How to deal with acne: what to watch for with retinoids and acne creams, and whether you can squeeze spots
Acne is a common skin disease; the common side effects of topical acne products are mostly dryness, irritation, redness or peeling where the product is applied, anyone with severe irritation or an allergic reaction should stop using the product and consult a doctor, and people who are pregnant, planning pregnancy or breastfeeding, children and people with eczema should ask a doctor before use (Department of Health Drug Office, January 2024). The treating doctor decides individual cases.
Why do I get acne?
Acne (acne vulgaris, also called pimples) is a common skin disease; its causes include heredity, hormonal changes and bacterial growth, and it most often appears on the face, back, chest and shoulders (Department of Health Drug Office, January 2024).
Oil gland secretion increases in adolescence, oil building up in hair follicles forms ‘blackheads’, and when these become infected by bacteria they turn red, swollen and inflamed as acne; unclean skin, often eating oily food, stress and lack of sleep may all increase acne, and some women are also more likely to get acne before their period (Department of Health Student Health Service, June 2022).
What are the side effects of retinoids and acne creams?
The active ingredients of topical acne products include benzoyl peroxide, sulphur, azelaic acid, salicylic acid, tretinoin, adapalene, and antibiotics such as erythromycin and clindamycin; the common side effects are mostly dryness, irritation, redness or peeling where the product is applied, and some people have burning, itching or stinging (Department of Health Drug Office, January 2024).
Tretinoin makes the skin red and flaky early in treatment, which may improve after one month, and overuse can cause redness, cracking and swelling of the skin; topical antibiotics may cause bacteria to become resistant; benzoyl peroxide has a bleaching effect and should be kept off hair and clothes (Department of Health Drug Office, January 2024).
Other reminders before use are in the table below; which product to use follows a doctor's or pharmacist's directions.
| Situation | The Drug Office's reminder |
|---|---|
| Severe irritation or an allergic reaction | Stop using it immediately and consult a doctor |
| Pregnant, planning pregnancy or breastfeeding | Consult a doctor before using any topical acne product |
| Children | Consult a doctor before use |
| People with eczema | Some products may severely irritate skin with eczema; consult a doctor before use |
| Sun exposure | Most products make the skin more sensitive to sunlight; a broad-spectrum sunscreen of at least SPF 15 is advisable; stop using the product if red patches appear on the skin |
| Using several products at once | Unless a doctor directs, do not use different topical acne products at the same time |
| Amount and length of treatment | Do not exceed the duration and dose prescribed by a doctor or recommended by a pharmacist |
How should I care for my skin day to day? Can I squeeze spots?
Advice on caring for acne includes washing the face often with mild soap and warm water, drinking plenty of water, eating more vegetables and fruit and less fried and other oily food, keeping regular hours with enough sleep, and staying cheerful and relaxed (Department of Health Student Health Service, June 2022).
Do not squeeze acne with your hands, and do not pick off the scab when acne is starting to heal; let it fall off naturally to avoid scarring; do not take medicines indiscriminately, and if the condition is severe, talk it over with your family and consult a doctor (Department of Health Student Health Service, June 2022).
Where can I see a doctor for acne?
Primary healthcare is the first point of contact for individuals and families in a continuing healthcare process, and family doctors are the main providers of primary healthcare (Health Bureau, December 2022); Dermatology & Venereology deals with skin diseases and sexually transmitted diseases (Hong Kong Academy of Medicine, Specialty Descriptions, April 2025).
The Department of Health's Social Hygiene Service has nine dermatology clinics providing specialist dermatology services (Government reply to the Legislative Council, November 2023); for referral, waiting and fees, see How to choose a dermatologist, and for private consultation fees, see Private dermatologist fees compared.
Whether referral to Dermatology is needed is decided by the treating doctor according to the condition.
Frequently asked questions
What are the side effects of tretinoin for acne?
Tretinoin makes the skin red and flaky early in treatment, which may improve after one month; overuse can cause redness, cracking and swelling of the skin; most topical acne products make the skin more sensitive to sunlight (Department of Health Drug Office, January 2024).
What should I watch for when using acne cream?
Do not exceed the duration and dose prescribed by a doctor or recommended by a pharmacist, do not use several products at the same time unless a doctor directs, and stop using the product and consult a doctor if severe irritation or an allergic reaction occurs; people who are pregnant, planning pregnancy or breastfeeding, children and people with eczema should ask a doctor before use (Department of Health Drug Office, January 2024).
Can I squeeze spots?
Do not squeeze acne with your hands, and do not pick off the scab when it is starting to heal, to avoid scarring; if the condition is severe, consult a doctor (Department of Health Student Health Service, June 2022).
How do I see a public dermatologist?
The Department of Health's Social Hygiene Service has dermatology clinics providing specialist dermatology services (Government reply to the Legislative Council, November 2023); for referral and fees, see How to choose a dermatologist.
What is 暗瘡 in English?
Acne; see Acne: the English term.