Facial Acne: How to Get Rid of It?

Facial acne, and especially those persistent and deep acne lesions on the chin, can be a prolonged, demanding, and frustrating experience that deserves careful management and understanding.

In today’s article, we will attempt to find the best solution for acne. Treating skin prone to imperfections primarily requires understanding the difference between occasional, individual lesions (popularly called pimples) and the chronic medical condition known as Acne Vulgaris.

Pimples or acne?

Pimples are mild, isolated inflammations that usually resolve quickly. In contrast, acne is a long-term disorder of the pilosebaceous units (hair follicles and their associated sebaceous glands) that manifests through recurring inflammatory and non-inflammatory lesions. Expert classification of lesions is crucial for selecting appropriate therapy. Lesions are divided into non-inflammatory and inflammatory forms.

Non-inflammatory lesions, which represent the primary stage of acne development, include comedones. These are better known as blackheads (open comedones) and whiteheads (closed comedones). They form when pores become clogged.

When the situation worsens, inflammatory lesions develop:

• Papules are red, raised bumps that are tender to the touch,
• while pustules resemble papules but contain a visible pus-filled tip.

 

The most severe forms are nodules and cysts, which are deep, painful lesions located well below the surface of the skin. The presence of nodules and cysts indicates moderate to severe acne and carries an extremely high risk of permanent scarring.

The Four Key Causes of Acne

Why do acne lesions appear? The development of acne is never caused by a single factor alone; rather, it is the result of a complex interaction of four main mechanisms that must all be targeted by treatment.

Hyperproduction of sebum: Increased secretion of oil (sebum) from the sebaceous glands, often triggered by hormonal changes (androgens), creates a fatty environment.

Follicular hyperkeratinisation (clogging): This is the first and fundamental stage in the development of acne. Instead of shedding normally, the skin cells (corneocytes) lining the interior of the follicle abnormally adhere to one another. This leads to the formation of a plug that traps sebum within the follicle, forming a microcomedone.

P. acnes (bacterial colonisation): In the anaerobic environment created by the clogged follicle, the opportunistic bacterium Cutibacterium acnes (formerly known as Propionibacterium acnes) begins to multiply uncontrollably.

Inflammation: The proliferation of bacteria together with the pressure from accumulated sebum and cells triggers a localised immune response. This inflammation results in visible redness, swelling, and tenderness of the lesion.

When Is It Necessary to Visit a Dermatologist?

Although mild forms of acne can be effectively managed with over-the-counter (OTC) active ingredients, patient triage is essential. Individuals whose acne does not respond to three weeks of OTC treatment, or whose acne rapidly progresses to severe forms, must seek professional help.

Special attention must be paid to severe, cystic acne. Early intervention in these cases is critical because cystic lesions cause deep inflammation that destroys collagen.

Given that follicular hyperkeratinisation or pore clogging is the first step in the pathophysiology, the treatment that normalises this process — namely topical retinoids — is essential for achieving long-term remission.

Simply destroying bacteria is insufficient, as it does not address the underlying problem of abnormal cell adhesion. Therefore, a professional approach always emphasises the regulation of cell turnover.

How to Get Rid of Acne?

The foundation of a skincare routine for acne-prone skin is protection of the skin barrier. The success of acne treatment often depends on minimising skin irritation, especially when using potent active ingredients.

Dermatological standards require the use of gentle, pH-neutral facial cleansers. Physical damage to the skin not only compromises the integrity of the skin barrier but also directly intensifies the inflammatory response, thereby worsening the condition of acne and drastically reducing the skin’s tolerance to active treatments.

Recommendation for facial cleansing: For gentle yet thorough removal of impurities without drying the skin, we recommend One Step – Face Wash. Its mild formulation preserves the hydrolipidic barrier, which is crucial during acne treatment.

Sun Protection and Hydration

The application of topical active ingredients, such as retinoids, inevitably causes dryness, flaking, and skin irritation. For this reason, non-comedogenic moisturisers (hydrating creams that do not clog pores) are vital for restoring the skin barrier.

Hydration is not merely a cosmetic step; it is a strategic component of therapy because it reduces unpleasant side effects and ensures adherence to long-term treatment of acne and pimples. In addition, sun protection (SPF) represents a clinical necessity. Topical active ingredients make the skin extremely photosensitive.

Continuous use of SPF reduces inflammation caused by UV radiation, enabling active ingredients to work without unnecessary complications or worsening of discoloration.

 

Complementary Ally: Niacinamide

How can inflamed acne be calmed? Niacinamide, the active form of vitamin B3, has proven to be an exceptionally useful addition to an acne treatment regimen.

Its role is multifaceted:

• it clinically reduces sebum secretion,
• it strengthens the skin’s lipid barrier (helping to retain moisture), and
• it exhibits anti-inflammatory effects.

 

Strategic application of niacinamide (usually in the morning) serves as support for the skin barrier, effectively compensating for irritation caused by strong nighttime treatments such as retinoids. Since acne treatment is a marathon, not a sprint, even the strongest medical treatment will fail if the patient discontinues it due to painful irritation.

Product recommendation: For a powerful dose of hydration combined with the soothing action of niacinamide, choose Aqua Perfector. This fluid contains niacinamide that regulates sebum and calms redness, along with hydrolysed hyaluronic acid for deep moisture without greasiness.

For treating mild to moderate acne and comedones, as well as for support in more severe cases, targeted over-the-counter active ingredients are used:

Salicylic Acid (BHA): Cleansing the Interior of Pores

Salicylic acid is lipophilic (oil-soluble). This lipophilicity enables it to penetrate deep into the pilosebaceous unit, dissolving accumulated cells, sebum, and clogs.

The primary function of BHA is keratolytic, meaning it promotes the shedding of cells inside the pores, making it ideal for targeted treatment of non-inflammatory blackheads and whiteheads (comedones).

Targeted solution: For a direct attack on clogged pores and active inflammation, we recommend SOS Skin. It contains 2% salicylic acid in combination with bisabolol and witch hazel, making it a powerful ally for clear skin.

Mandelic Acid (AHA): A Multi-Purpose Treatment

Mandelic acid is an exceptionally good choice for treating acne, especially if you have
sensitive skin or are prone to irritation from stronger active ingredients such as glycolic acid or retinol. Mandelic acid is an alpha-hydroxy acid (AHA), but its molecule is significantly larger than, for example, glycolic acid. Because of this, it penetrates the skin more slowly, making it the gentlest AHA acid and an ideal option for sensitive skin.

The combination of mandelic acid with niacinamide can provide an exceptionally gentle yet effective approach in the fight against acne and inflammation, as niacinamide further reduces skin redness. Users who use mandelic acid often praise it because it works on acne and hyperpigmentation without drying the skin — a common side effect of stronger acids.

Product recommendation: Try the Glow Up exfoliating serum. Its advanced formula
combines mandelic acid with glycolic acid and PHA gluconolactone for multiple effects on skin texture and tone, with minimal irritation.

When OTC treatments are insufficient, the next step is therapies prescribed by a
dermatologist or the use of potent cosmetic retinoids that allow higher concentrations and more specific mechanisms of action..

Topical Retinoids: Cell Regulators and Prevention

Topical retinoids (derivatives of vitamin A) are considered the scientific gold standard in the treatment of acne — not only for treating existing lesions but also for the long-term maintenance of clear skin.

Retinoids are the only ingredients that directly act on the normalisation of cell turnover (follicular hyperkeratinisation). They prevent abnormal adhesion of cells within the follicle, thereby preventing the formation of microcomedones — the source of all subsequent lesions. Retinoids should not be used merely to suppress active inflammation; they must serve as the
primary treatment for maintaining clear skin.

Gold standard: For introducing retinoids into your routine, Aprive offers Inception 0.3% Retinol for beginners, while more experienced users can progress to Skilled (0.5%) or Master (1%) creams, which contain the latest encapsulated retinol technology for maximum efficacy with reduced irritation.

The table below lists active ingredients with their described targeted effects on acne:

 

Foods That Cause Acne

Research confirms that lifestyle factors and diet can significantly modulate the intensity and frequency of inflammation.

The Link Between Food and Acne

The pathogenesis of acne involves hormonal mechanisms, and diet has an indirect influence on those hormones.

Two dietary factors are consistently associated with the worsening of acne:

• Foods with a high glycaemic index (GI): Foods such as sugar, white bread, pasta,
  and certain processed grains cause a rapid spike in blood insulin. High insulin levels
  stimulate the production of IGF-1 (Insulin-like Growth Factor-1). IGF-1 directly signals
  the sebaceous glands to increase sebum production, thereby worsening the first
  factor in acne pathogenesis.
• Dairy products: Consumption of dairy products, especially skimmed milk, is also
  associated with acne. This connection is attributed to IGF-1 and other growth
  hormones naturally present in milk.

 

How to Prevent Facial Acne? Dietary changes do not replace medical treatment, but they act on hormonal and inflammatory pathways, complementing the effects of topical and oral treatments. Individual sensitivity can be assessed by excluding potential triggers (e.g., dairy products) from the diet for 4 to 6 weeks.

Reducing Inflammation from Within

Certain supplements can help control the inflammatory processes associated with acne:

• Omega-3 fatty acids found in fish oil are known for their strong anti-inflammatory action. Their supplementation can reduce the intensity of inflammatory acne by targeting the fourth pathogenic factor.
• Zinc is an important mineral that supports immune function, wound healing, and has anti-inflammatory effects.

 

Stress and External Factors

Chronic stress is not a direct cause of acne, but it can be a significant trigger for worsening an existing condition. Stress promotes the production of the hormone cortisol, which can indirectly intensify inflammatory processes in the skin. Managing stress through relaxation techniques or physical activity supports overall skin health.

It is also important to pay attention to external factors, such as so-called Acne Mechanica. These are acne lesions caused by pressure, friction, or heat, such as pressing unclean hands or phones against the face, or rubbing from the edges of caps and helmets.

Regularly changing pillowcases (at least once a week) is a recommended hygiene measure to reduce the transfer of bacteria and sebum onto the skin.

How to Calm Inflamed Acne?

It is estimated that ceramides constitute about 50% of the total lipid mass, making them fundamental structural components.

Cholesterol accounts for approximately 25%, while the remaining 10–15% consists of free fatty acids (FFA). Other compounds, including ceramide precursors and minor lipids, make up the rest. This stoichiometric balance and lamellar organisation are essential for the formation of an impermeable barrier.

For optimal functioning, cells in the deeper layers of the skin require a perfectly hydrated environment. When the skin is dehydrated, it is crucial to quickly restore its hydrolipidic barrier.

It has been proven that topical application of ceramides, phospholipids, and sphingolipids (from plant oils) acts as emergency assistance. They not only deliver essential nutrients but also create deep moisture reservoirs, allowing the barrier to regenerate extremely quickly.

Ceramides, Phospholipids, and Sphingolipids

A precise understanding of their therapeutic potential requires differentiation between the three classes of lipids in question:

Ceramides are amides formed by the bonding of a long-chain fatty acid with a sphingoid base. Due to their amphiphilic nature, they are key to stabilising lamellar structures within the stratum corneum (SC). The diversity of ceramides, which arises from different chain lengths and hydroxylations, allows them to form a robust and complex lipid framework. Their ability to organise lipids into tightly packed crystalline phases directly correlates with the functionality of the skin barrier.

Phospholipids, such as phosphatidylcholine, are primarily components of cell membranes and are not dominant in mature SC because most are metabolised during keratinocyte differentiation. However, in the context of topical application, they are extremely important. Their amphiphilic properties make them excellent emulsifiers and stabilisers of formulations. In advanced formulation science, phospholipids are used as building blocks for liposomes and niosomes — delivery systems that improve the penetration and bioavailability of other active lipids into the skin.

Sphingolipids are a broader class of lipids that encompasses ceramides as well as their precursors such as sphingosine and sphinganine. These precursors have biological activity that goes beyond a purely structural role. They are key intermediates in the metabolic pathway of ceramide synthesis (e.g., via sphingomyelinase and ceramide synthase) and exhibit direct effects on cell signalling and the skin’s antimicrobial defence.

The use of ceramides, phospholipids, and sphingolipids in acne treatment goes beyond simple hydration and enters the domain of targeted support.

• Rescue for the Barrier: To restore the barrier damaged by acne treatments, you can turn to Aqua Perfector, which provides deep and surface hydration. It intensely hydrates all layers of the skin.
• For more mature skin: Skin that lacks moisture, firmness, volume, and elasticity can find a solution in AgeLess cream. A hydrating and revitalising anti-age cream for all skin types, including sensitive skin. The peptide complex (Matrixyl 3000 and carnosine) stimulates the synthesis of collagen and elastin.

Hyperpigmentation and Acne Scars

One of the most challenging aspects of acne is treating the visible marks that remain after the active lesion subsides.

Post-Inflammatory Hyperpigmentation (PIH) and Scars

It is crucial to distinguish temporary discoloration from permanent changes in skin texture.

PIH is the result of increased melanin production (dark spots) or dilated capillaries
(red spots). It does not affect skin texture and is treatable with topical agents,
although it may take months..

Permanent scars (atrophic scars) represent changes in skin texture (indentations,
pits, boxcar lesions) caused by collagen loss due to deep, uncontrolled inflammation.

Treatment of hyperpigmentation requires active ingredients that target melanin production and accelerate cell turnover.

Kako ukloniti ožiljke od akni?

Glycolic acid is an alpha-hydroxy acid (AHA) that acts in several ways:

• Chemical peeling (exfoliation): It removes dead cells from the surface of the skin,
  helping to smooth and even out skin texture and reducing the visibility of superficial
  scars and hyperpigmentation (dark spots that remain after acne).
• Collagen stimulation: Due to its small molecular weight, glycolic acid can penetrate deeper into the skin and stimulate the production of collagen and hyaluronic acid in the dermis.

Increased collagen production is key because it helps “fill in” indented (atrophic) acne scars, making them less visible. Glycolic acid is most effective for shallow, atrophic scars (small indented scars) and post-inflammatory hyperpigmentation (dark or red spots that are not true scars but changes in colour).

The Maintenance Phase for Clear Facial Skin

Acne treatment does not end with clearing the facial skin. That is when the most important phase begins: maintenance of facial cleanliness. Acne is a chronic condition, and recurrences are extremely common if therapy is discontinued. The maintenance phase is a long-term plan whose goal is to prevent relapse.

Since the primary problem is follicular hyperkeratinisation, the foundation of long-term maintenance is the continuous, daily or evening application of a topical retinoid.

Retinoids keep pores open and prevent the formation of new microcomedones, interrupting the acne cycle at its very beginning.

Practical Schedule for Facial Skincare Routine

 

A successful long-term routine integrates medical treatment with support for the skin barrier, thereby ensuring both efficacy and tolerance.

Final Recommendations…

Treating acne (Acne Vulgaris) requires a multi-phase, scientifically grounded strategy that recognises the chronic nature of the disease. Treating acne (Acne Vulgaris) requires a multi-phase, scientifically grounded strategy that recognises the chronic nature of the disease.

Long-term skin clarity is achieved only through a consistent maintenance phase based on the continuous use of retinoids, which actively prevents the formation of new lesions.

The recommendation is that individuals with painful or cystic acne should consult a dermatologist immediately.