Understanding Acne
Acne is a chronic and highly common skin condition that occurs when hair follicles become clogged with oil (sebum) and dead skin cells. This clogging process, often combined with bacteria and inflammation, leads to the formation of pimples, blackheads, and cysts.
Teenage Acne
Adolescent acne is commonly triggered by hormonal fluctuations during puberty, leading to increased sebum production and clogged pores. During the teenage years, acne often presents as widespread breakouts with a mix of blackheads, whiteheads, and superficial pustules. In contrast to adult acne, teenage acne is often more responsive to standard topical and oral treatments and tends to resolve more quickly.
Adult Acne
Adult acne can manifest as persistent breakouts from adolescence, late-onset acne occurring for the first time in adulthood, or even recurrent acne after a period of clear skin. Unlike teenage acne, adult acne can be triggered by various factors, including hormonal imbalances, stress, certain medications, and lifestyle habits. While less common than teenage acne, adult acne can greatly impact one’s confidence and self-esteem.
Types of Acne I Treat
Papules
Small, raised bumps on the skin that are often red and may feel tender to the touch. They indicate inflammation within the hair follicle.
Pustules
Small, inflamed bumps containing pus, sitting at the surface of an inflamed follicle. These are what most people mean by a pimple. They are not the same as whiteheads, which are closed comedones and are not inflamed.
Nodules
Larger, firm, and often painful bumps that develop deeper within the skin. They represent a more severe form of inflammation and can persist for weeks or months.
Cystic Lesions
Large, pus-filled, and often painful bumps that occur deep within the skin. They are the most severe form of acne and can often lead to scarring. Scarring that has already formed is addressed separately, as described in the acne scar treatment guide.
Causes of Acne
Acne often begins with an excess of sebum (oil) production by the skin’s glands. This excess oil can mix with dead skin cells and debris, leading to clogged pores. If these pores become blocked, blackheads or whiteheads may form.
These clogged pores also create an ideal environment for the bacteria involved in acne to thrive. As the bacteria multiply, your immune system reacts to the clogged and infected pores, resulting in redness, swelling, and pus-filled lesions.
Acne in both teenagers and adults can be exacerbated and triggered by:
- Hormonal Changes: Menstrual cycles, stress, and underlying hormonal imbalances (like PCOS) can increase sebum production, making the skin more susceptible to breakouts as androgens stimulate the oil glands.
- Genetics: A strong family history of acne suggests a genetic predisposition, meaning you are more likely to struggle with the condition if it runs in your family.
- Skincare and Makeup: Using heavy, oil-based, or pore-clogging (comedogenic) products can physically block hair follicles and exacerbate the formation of acne.
- Diet & Lifestyle: High sugar and greasy foods may lead to systemic inflammation and hormone fluctuations, while lack of sleep and chronic stress elevate cortisol levels, further promoting acne.
- Environmental Factors: External elements such as pollution, high humidity, and excessive sweating can create a breeding ground for bacteria and cause skin irritation, contributing to breakouts.
Why Treat Acne Early
Untreated or improperly managed acne can leave behind permanent physical and emotional marks. The intense inflammation can result in lasting consequences like severe scarring and stubborn post-inflammatory hyperpigmentation.
Hence, early intervention is critical, as treating acne promptly is the best defence against permanent textural damage, and it also helps to protect your long-term confidence.
Acne Treatments I Use
Which treatment I reach for depends on the type of lesion, the severity, your skin type and any other condition affecting the skin. The list below is grouped by what the acne is doing, not by how new the technology is.
Comedonal acne: blackheads and whiteheads
- Laser Therapy: Utilising specific wavelengths of light, laser therapy addresses the bacteria involved in acne and reduces inflammation. This non-invasive acne laser treatment potentially helps control breakouts, reduce redness, and promote healing.
- Topical Treatments: These treatments can help manage mild to moderate acne by potentially unclogging pores, reducing inflammation, and preventing the growth of the bacteria involved in acne. Examples include retinoids and antibacterial creams.
- AGNES RF, and sometimes AviClear: For comedonal acne I usually use AGNES RF, and I will consider AviClear as well depending on the skin and the spread of the lesions.
Papular and pustular acne
- Gold Photothermal Therapy (PTT): Gold nanoparticles are used to manage the bacteria involved in acne and sebaceous glands. Gold PTT could lead to long-term acne control and improvement in skin texture.
- Platinum Photothermal Therapy (PTT): Another treatment that employs platinum nanoparticles to address acne and control sebum production, Platinum PTT may be particularly helpful for individuals with inflammatory acne.
- AviClear: For papular acne AviClear is usually my choice. It is a 1726 nm laser aimed at the sebaceous gland, given as a course of sessions, and improvement can continue after the final session.
Nodular and cystic acne
- AGNES RF: For nodular and cystic acne this is usually what I use. AGNES RF passes radiofrequency energy through a fine insulated needle to treat individual sebaceous glands, which reduces oil production at the lesions treated. It is the option I reach for most often where lesions are deep and scarring is a concern.
- Isotretinoin: This oral medication helps treat severe or recalcitrant acne. Isotretinoin reduces sebum production, regulates skin cell turnover, and reduces inflammation. I prescribe it for severe acne that has not responded to other treatments.
Medication or a procedure?
Some people are treated with medication alone. That tends to be younger children and teenagers. Whether I add a procedure depends on the skin type, the severity of the acne, and any other condition affecting the skin — rough texture, for instance, may do better with a non-insulated microneedle fractional radiofrequency device such as Secret RF.
A procedure is not always appropriate for the type of acne in front of me. Where that is the case I will say so and treat the acne another way.
About Dr Gerard Ee
MBBS (UK), MRCS (Edinburgh), PGDip Practical Dermatology (Cardiff)
I earned my medical degree (MBBS) at St George’s University of London, and worked at Singapore General Hospital, the National University Hospital and Mount Sinai Hospital in New York before becoming a member of the Royal College of Surgeons of Edinburgh.
I trained in surgery to MRCS (Edinburgh) and hold a postgraduate diploma in practical dermatology from Cardiff University. I have practised aesthetic medicine for more than ten years, with a particular focus on acne, acne scarring and pigmentation. My aim at a consultation is that you leave understanding what is driving your acne and why a particular plan has been suggested.
Acne Treatment Options
Acne is the focus
Doctor-led consultation
Medicine and procedures
Reviewed at one week
Adult Acne Treatment Cost in Singapore
| Treatment | Cost |
| Topical Treatments | From $150 |
| Gold Photothermal Therapy | From $700 per session |
| Platinum Photothermal Therapy | From $700 per session |
| AGNES RF | $800 to $1500 |
| AviClear | From $1500 |
| Isotretinoin | From $500 |
The final cost of treatment may vary based on the type and severity of your acne, the number of sessions required or the treatment duration. Book a consultation today for a personalised quote.
Frequently Asked Questions About Acne Treatments in Singapore
What happens at an acne consultation
The first appointment is a history and an examination, not a sales conversation. What I ask about:
- When the acne first started
- Family history of acne
- Whether the periods are regular
- The type of acne and where it sits on the face or body
- What skincare and make-up products are being used
- Diet and sleep
What changes my recommendation most often is risk and family planning. If you are trying to conceive, or may be, say so before anything is prescribed.
How often I review acne treatment
Everyone is reviewed at one week. After that it depends on what you are on:
- Lasers — I see you every two weeks
- HydraFacial — monthly
At review what matters is how many new lesions are appearing, how many are painful, whether there are side effects, and whether the plan has actually been usable day to day. If it has not, tell me — adjusting it is easier than abandoning it.
Acne treatment in pregnancy and breastfeeding
If you are pregnant, think you may be, or are breastfeeding, tell me before anything is prescribed. The plan is built differently.
- Topical creams need to be changed. Several standard acne topicals are not suitable at these times.
- AGNES RF and AviClear are not done during pregnancy or breastfeeding.
- Isotretinoin causes severe birth defects and is not used in pregnancy.
There is more detail on acne and pregnancy.
Show the 8 references
- Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30. PubMed 38300170
- Nast A, Al Wattar BH, Beylot Barry M, et al. Update of the EuroGuiDerm evidence-based guideline for the treatment of acne — short version. J Eur Acad Dermatol Venereol. 2026;40(7):1162-1172. PubMed 41847993
- Arowojolu AO, Gallo MF, Lopez LM, Grimes DA. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2012;2012(7):CD004425. PubMed 22786490
- Hebert A, Thiboutot D, Stein Gold L, et al. Efficacy and safety of topical clascoterone cream, 1%, for treatment in patients with facial acne: two phase 3 randomized clinical trials. JAMA Dermatol. 2020;156(6):621-630. PubMed 32320027
- Alexiades M, Kothare A, Goldberg D, et al. Novel 1726 nm laser demonstrates durable therapeutic outcomes and tolerability for moderate-to-severe acne across skin types. J Am Acad Dermatol. 2023;89(4):703-710. PubMed 37328000
- Ahn GR, Kim JM, Park SJ, et al. Selective sebaceous gland electrothermolysis using a single microneedle radiofrequency device for acne patients: a prospective randomized controlled study. Lasers Surg Med. 2020;52(5):396-401. PubMed 31502662
- National Institute for Health and Care Excellence. Acne vulgaris: management. NICE guideline NG198.
- Cutera. AviClear important safety information. Manufacturer safety information, not comparative efficacy evidence.
Acne consultations and treatment with Dr Gerard Ee take place at The Clifford Clinic, 50 Raffles Place, Singapore.
For more detail, read the separate guides to spironolactone, the contraceptive pill for acne and isotretinoin.
This page is written from published research and from clinical experience in Singapore since 2012. It is for general education, not medical advice. Whether a treatment suits you, what it may achieve and what it may risk can only be established at a consultation. Dr Gerard Ee is the Medical Director of The Clifford Clinic, a private clinic in Singapore, and treatments discussed on this site are provided commercially.
