Pimple treatment: your options, and when to see a doctor

What is happening in your skin

Acne starts when hair follicles become blocked with excess oil and dead skin cells. Bacteria can grow in the blocked follicle and cause inflammation and pus. Hormone changes, such as those in puberty, around periods or in pregnancy, are a common trigger, and so are conditions such as polycystic ovary syndrome and some medicines (NHS).

You may have more than one kind of spot at a time. Whiteheads are small skin-coloured bumps. Blackheads are flat or slightly raised dark spots. Papules are raised bumps, which look pink or red on lighter skin and brown or purple on brown and black skin. Pustules are bumps filled with pus. Nodules and cysts are larger, deeper and often painful lumps. The deeper and more inflamed the spot, the greater the risk of a scar.

That last point shapes the whole treatment plan. Treatment is not only about how your skin looks this month. It is about calming inflammation early enough that the skin does not need to repair itself with scar tissue.

What to do first, at home

The NHS and NICE give simple basics. Wash twice a day with a gentle cleanser, remove make-up at night, and choose skincare and make-up labelled non-comedogenic, meaning it should not clog pores. Avoid heavy oils on acne-prone skin, and let sweat-prone areas breathe in loose clothing.

Over-the-counter products with benzoyl peroxide or salicylic acid are reasonable to try for mild acne, and a pharmacist can advise. Give any product time. Acne treatments usually take about 6 to 8 weeks to show an effect, and they can sting, dry or peel the skin at first (NICE CKS). Switching products every week is one of the most common reasons treatment appears not to work.

Use a moisturiser and a sunscreen every morning. Many acne medicines make skin drier and more sun-sensitive, and in Indian skin, sun exposure darkens the marks that pimples leave behind.

Skin concerns we assess at Clinic Eximus

What does not work, and what can make it worse

Several popular habits do more harm than good. The NHS says plainly not to pick or squeeze spots, because this can cause scars, and not to scrub, because scrubbing irritates the skin and can make acne worse.

• Popping or picking: Pushing a spot open spreads inflammation deeper. Picking is a recognised risk factor for scarring, along with deep, painful acne and a family history of scars (American Academy of Dermatology).
• Scrubbing and over-washing: Harsh scrubs and washing many times a day strip the skin and add irritation. NICE advises against over-cleaning.
• Toothpaste, lemon and other kitchen remedies: Nothing in the clinical guidelines recommends them. Irritation can itself leave dark marks, which Indian skin is prone to.
• Overnight cure claims: No acne treatment clears skin in a night. Anyone promising that is selling a product, not describing the evidence.
• Stopping the moment skin improves: Acne usually relapses when treatment stops. Doctors often continue a gentle maintenance product after the skin clears (NICE CKS).
• Antibiotic tablets on their own: Guidelines advise combining a tablet antibiotic with a topical treatment, and limiting how long it is used.

Creams and gels a doctor may suggest

The strongest recommendations in the American Academy of Dermatology's 2024 guideline are for benzoyl peroxide, topical retinoids and topical antibiotics, followed by oral doxycycline and, for severe acne, oral isotretinoin. Salicylic acid and azelaic acid are conditionally recommended.

Topical retinoids, such as adapalene and tretinoin, unblock pores and reduce inflammation. A 2025 Indian expert consensus (PRACT-India) calls them the preferred first treatment for acne, often paired with benzoyl peroxide or a topical antibiotic. Benzoyl peroxide kills acne bacteria. Azelaic acid calms inflammation and also helps fade the dark marks pimples leave, which is useful in Indian skin. Topical antibiotics are used together with another product, not alone.

Typical early effects are dryness, burning, redness and peeling. Doctors often start gently and build up, which is why the first weeks can feel slow. A first course is usually judged at around 12 weeks (NICE CKS). Pregnancy and breastfeeding change what is suitable, so tell your doctor if either applies or might.

Tablets a dermatologist may weigh

Some acne needs treatment from inside the body. These are prescription medicines, and the decision is always the prescribing doctor's, so this section describes what they are and what a doctor considers, not what you should take.

Antibiotic tablets such as doxycycline reduce the bacteria and inflammation behind moderate to severe acne. Guidelines advise using them together with a topical treatment and for the shortest useful time, often reviewed every few months. For some women, hormonal treatments, such as the combined contraceptive pill or spironolactone, are an option when acne flares around periods or alongside conditions such as PCOS. These need a proper check first, and they are not suitable for everyone.

Isotretinoin is a retinoid tablet reserved for severe acne, acne that leaves scars, or acne that has not responded to standard treatment, according to the AAD guideline. Common effects are very dry lips, skin and eyes. Less common but important effects include mood changes and changes in liver tests and blood fats, so doctors monitor people on it. It must be avoided in pregnancy, and doctors discuss contraception and timing before and after a course (ERAiSE consensus, 2026). If you are taking or have recently finished isotretinoin and are planning a procedure, ask the prescribing doctor first.

What a clinic can add

The strongest evidence in acne is for medicines. In-clinic care is usually an addition, not a replacement. A doctor may inject a corticosteroid into a large, painful lump to settle it faster, which the AAD guideline lists as good practice for larger lesions. Some doctors also use chemical peels or light-based treatments alongside medicines for suitable skin, with the evidence for these being more limited than for medicines.

Facials such as HydraFacial cleanse and hydrate the skin. They are not an acne treatment on their own, and whether one suits you during active acne is for your doctor to say, because irritated or inflamed skin may need to settle first.

A clinic visit is also where the cause is looked for. A doctor can check whether hormones, a medicine or a skincare product is feeding the acne, and can see whether what you call acne is something else.

HydraFacial at Clinic Eximus

How to stop pimples becoming scars

Scars are easier to prevent than to treat. The American Academy of Dermatology advises treating acne early, especially if scars run in your family, and not touching or picking at spots. A 2021 review argues for early, sustained anti-inflammatory treatment for everyone with acne, and discussing scar risk at the very start of treatment.

A 2024 consensus of Indian dermatologists cites a study of more than 6,000 Indian patients with acne in which over 29% had scars. If you already have dips in the skin, the plan is different: active acne is settled first, then a doctor identifies the scar type, since rolling, boxcar and ice-pick scars respond to different approaches. Treatment can improve how scars look, but it does not remove them.

Our acne scar treatment page covers scar types, the evidence, safety in Indian skin and indicative costs.

Acne scar treatment at Clinic Eximus

Dark marks that stay after pimples

Flat brown or dark patches left after a pimple has healed are usually post-inflammatory hyperpigmentation, not scars. They are more common in darker skin, and nearly half of non-white women in one study rated them severely troublesome. Marks in the outer skin layer often fade over 6 to 12 months, while deeper ones can last years (2021 review).

Daily sunscreen is the most important step, since sun darkens existing marks. Treating acne early also reduces them, and doctors sometimes add azelaic acid or other fading creams. Harsh scrubs and peels done without guidance can add new marks, so Indian skin needs care with strong treatments.

Pigmentation treatment at Clinic Eximus

When to see a doctor

The NHS advises seeing a doctor if you have tried treating acne yourself and it is not getting better, if you have lots of spots or they are deep, painful or leaving scars, if the skin looks infected (hot, swollen and red, though redness is harder to see on brown and black skin), or if acne is affecting your mental health.

NICE guidance suggests specialist referral when two full courses of treatment have not worked. A sudden, severe flare with fever or painful, breaking-down lesions needs urgent medical attention.

Acne affects confidence and mood, and that is a medical reason to seek treatment, not a reason to wait. At Clinic Eximus, your first visit is an assessment of your skin and your history before anything is prescribed or booked.

Skin care at Clinic Eximus, Delhi and Noida