Many patients complain to their dermatologist that they feel confused about their skin. They have blemishes, and in some cases have been dealing with this problem for quite some time, but certain areas of their skin have also become dry, red, irritated and highly sensitive, possibly with flaky patches.

So do you have oily, combination, acne-prone or sensitised skin? It is important to understand how various types of acne treatments work and what side effects they can have.


How do acne treatments work?

Sebum plays a central role in the start of acne, although other factors are also involved. Recent scientific studies analysed the role of sebum in the appearance of spots, blackheads and other acne lesions and highlighted two joint phenomena occurring in the people affected:

  • hyperseborrhoea -> the skin secretes too much sebum in certain areas (rich in sebaceous glands).
  • dysseborrhoea -> the sebum of acne-prone skin has an imbalanced composition compared to that of skin not prone to acne.
  • moreover, excess levels of lipids in sebum promote the growth of certain bacteria, setting into motion an inflammatory cascade responsible for the formation of lesions.

In general, topical and oral acne treatments aim to combat the effects of poor-quality sebum (except for isotretinoin, which directly influences its production) to prevent the appearance of spots. They can also have anti-inflammatory and even antibacterial action.

What are the possible side effects for the skin?

It all depends on the treatment, but they can be broken down into two types.

Your Skin - Woman - Atopic dermatitis

By reducing sebum production (an intended effect, to combat the main contributing factor in acne) and thinning the epidermis (an undesirable effect of keratolytic treatments), acne treatments also reduce the effectiveness of the skin’s protective hydrolipidic film. Thus, oily acne-prone skin can become dehydrated in response to treatment and show symptoms of dry and irritated skin such as sensations of tightness, flaky patches, burning, localised redness, etc. With oral treatments, this dryness is more general, also affecting the mucous membranes, lips, nose, eyes, genital area, etc.

Woman under umbrella

Several acne medications are also photo-sensitising or make the skin more sensitive to the sun: any voluntary exposure to UV rays should be avoided when taking these treatments, or the photo-sensitising treatment should be temporarily discontinued during the summer.

What treatments have these effects?

Several types of acne medications can have side effects for the skin. Some of the topical treatments include:

  • Retinoids
  • Benzoyl peroxide
  • Adapalene

Oral treatments:

  • Retinoids (isotretinoin)