What drives acne
Acne starts in the hair follicle and its oil gland. Four things interact. Dead skin cells block the follicle, a process called hyperkeratinisation. Androgen hormones increase oil. The bacterium Cutibacterium acnes multiplies. Inflammation then follows. Poor hygiene is not the cause.
Treatment is matched to those drivers. One visit does not settle acne. Care runs over time, and most plans go on to a maintenance stage. How you respond depends on the grade, cause, skin type, hormones and how closely you follow the plan. Results vary.
Grading comes first
Open and closed comedones, meaning blackheads and whiteheads, with little inflammation.
Red, inflamed papules and pustules alongside comedones.
Deep, tender nodules and cysts. This grade is the most linked to scarring, so early medical care matters. If you have this grade, try not to wait.
When it is not acne: fungal acne
Malassezia folliculitis, often called fungal acne, is driven by yeast. It shows up as uniform bumps of one type, often itchy, commonly on the chest, back and shoulders. It does not respond to usual acne treatment, and some antibiotics can make it worse. If several acne treatments have not helped, ask whether this may be the cause.
Acne treatment in Singapore: medical management
Medicine is the first-line step. Topical and oral options target skin-cell build-up, oil, bacteria, or more than one of these at once. Some need a check before starting and monitoring during use. Your doctor goes through the side effects of each option first. Some medicines act on one driver and others on several, and the choice follows your grade.
Where laser fits
R2 Glow works on inflammatory activity in the skin, not on pigment.
Directed at inflammation around the follicle and at the blood vessel component.
Neither laser takes the place of medical care. Light does not reduce androgen-driven oil or follicle blockage, so a light-only plan addresses just one driver of the four.
Dark marks and true scars are different
Post-inflammatory hyperpigmentation is a colour change. The skin surface stays intact. In Fitzpatrick III to V skin, which covers most of Singapore, these marks can be the longer-lasting problem. Scarring is a change in structure, with ice-pick, boxcar and rolling types. Each needs a different approach, so assessment separates the two. A dark mark is pigment in skin that is still whole. A scar is a change in the skin itself, so treating one as the other misses the problem.
The order of treatment matters
What acne treatment cannot do
Treatment for active acne does not remodel scars that have already formed. Laser alone cannot manage acne. Usual acne treatment will not resolve fungal folliculitis. No single method fits every presentation, and timing cannot be quoted in advance. Laser in particular addresses only inflammation, so it cannot stand in for medical care.
Who needs more care
Suitability is decided in person, and no single approach fits every presentation. Some medicines need assessment and monitoring, so they are not simply started on request. Deep, tender nodules or cysts deserve early medical attention because of the link with scarring. Uniform, itchy bumps on the chest or back should raise the question of fungal folliculitis, as some antibiotics can worsen it. Back, chest and shoulder acne is common, and it gets the same assessment as acne on the face. Surface area and how easily an area can be reached then shape the plan.
How fees work
Fees are not published. They depend on your grade, whether medicine alone or a combined approach is needed, the areas involved, and how the plan is staged. Cost is set out at consultation, before anything is agreed. A plan for the face differs from one that also covers the back, chest and shoulders.