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Consult a dermatologist online for acne treatment

A common reason for consulting a dermatologist, acne is a skin condition characterised by an outbreak of spots, blackheads and cysts. For an appropriate diagnosis and treatment, consult a dermatologist online 7 days a week on Feeli, without an appointment.

What causes acne?

This very common skin problem most often appears during adolescence. It shows up as oily skin with spots and cysts appearing on the face, chest, back or torso. The scalp can also be affected. Most often, it stems from the hormonal upheaval of puberty, which causes an excess of sebum, leading to acne and the resulting skin problems. Each pilosebaceous follicle consists of a hair with a corresponding sebaceous gland. Each gland secretes sebum, which flows out through the pores of the skin and coats the skin to protect it. Normally, sebum is very fluid. In acne, sebum is secreted in excess and becomes thicker. At the same time, dead cells clog the skin, blocking the pores. This fat-rich environment favours the growth of Propionibacterium acnes, a bacterium normally present on the skin that then multiplies abnormally. This leads to the appearance of spots, redness, cysts and acne lesions. This skin issue is more often bothersome than serious, but it can have significant psychological effects at an age when others' opinions matter particularly. In the large majority of cases, 90%, acne clears up spontaneously between the ages of 20 and 25. Although acne can cause infected spots or pustules to appear, it is not an infectious disease. Juvenile acne is the classic acne of adolescence; there is also inflammatory acne in adults, cystic acne, or hormonal acne. Acne is generally not considered a dermatological emergency, even though it can significantly affect overall wellbeing.

What are the symptoms of acne?

An inflammatory condition characterised by inflammation of the pilosebaceous follicles (folliculitis), the symptoms of acne can include:
 • Comedones (spots): a blackhead when the hair follicle is open, a whitehead when it is blocked (closed). These spots form when the hair follicles are clogged by a mixture of sebum, bacteria and dead skin cells;
 • Papules: red, raised inflammatory spots or lesions with no visible head;
 • Inflammatory lesions more inflamed than papules can lead to pustules, filled with pus and generally more visible;
 • Cysts and nodules: these result from a build-up of sebum, bacteria and cells, and cause deeper, more painful lesions. Cysts are larger and are generally accompanied by a visible inflammatory reaction;
 • Erythema: redness caused by inflammation of the skin around the lesions.
Acne can also leave scars, particularly from scratching. It can also cause hyperpigmentation once the lesions have healed. These changes in skin pigmentation can then persist. Regarding the risk factors for acne, we can mention:
 • Excessive sebum production;
 • Hormonal changes;
 • Bacterial proliferation on the skin;
 • Environmental factors;
 • Or indeed genetic factors.
Treatment for acne can include topical treatments and, depending on the severity of symptoms, systemic medications such as retinoids and antibiotics.

How is acne treated?

Acne treatments can include topical treatments, such as:
 • Retinoid-based creams, such as adapalene, tretinoin and tazarotene. These retinoids are derived from vitamin A and work by preventing follicle blockage and promoting cell renewal;
 • Topical antibiotics, such as erythromycin and clindamycin. These antibiotics are sometimes prescribed to reduce bacterial colonisation of the skin. However, their use should not be prolonged, as this risks causing bacterial resistance;
 • Benzoyl peroxide. It is often combined with other treatments for its antibacterial and anti-inflammatory properties;
Other systemic acne treatments can sometimes include oral antibiotics (doxycycline, tetracycline, minocycline), oral contraceptives (combined pills) or oral retinoids (isotretinoin). Isotretinoin is generally reserved for severe, resistant acne, as it is a powerful oral retinoid. In all cases, these treatments can cause side effects and require medical advice, as well as follow-up where possible. Finally, acne treatments can involve dermatological interventions, such as comedone extraction, peels and laser treatments. For further medical advice, visit Feeli for an online consultation.

What makes acne worse?

Several risk factors can promote or worsen acne. Among these triggers, we can mention:
 • Hormonal fluctuations, particularly during puberty, the menstrual cycle and pregnancy. Hormones can indeed stimulate sebum production. Sometimes, acne is linked to a hormonal imbalance caused by conditions such as polycystic ovary syndrome (PCOS);
 • Some studies suggest the impact of an unbalanced diet as a factor that worsens acne. Dairy products, foods high in refined carbohydrates and sugars and, more broadly, high-glycaemic-index foods may be implicated;
 • Psychological factors, such as stress. Stress can in particular trigger inflammatory responses in the body and contribute to worsening acne;
 • Smoking, alcohol or other irritant chemical substances. These irritants can be found in some skincare products, but also in the environment (endocrine disruptors);
 • Overly harsh cosmetic products;
 • Friction or pressure on the skin from clothing, helmets, backpack straps or other objects.

What causes acne in adults?

The causes of acne in adults are varied, and it can be linked to several factors, such as:
 • Hormones, particularly in women, are often involved in the onset of acne in adults. Hormonal fluctuations, notably changes linked to the menstrual cycle, pregnancy and menopause, are periods more prone to acne in some women. Taking certain hormonal contraceptives can also play a role;
 • Stress is known to increase the risk of acne flare-ups. It can also disrupt sleep and eating habits and thus impact skin health;
 • Polycystic ovary syndrome (PCOS);
 • Sometimes, foods high in refined sugars and carbohydrates;
 • Certain cosmetic products that clog the skin's pores;
 • Exposure to chemical substances;
 • Certain medications, such as corticosteroids, oral contraceptives or certain hormones;
 • Hereditary factors.

What is the difference between mild, moderate and severe acne?

Assessing the severity of acne takes into account, in particular, the type and number of skin lesions present, as well as the areas of the body affected. Acne is thus commonly classified into 3 categories:
 1. Mild acne, characterised by the presence of blackheads and whiteheads (comedones), and sometimes a few papules. Mild acne tends to be localised to the face, back or chest. The risk of permanent scarring is generally low;
 2. Moderate acne is characterised by the presence of papules and pustules, in addition to some comedones. Moderate acne can also spread to larger areas of the body (chest, back, face). The risk of scarring is higher, particularly if the person scratches the lesions or if the acne is poorly treated;
 3. And severe acne, characterised by the presence of nodules and/or cysts, in addition to the other features of mild and moderate acne (comedones, papules, pustules). Severe acne can also spread over a larger part of the face, chest or back. The risk of skin texture changes is higher, as is the risk of permanent scarring.
It is therefore essential to consult a healthcare professional for treatment suited to the severity of the acne. Treatment does indeed take into account the severity of the acne, its location, and the type and number of lesions. The doctor can also adapt the treatment based on the patient's medical history. Treatments generally include topical medications, oral medications, antibiotics and dermatological procedures. The dermatologist can also give advice on skincare. Early, appropriate treatment can help prevent the risk of complications, such as permanent scarring.

The benefits of using Feeli

An online consultation with a Feeli dermatologist is the most effective way to get advice as quickly as possible if you have acne. Feeli offers you a responsive service that gives you great flexibility in your schedule: no appointment needed. This approach to medical practice offers many advantages for treating an acne flare-up. And so that the doctor can properly assess the state of your face, Feeli invites you to send photos that help the dermatologist prescribe the right treatment for you. There are also no travel restrictions for teleconsultation, so you can see a dermatologist without leaving home: a useful, time-saving solution and an alternative for those without means of transport or who face mobility issues. If you live in the countryside, it isn't always easy to see a dermatologist; online consultation helps avoid medical deserts without having to travel hundreds of kilometres to see a specialist.