Acne for guys: what helps and when to see a doctor

What helps with acne is mostly boring: wash gently up to twice a day with a gentle cleanser, leave the spots alone, wear sunscreen, and give any over-the-counter treatment weeks to work. If that doesn't clear things up, if the spots are deep and painful, or if they leave scars or hit your mood, see a GP or a board-certified dermatologist, because stronger treatments exist. This is general information from health bodies, not medical advice for your skin.

Acne is common, and it can look worse in your own mirror than it does to anyone across a table. It's also one of the few appearance problems with a proper medical route, so you aren't stuck with "just deal with it."

The basics, according to the AAD and the NHS

The American Academy of Dermatology (AAD) lists six at-home tips for acne, and the NHS page on acne overlaps with them.

Wash gently. The AAD says to wash your face up to twice daily and after sweating, with a gentle, non-abrasive cleanser applied with your fingertips, and to skip washcloths and sponges, which can irritate skin. The NHS says to wash twice a day with a gentle cleanser. Both warn against scrubbing: the NHS says it can make acne worse.

Skip the harsh stuff. The AAD says astringents, toners and exfoliants can dry your skin and make acne look worse, and it suggests products labeled "alcohol-free." The NHS says to use non-comedogenic products, which are made not to clog pores. The NHS also says to remove make-up at the end of the day.

Don't pick or squeeze. The AAD says picking, popping or squeezing slows healing and raises the risk of scarring and dark spots. The NHS says squeezing spots can cause scars. It's the hardest tip to follow and the one that matters most for what your skin looks like in a year.

Keep your hands off your face. The AAD tells you to avoid touching your face throughout the day.

Watch your hair. The AAD says that if your hair is oily, you should shampoo more often and keep it away from your forehead, since hair oil can contribute to forehead acne. Heavy styling product along the hairline is worth checking if you break out there. See how to style your hair for lighter options.

Use sunscreen. The AAD says to avoid tanning beds, seek shade outdoors, and use a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher on uncovered skin, in a product labeled non-comedogenic.

Body acne. The NHS says that if you have acne on your body, wear loose, breathable clothing, especially when exercising or sweating.

Over-the-counter treatments

The NHS says products containing salicylic acid or benzoyl peroxide may help, and suggests asking a pharmacist for advice. That's a good route: a pharmacist can tell you what suits your skin and what to avoid with other products you use.

A few points on using them, from the pages above:

• Patience. The AAD says results can take several weeks to a few months, and that switching treatments too often can cause irritation and breakouts. Its page about beard acne says treatment often takes two to three months, and that if breakouts haven't decreased after a month, you may need a different type. Those timelines differ by page, so ask your pharmacist or dermatologist how long to try yours.
• Cover the whole area. The AAD's beard acne page says to put the treatment on all the acne-prone skin, not only on the spots.
• Read the label. Follow the directions on the pack, and ask a pharmacist if your skin gets red, sore or peeling. That's general advice, not from the pages above.

When to see a doctor or dermatologist

The NHS says to see a GP if you have acne and:

• you've tried treating it yourself and it isn't getting better,
• you have many spots, or the spots are deep, painful or causing scars,
• you have signs of a skin infection, such as hot, swollen, red skin, or
• it's affecting your mental health.

The AAD says that if breakouts continue after you follow its tips, see a board-certified dermatologist.

The NHS says acne can affect mental health and lead to anxiety, depression and low self-esteem, and it lists that as a reason to see a GP. The NHS also lists treatments a GP or dermatologist may offer: retinoid creams or gels, isotretinoin tablets for more severe acne, antibiotic creams or tablets, and the combined pill, which can help manage hormone levels that contribute to acne. What's right for you is for a doctor to decide after seeing your skin and your history, so this list isn't a menu.

What not to believe

• "Dirty skin causes acne." Neither page above says that, and both advise against scrubbing. The NHS lists causes such as hormone changes, some medicines and greasy skin or hair products.
• "It'll clear overnight." The AAD says results can take several weeks to a few months.
• "Buy the 10-step kit." The AAD warns that switching treatments too often can cause irritation and breakouts, and the basics above are what the two health bodies list.
• "Pop it so it heals faster." The AAD says the opposite.

No product here is ranked on purpose. A pharmacist or dermatologist can recommend based on your skin. Online lists of "best acne products" are usually written by people selling something.

Acne and dating

How much skin matters differs from person to person, and no study can tell you how it matters to the one you're talking to. What you can control is whether you're looking after it, instead of hiding it or picking at it before a date. If your skin is the thing keeping you from going out, getting treatment is a reasonable step. If you want a full five-minute routine that includes sunscreen and moisturizer, see skincare for guys. For the rest of the basics, the grooming checklist covers what to do the week of, and how to be more attractive is honest about what changes and what doesn't. Nerves about skin before a date are normal too, and first date nerves has ways to handle them.

What to do next

1. Tonight: wash with a gentle cleanser and your fingertips, no scrubbing, then rinse with lukewarm water.
2. Tomorrow morning: put on a non-comedogenic, broad-spectrum sunscreen with SPF 30 or higher.
3. For two weeks: don't pick, pop or squeeze. If you catch yourself doing it, wash your hands and walk away from the mirror.
4. Talk to a pharmacist about one over-the-counter treatment, and use only that for the time they suggest.
5. Book a GP or dermatologist visit if you have deep, painful spots, scarring, signs of infection, or if acne is wearing on your mood.
6. Take a photo of your skin in the same light every two weeks so you can see change you won't notice in the mirror.

Sources

• American Academy of Dermatology: Acne, tips for managing (opened in full)
• American Academy of Dermatology: Beard care, treating common beard problems (opened in full; the treatment timing and whole-area application for beard acne)
• NHS: Acne (opened in full)

These are patient-information pages, not trials. The AAD's separate treatment pages weren't read, so prescription treatments are described only as the NHS page lists them.