Dermatology · HappyDERM Wrocław and Nysa
Acne treatment in Wrocław
We treat acne in teenagers and in adults who “grew out of it” long ago only to see it return after thirty. At the first visit we assess the type of lesions and the risk of scarring, check what has already been used and put together a routine that can be kept up for three to four months, because that is usually how long it takes before the full effect is visible. Patients are seen by Małgorzata Micał-Strąk, MD, PhD, and Ireneusz Pijanowski, MD, specialists in dermatology and venereology.
Please do not squeeze lesions before the visit. Painful nodules, fresh scars or acne that affects well-being are a reason not to delay the appointment.
Acne is more than a few spots
Acne is a chronic disease of the hair follicles and sebaceous glands. It affects the face, back and chest. How it is treated depends not on the number of lesions but on their type: comedones (open and closed) are treated differently from papules and pustules, while painful nodules and cysts are already an indication for systemic treatment, because they most often leave scars. A separate group is adult acne, especially in women, where the lesions sit on the jawline and neck and worsen before menstruation. We then ask about the cycle, contraception and plans for pregnancy, because this changes the choice of medicines.
Why it develops and why washing does not help
Acne is not caused by dirt. It develops when the follicle openings become blocked by keratinising epidermis, the glands produce too much sebum, the composition of bacteria on the skin changes and inflammation appears. Hormones and genes lie behind all this, which is why more frequent washing and scrubbing does not remove the cause and often makes things worse. Factors the patient can influence include heavy, oily cosmetics, a helmet or mask (lesions exactly where the pressure is), work involving oils, and some medicines and supplements. Please bring a list of everything you take to the visit, but do not stop anything on your own.
When to see a dermatologist
- painful nodules or cysts appear,
- scars or dark marks remain after lesions,
- products from the chemist do not bring control after 2–3 months,
- acne affects self-esteem, school or work,
- you are pregnant, planning a pregnancy or breastfeeding and want to be treated safely.
Are hormone tests necessary?
Not routinely. We order them when something in the history points to it: irregular cycles, excess hair growth, greasy hair with hair loss, acne appearing suddenly in adulthood. In most patients the result would not change the treatment, so there is no point in doing them.
What the visit looks like
We talk about how long the lesions have been present, what makes them worse and how the skin responded to previous treatment. The doctor examines the skin, assesses the type of lesions, post-inflammatory marks and scars, and rules out conditions that mimic acne (rosacea, folliculitis, drug-induced lesions). You leave with a specific routine: what to apply, to which area, at what time of day and after how long we will assess the result. This is usually 8–12 weeks. At the follow-up we check tolerance and regularity and change the plan if necessary. Not everyone needs additional tests.
How we treat acne
We choose the treatment according to severity, age, coexisting illnesses and plans for pregnancy. Below is what we use most often. This text does not replace a prescription or a medical assessment.
Topical treatment
The basis for mild and moderate acne: retinoids, benzoyl peroxide, azelaic acid and topical antibiotics in combinations. They are applied to the whole area prone to lesions, not just to spots. For the first 2–4 weeks the skin may peel and sting; we explain how to get through this rather than give up.
Oral treatment
With severe lesions or no improvement after topical treatment: an antibiotic from the tetracycline group for a limited time, always together with topical treatment (an antibiotic on its own is a mistake that builds resistance), and in women sometimes hormonal treatment.
Isotretinoin
For severe, scarring or recurrent acne. Effective, but it requires blood tests before and during treatment and, in women, strict contraception, because the medicine severely harms the foetus. We run the course over several months with follow-ups every 4–8 weeks.
Treatments
Medical peels and lasers support treatment but do not replace it. We deal with scars only once no new lesions are forming; the methods are described on the page acne scars.
Once improvement is achieved, we do not stop everything at once. Usually one topical product is continued for longer so that acne does not return after a month. If the routine is too complicated or the skin reacts too strongly, please tell us at the follow-up rather than at the chemist.
A red mark, a dark mark or a scar
After a lesion heals, the skin may be red or darker for several months. This is a flat post-inflammatory mark, not a scar, and it usually fades on its own, faster with daily sun protection. A scar is a permanent change in the structure of the skin: a pit, a thickening or a firm lump. It forms mainly after deep lesions and after squeezing. First we stop new lesions from forming, and only then plan scar treatment, choosing the method according to the type of scars and the skin phototype.
Skincare: less is more
What helps
- washing twice a day with a mild cleanser,
- cosmetics and sunscreens labelled non-comedogenic,
- removing make-up in the evening,
- sunscreen every day, especially during treatment with retinoids,
- prescribed medicines used as agreed.
What to avoid
- squeezing and picking,
- brushes, scrubbing and strong peels at home,
- introducing several new products at once,
- stopping treatment without discussing side effects,
- “miracle cures” promising results within a week.
More practical advice in the guide how to care for acne-prone skin.
Questions about acne treatment
How long before the effect is visible?
We make the first assessment after 8–12 weeks. Before then the skin may even look worse, especially with retinoids. If strong side effects appear, the follow-up is earlier.
Is an antibiotic on its own enough?
No. We use an antibiotic together with topical treatment and for a limited time; otherwise bacterial resistance grows and acne returns once it is stopped.
Can acne be treated during pregnancy?
Yes, but the choice of medicines is limited. Oral and topical retinoids are excluded in pregnancy; azelaic acid and benzoyl peroxide, among others, remain. Please mention pregnancy or plans for it at the start of the visit.
Does diet matter?
In some people, foods with a high glycaemic index and large amounts of milk make the lesions worse. We do not recommend restrictive diets, but if you notice a link, it is worth checking.
When should scars be treated?
When no new lesions have formed for several months. We then assess the type of scars and choose the method; one method does not suit all.
How much does a visit cost?
The prices of consultations and treatments are in the price list. When booking, reception gives the cost of the particular visit.
Sources
- NICE NG198: Acne vulgaris, management (2026 update).
- American Academy of Dermatology: Guidelines of care for the management of acne vulgaris.
- European Medicines Agency: pregnancy prevention during treatment with retinoids.
This text is for information. Treatment, contraindications and tests are decided by the doctor during the visit.
Book an appointment about acne
Wrocław, ul. Barlickiego 31/1u, and Nysa, ul. Mariacka 10. Please call 573 290 488 or write via the form. Bring the packaging of the products you use on your skin to the visit.