Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that’s hot or painful to touch.
Acne most commonly develops on the:
Face – this affects almost everyone with acne
Back – this affects more than half of people with acne
Chest – this affects about 15% of people with acne
Types of spots
There are six main types of spot caused by acne:
Blackheads – small black or yellowish bumps that develop on the skin; they’re not filled with dirt, but are black because the inner lining of the hair follicle produces pigmentation (colouring).
Whiteheads – have a similar appearance to blackheads, but may be firmer and won’t empty when squeezed.
Papules – small red bumps that may feel tender or sore.
Pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus.
Nodules – large hard lumps that build up beneath the surface of the skin and can be painful.
Cysts – the most severe type of spot caused by acne; they’re large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring.
What can I do if I have acne?
These self-help techniques may be useful:
Don’t wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse.
Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse.
Don’t try to “clean out” blackheads or squeeze spots. This can make them worse and cause permanent scarring.
Avoid using too much make-up and cosmetics. Use water-based products that are described as non-comedogenic (this means the product is less likely to block the pores in your skin).
Completely remove make-up before going to bed.
If dry skin is a problem, use a fragrance-free, water-based emollient.
Regular exercise can’t improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising, as sweat can irritate your acne.
Wash your hair regularly and try to avoid letting your hair fall across your face.
Although acne can’t be cured, it can be controlled with treatment. Several creams, lotions and gels for treating spots are available at pharmacies.
If you develop acne, it’s a good idea to speak to your pharmacist for advice. Products containing a low concentration of benzoyl peroxide may be recommended – but be careful, as this can bleach clothing.
If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription.
When to seek medical advice
Treatments can take up to three months to work, so don’t expect results overnight. Once they do start to work, the results are usually good.
Acne is very common in teenagers and younger adults. About 80% of people aged 11 to 30 are affected by acne.
Most people have acne on and off for several years before their symptoms start to improve as they get older. Acne often disappears when a person is in their mid-twenties.
Your GP can diagnose acne by looking at your skin. This involves examining your face, chest and back for the different types of spot, such as blackheads or sore, red nodules.
How many spots you have and how painful and inflamed they are will help determine how severe your acne is. This is important in planning your treatment.
Four grades can be used to measure the severity of acne:
Grade 1 (mild) – acne is mostly confined to whiteheads and blackheads, with just a few papules and pustules
Grade 2 (moderate) – there are multiple papules and pustules, which are mostly confined to the face
Grade 3 (moderately severe) – there’s a large number of papules and pustules, as well as the occasional inflamed nodule, and the back and chest are also affected by acne
Grade 4 (severe) – there’s a large number of large, painful pustules and nodules
Acne in Women
There’s a range of informally run message boards and blogs about acne on the web. You may find it supportive to read about other people’s experience of living with acne.
For example, talkhealth provides a free acne support and information community.
The Mix (formerly Get Connected) also has a website and helpline for teenagers and young people with emotional and other difficulties.
Make-up can help cover up scars and can be particularly useful for facial scars.
Camouflage make-up specially designed to cover up scars is available over the counter at pharmacies. You can also ask your GP for advice.
If you’re interested in learning more about covering a mark, scar, non-infectious skin condition or a tattoo, you can also visit the Changing Faces skin camouflage service or call 0300 012 0276.
How does Duac gel work?
Duac once daily gel contains two active ingredients, clindamycin phosphate and benzoyl peroxide.
Clindamycin is an antibiotic that is used to treat infections with bacteria. Clindamycin is active against a wide variety of bacteria, including the bacteria associated with acne,Propionebacterium acnes. This is a common type of bacteria that feeds on sebum produced by the sebaceous glands in the skin. It produces waste products and fatty acids that irritate the sebaceous glands, making them inflamed and causing spots. Applying clindamycin to the skin controls bacterial numbers, brings the inflammation of the sebaceous glands under control, and allows the skin to heal.
Benzoyl peroxide is a type of medicine known as a keratolytic. It works by breaking down keratin, a protein which forms part of the skin structure. When you apply benzoyl peroxide to the skin it causes the top layer of skin cells to break down and shed. This helps break down comedones (blackheads and whiteheads) and unblocks the sebaceous glands. It also helps to prevent the formation of new comedones.
Benzoyl peroxide also has an antibacterial action and directly kills thePropionebacterium acnes bacteria on the skin.
How long does Duac gel take to work?
The two active ingredients have a complementary effect on acne. It may take two to six weeks of treatment before the full effect of both medicines on the acne is seen, so it’s important to persevere with using the gel and be patient. If you haven’t seen any improvement after six weeks of use you should get advice from your doctor.
How do I use Duac gel?
- Wash the skin with a mild cleanser and pat it dry before applying the gel.
- Apply the gel thinly to the whole affected areas of skin (not just the individual spots) once a day in the evening. If the gel doesn’t rub in easily you are applying too much.
- Avoid getting the gel in contact with the eyes, mouth, lips and mucous membranes such as the lining of the nose. Rinse the gel off thoroughly with water if you accidentally get it on these areas.
- Avoid applying the gel to broken, irritated or sunburnt skin.
- Wash your hands after applying the gel.
- Benzoyl peroxide can be irritating to your skin. If you experience excessive redness, dryness or peeling of your skin after using Duac, decrease the amount of gel you use and use it less frequently (or stop temporarily). If any soreness persists consult your doctor.
- Do not use this product excessively – this won’t make it any more effective but will increase the chance of it irritating your skin.
- Do not use for longer than 12 weeks at a time.
Important information about Duac gel
- Benzoyl peroxide can make your skin more sensitive to sunlight. Avoid exposing the treated areas of skin to excessive sunlight, or to sunbeds or sunlamps. If you can’t avoid sun exposure you should wear appropriate protective clothing such as a hat, or use a suitable sunscreen lotion.
- This product may bleach hair and coloured fabrics including clothing, towels and bed linen. Be careful to avoid getting the gel on these materials.
- When clindamycin is taken by mouth it can sometimes cause inflammation of the bowel (colitis). Although this is very unlikely to occur when you use the antibiotic on the skin, if you get diarrhoea either during or after using Duac gel, particularly if it becomes severe or persistent, or contains blood or mucus, you should stop using it and consult your doctor immediately.
Duac gel should be used with caution by
- Patients with sensitive or eczema-prone skin.
- People with a history of inflammation of part of the intestines (enteritis), ulcerative colitis or inflammation of the large intestine due to antibiotic treatment (antibiotic-associated colitis).
- People who have recently used any other medicines containing clindamycin or erythromycin. This is because the acne bacteria on your skin may have developed resistance to clindamycin, which could make Duac gel less effective.
Duac gel should not be used by
- People who are allergic to benzoyl peroxide, clindamycin, the related antibiotic lincomycin, or any other ingredient of the gel.
- Children under 12 years of age.
Can I use Duac gel while pregnant or breastfeeding?
- As with all medicines you should make sure your doctor knows if you are pregnant or breastfeeding before using Duac gel.
- The safety of Duac gel in pregnancy has not been specifically studied, however it is not expected to be harmful. It should be used with caution during pregnancy, and only if the benefits to the mother outweigh any potential risks to the developing baby. Ask your doctor for further information.
- The safety of Duac gel for use during breastfeeding has not been established. Clindamycin passes into breast milk when taken by mouth. For this reason, Duac gel should be used with caution during breastfeeding and only if the benefits to the mother outweigh any possible risk to the nursing infant. If your doctor says you can use Duac gel while breastfeeding, make sure you don’t apply it to areas where it could be ingested by the baby or transferred to the baby’s skin while you are feeding. Stop using the medicine and consult your doctor if the child develops diarrhoea while you’re using Duac gel.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop using DUAC ONCE DAILY GEL and see a doctor straight away if you notice any of the
following serious side effects – you may need urgent medical treatment:
Signs of an allergic reaction (such as swelling of your face, eyes, lips or tongue, nettle rash or difficulty
Severe or prolonged diarrhoea, or abdominal cramps
Severe burning, peeling, or itching
Other possible side effects:
If you notice any of these side effects, try using DUAC ONCE DAILY GEL less often, or stop using it for
one or two days and then start again.
Very common side effects
(at least 1 in 10 people are affected)
At site of application:
Skin burning sensation, peeling, itching, dry skin
Redness of your skin, especially during the first few weeks of use
These side effects are generally mild.
Common side effects
(less than 1 in 10 people are affected)
At the site of application:
Sensitivity to sunlight, skin pain
Red, itchy skin, rash (dermatitis)
Uncommon side effects
(less than 1 in 100 people affected)
At the site of application:
Tingling (paraesthesia), worsening of acne
Other side effects have occurred in a very small number of people but their exact frequency is unknown:
Inflammation of the intestine, diarrhoea, including bloody diarrhoea, stomach pain
At the site of application:
Skin reactions, discoloration of the skin
Raised itchy rash (hives)