some limited evidence of dietary factors, commonly sugar, gluten or dairy.

vi.

Lifestyle

Stress, smoking or alcohol, skincare habits and sleep.

Why our approach is different

Skin of colour has a higher tendency to react to inflammation with pigment changes.

This means that overly aggressive treatments can do more harm than good. Acne treatment must balance effectiveness with protection of the skin barrier and careful control of irritation. At Dr Mélanin, we approach acne in skin of colour with this understanding at the centre of care.

Looks, behaves and heals differently

How acne differs in skin of colour

While the pathophysiology of acne is similar, the way acne looks, behaves and heals can differ in skin of colour. These differences matter, because they affect how acne should be treated and managed safely.

i.

Hidden inflammation

Studies show that acne in skin of colour often has a stronger inflammatory component, even in spots that may appear mild on the surface. Redness and swelling may be less visible, but inflammation is still present under the skin.

Because inflammation drives many of acne's long-term complications, controlling it early is especially important.

ii.

Pomade acne

Acne linked to hair and scalp products is more common in skin of colour, due to heavier oils, creams or styling products that can block pores along the hairline and forehead.

Understanding lifestyle and grooming factors is an important part of effective acne management.

iii.

Dark marks (PIH)

Post-inflammatory hyperpigmentation, or PIH, describes the dark marks left behind after spots heal. These are not scars, but areas where the skin produces extra pigment in response to inflammation or injury, to protect itself.

In skin of colour, these marks are more common, more noticeable, and can last much longer than the acne itself, sometimes for many months or even years.

For many clients, these dark marks are more distressing than active breakouts.

Your treatment

A layered approach

Acne is treated using a combination of approaches, tailored to the type and severity of your acne, your skin type, and how your skin responds to inflammation.

The foundation

Skincare

Skincare forms the foundation of all acne treatment and is essential for improving breakouts, supporting the skin barrier, and reducing the risk of pigmentation and scarring.

Skincare
Within the skin

Topical medications

Topical medications may be prescribed to target clogged pores, reduce bacterial activity, and calm inflammation directly within the skin.

From within

Oral medications

In some cases, oral medications are used to address underlying drivers of acne, such as hormonal influences or more widespread or persistent breakouts.

Medical consultation
In clinic

Clinic treatments

Chemical peels may be used to help with congestion, inflammation and skin renewal, while selected injectable treatments such as polynucleotides may be recommended to support skin repair, reduce inflammation and improve overall skin quality alongside medical treatment.

Chemical PeelsPolynucleotidesMicroneedling

Most plans combine skincare, medications and in-clinic treatments, to treat active acne, minimise long-term marks or scarring, and support healthier, more resilient skin over time.

Signature Programme IIAffinée

Acne and scar refinement. A structured programme that brings acne under control first, then gently refines the marks and texture it leaves behind.

Discover

Between your appointments

Caring for acne-prone skin at home

Small, consistent habits make a real difference to how your skin responds to treatment. Here is the guidance we share with our clients.

Cleansing

  • Be gentle. Avoid harsh cleansers, soaps and scrubs. Physical exfoliants and cleansing brushes damage the skin and worsen acne.
  • Twice a day, at most. Acne is not related to hygiene, and over-cleansing damages your skin's barrier, making acne worse.
  • Remove make-up kindly. Make-up wipes and micellar waters with surfactants are too harsh. Cleansing balms or fluids are gentler; follow with your cleanser, as some balms can leave residue.
  • Pat, don't rub. Let your skin air dry after cleansing and apply moisturiser to damp skin. If you use a towel, choose a clean, soft one in natural fibres such as cotton or silk.
  • Keep water lukewarm. Long, hot showers, baths, steams and saunas increase water loss from the skin, drying it out and worsening inflammation. Use gentle, fragrance-free body washes.
  • Cleanse after exercise. If you sweat, use a gentle cleanser as soon as you finish. Dried sweat dehydrates the skin and can make acne worse.

Your skincare

  • Keep it simple. Mild cleansers and effective moisturisers are the foundation. Brands we often recommend include CeraVe, Aveeno, Eucerin, Cetaphil, Avène and La Roche-Posay.
  • Look for the right labels. Choose products marked "non-comedogenic" or "oil-free", suited to blemish-prone skin.
  • Don't skip moisturiser. In skin of colour, dehydrated skin can overproduce oil to compensate, appearing oily when it is really dehydrated. If your skin is oily, use a lightweight, oil-free moisturiser.
  • Avoid fragrance and alcohol. Even "natural" essential oils, such as rosemary oil, can irritate, burn or pigment the skin.
  • One active at a time. Active ingredients can be very beneficial, but used together they can cause dryness and irritation, and damage the skin barrier. They work best introduced in a controlled, monitored way.
  • Build up slowly. Some topical treatments can dry or irritate the skin at first. If your skin becomes red and irritated, pause for a few days and seek advice promptly. Starting with a shorter contact time, or less often, can help.
  • Be patient. Avoid trying several new products at once. Your skin cycle is roughly as long as your age in days, starting at 28, and it takes a few cycles before a product can be seen to work.

Sun protection

  • SPF 40 or higher, every day. Sun exposure dehydrates the skin and can deepen the pigmentation acne leaves behind, especially in skin of colour.
  • Broad protection. Choose a sunscreen with UVA, UVB and visible light protection. A tinted SPF containing iron oxides adds protection from visible light.
  • Fewer layers. For acne-prone skin, we generally recommend a moisturiser containing SPF, as layering excess products can clog pores.
  • Cover up. Avoid direct sunlight, wear a hat and keep exposed areas covered when you are outdoors.

Hair & make-up

  • Choose your base wisely. Powder or liquid foundations tend to be better tolerated. Cream or oil-based foundations can block pores. Skin-friendly brands include bareMinerals and e.l.f. Cosmetics.
  • Keep tools clean. Apply base make-up with clean fingers or a beauty blender, washed daily with soap and used damp. Avoid brushes unless you wash them regularly.
  • Hair away from your face. Tie your hair back during the day and keep it clean, especially if it is oily or you use hair products. At night, a silk bonnet prevents product transfer onto your skin.
  • Silk pillowcases. Sleep on 100% silk and change pillowcases regularly, using each side only once, as harsh fabrics can be abrasive.
  • Don't share. Towels, pillowcases and make-up can all spread bacteria.

Everyday habits

  • Keep an acne diary. Note new skincare, your menstrual cycle, changes in diet, stress or sleep, to help reveal triggers and patterns.
  • Hands off. Touching your face transfers oil and bacteria onto your skin.
  • Never pick or squeeze. This increases inflammation, risks infection and can lead to scarring.
  • Nourish from within. Stay hydrated and eat plenty of fresh fruit, vegetables and grains. Foods rich in omega-3s, antioxidants and zinc help repair the skin.
  • Manage stress. Stress can heighten hormonal activity and trigger breakouts.
  • Skip the DIY. Home masks such as yoghurt, turmeric, lemon, honey, gram flour, soda or toothpaste can burn and pigment the skin. Be wary of social media trends without dermatological evidence.
  • Pause hair removal. Avoid waxing, threading, electrolysis, epilation and depilatories while your skin barrier is compromised. Wait 1–2 weeks before carefully shaving the area.

Your wellbeing matters

Acne affects more than your skin.

Many people living with acne experience low self-esteem, anxiety or depression, and negative feelings about their appearance. These feelings are real and valid. If you are struggling, please talk to a healthcare professional, as support and treatment are available.

Your questions

Frequently asked questions

01Does skin of colour need specialist acne products?

Skin of colour does not need specialist products simply because of skin tone. Acne treatment should be chosen based on skin type and the condition of the skin. However, treatments must be selected and introduced carefully to reduce irritation and the risk of pigmentation.

02How is acne diagnosed?

A healthcare professional can usually diagnose acne through a simple skin examination. Tests are rarely needed, as acne is easily recognised by the type and pattern of spots on areas such as the face, neck, chest or back.

03Are dark marks after acne the same as scarring?

No. Post-inflammatory hyperpigmentation (PIH) is not scarring, but areas where the skin has produced extra pigment in response to inflammation. In skin of colour these marks can last for many months or even years, which is why controlling inflammation early, and protecting the skin while it heals, is central to how we treat acne.

Can't find your answer? Please reach out to us.

Read more about

Related concerns

Hyperpigmentation Scarring Enlarged Pores Uneven Skin Texture

Disclaimer

Your results, side effects, treatment plans, downtime and recovery may vary, as all our clients are unique. The information provided on this page is based on the average client experience. If you would like more detail about how your experience may differ, please book an in-person consultation.

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