Why do I have persistent facial acne?

Question

Hello doctor,

I have had acne on my face for about two years. Sometimes the affected areas become slightly itchy and develop red patches. I have been using a very gentle face wash, but it has not helped so far.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Since you have been dealing with facial acne for the past two years, this is most commonly linked to hormonal changes that happen during the teenage and early adult years. During this phase, the body produces more oil (sebum), which can block skin pores. When pores get blocked, acne-causing bacteria can grow, leading to pimples, redness, and sometimes itching.

You mentioned red spots with occasional mild itching. This usually points to inflammatory acne, which means the pimples are irritated and swollen. In some cases, there can also be a mild skin irritation or seborrheic overlap (a condition where oily areas of the skin become red and itchy). These problems can worsen with sweating, stress, use of oily skincare products, or frequent touching of the face.

You are currently using a gentle cleanser, meaning it cleans the skin without damaging the skin’s natural protective layer (skin barrier). While it is good for daily cleansing, it alone is usually not enough to treat active acne, especially when redness and itching are present.

For acne like yours, a proper treatment routine usually needs targeted medicines, such as:

Topical retinoids (vitamin A-based creams) to prevent new pimples from forming.
Benzoyl peroxide or topical antibiotics to reduce acne-causing bacteria and calm inflammation.
A light, non-comedogenic moisturizer, which means a moisturizer that does not block pores, to reduce dryness and irritation caused by acne treatments.

Please avoid harsh scrubs, frequent face washing, steroid creams, or home remedies, as these can increase redness, itching, and worsen acne instead of improving it.

Lifestyle factors also matter. High-sugar or junk foods, poor sleep, and stress can aggravate acne.

Since your acne has persisted for two years despite basic care, it is important to consult a dermatologist. A skin specialist can assess how severe the acne is, check for fungal or allergic causes, and start proper prescription treatment early to prevent permanent scarring.

If you prefer, you may also upload a clear photo of your face here, and I can guide you further based on what I see.

I hope this helps.

Please revert in case of further queries.

Thank you.