Acne Treatment

Melbourne Eastside Dermatology is a dermatologists-led specialist practice in managing acne and acne scarring.   All patients should be seen and assessed by dermatologists or dermatology nurse practitioners for medical therapy of acne and consideration of acne scarring therapy.

Acne is commonest amongst teenagers due to the surge of hormonal-skin changes.  Dermatologists will usually undertake a relevant medical and family history.  Important medical conditions such as Polycystic Ovarian Syndrome (PCOS) or rare endocrinology conditions (such as congenital adrenal hyperplasia) will need to be ruled out.

Some patients experience acne since young and others will have a later onset in their life.  In adult acne, more emphasis will be put on assessing whether there are any external triggers (such as lifestyle, diet, make up , skin care, working conditions, weight training supplements or medications) that are modifiable.  Severe persistent cases are also more likely to require investigation  Medical therapy is also going to be centered around the personal circumstances such as planning for pregnancies, work or active lifestyle.

While these are not always or routinely performed, there are tests such as blood tests to rule out hormonal problems, and imaging modality including ultrasound to rule out Polycystic Ovarian Syndrome.


  • Dietary modification – including avoiding excessive dairy/sugar/high GI diet.
  • Lifestyle modification – avoidance of hot humid environment.
  • Makeup modification – light lotion-based makeup is better than oil-based.
  • Skin care advice – Active ingredients in non-prescription skin care include Salicylic Acid, Retinol, Benzoyl Peroxide.
  • Avoidance of supplements that trigger acne – these include high energy based weight training supplements, testosterone or anabolic steroid.


  • Superficial chemical peels including Salicylic Acid, Lactic Acid and Retinoid.
  • Lower level light therapy (LLLT) using a combination of blue and red LED light treatment using our SmartLux device.


Your treating specialist practitioners may prescribe a variety of treatment

  • Topical antibiotic
  • Topical retinoid
  • Topical Benzoyl peroxide
  • Oral antibiotic
  • Oral contraceptive pills
  • Oral hormone-reducing tablets such as Spironolactone
  • Oral retinoid (such as Isotretinoin)
  • Steroid injection for acne cysts


This remains the most effective oral medication treatment. This is a form of active vitamin A (Retinoid) oral therapy.

  • In Australia, this requires specialist dermatologists (FACD) for prescription and a specific retinoid number for dispensing by pharmacists.
  • Majority of patients will have completely (or close to completely) clear skin at the end of treatment course.
  • Treatment course range from 6 to 18 months, sometimes longer, depending on tolerability.
  • Commonest side effect are dry lips, dry skin and sunburn tendency – All patients will experience this and usually manageable with lip balm, moisturiser and regular sun protection.
  • Some patients will experience some acne worsening in the initial treatment.  This is very important to manage and dermatologists may prescribe oral antibiotics or steroid to reduce this.
  • Depression has been widely publicised as being a potential side effect of this treatment.  However, the this is very rarely seen and this will be discussed with any patients before commencing treatment.


As specialist dermatologists, we often encounter many severe cases of acne cysts that are huge, sometimes painful and most importantly frequently leave behind permanent scarring.

  • Steroid injection directly into the cysts will likely be used and this usually shrinks the cysts almost instantly within a few days.
  • Treatment after will include medical therapy to avoid the recurrence of these cysts.  Isotretinoin is frequently used for this reason.
  • We would recommend to avoid excision of these cysts as these will cause scarring (even the biggest cysts are likely going to reduce with a simple injection).  Please seek specialist dermatologists treatment before undertaking any procedures.

Acne Scarring Treatment

The general rule is that acne has to be managed medically to the point that it is clearing well before scarring is to be treated.  However, established scarring may also be treated early as it is always easier to treat fresh early scars before they become thick and difficult to manage.


  • Hypertrophic and keloid scars (common on chest, back, shoulders and jaw).
  • Atrophic scars (where tissue is lost) – this would include ice-pick scars, box scars, rolling scars

We currently offer the following options for acne scarring treatment.

Non-energy devices or treatment

  • Micro-needling for small areas scars
  • Steroid injection to reduce cysts
  • Steroid injection to reduce thickened/keloid scars
  • TCA CROSS topical surface chemical ablative therapy (excellent for ice-pick scars)
  • Needle subcision for tethered scars (where scars are bound down to deep tissue)

Low downtime energy-based devices treatment

  • Venus VIVA nano-fractionated radiofrequency treatment
  • PicoWay Resolve acne scarring treatment

Ablative laser therapy is sometimes required for deep scarring. This will require a significant downtime and frequently produce  post inflammatory pigmentation for darker skin patients.  Please note we currently do not provide these ablative laser therapy (such as CO2 or Erbium laser) .  We would liase with suitable colleagues to perform these if required.

How long does it take to clear acne?

It depends on treatment prescribed.  Some milder cases of acne can clear with topical treatment (with or without oral medications) within a few weeks.  If we prescribe oral medications (such as oral antibiotics), it is usually up to a few months to see significant benefit.

Is Isotretinoin safe?

This is one of the most frequently medications that Australian dermatologists prescribe.  While it does cause dry lips and skin in every single patient, the dangerous side effects are considered rare (such as depression, or intracranial hypertension).

Can I have Isotretinoin?

For women if you are planning to have a baby or are not using appropriate contraception,  this medication is not suitable as birth defects are possible if taken during pregnancy.  Majority of patients are able to have this treatment, but only after assessment by dermatologists for suitability of this.

Can LED therapy clear acne?

Low level light therapy (LLLT) using blue and red light can help acne, but the effect is usually temporary.  This can also be combined with photodynamic therapy (PDT) for better result.  We can also utilise Vbeam vascular laser therapy to reduce acne.  While many beauty clinics offer this as the first option of therapy, we would decide on the suitability or the effectiveness of this compared to other medical therapies according individual acne type, medical history, desired outcome and personal preference.

Can I treat acne scarring and go back to work the next day?

Yes, we provide low downtime acne scarring treatment (see below).

What are the low downtime treatments for acne scarring?

Our practices provide 2 of the most advanced low downtime treatment.  Venus Viva uses nano-fractionated radiofrequency technology to heat up the dermis while gently ablate the surface, whereas PicoWay Resolve uses fractionated Picosecond laser to create little pockets of Laser Induced Optical Breakdown (LIOB) to stimulate collagen regeneration under the scar.  Both treatments would allow patients to go back to social activity quickly as the red marks generally fade after 1-2 days.

Does Venus Viva leave behind brown marks?

Generally this does not leave behind post inflammatory hyperpigmentation, but for Asians or darker skin patients, we will do a test patch to ensure this does not happen, before treating the whole face.  (See our Venus Viva page for more details).

Does PicoWay Resolve leave behind brown marks?

Generally no.  It will produce intense red marks for a day or 2, and this will fade.  Sometimes petechiae (Very small areas of bruising) can be seen for a few days.  PicoWay is perhaps one of the least-downtime laser treatment for scarring due to the picosecond technology (See our PicoWay page for more details).

Can Venus Viva and PicoWay Resolve treat deep scars?

These low-downtime devices are more suited for superficial scars.  We will combine this with other methods such as TCA CROSS or subcision for deeper scars.  For very severe acne scars, ablative lasers may be required.

What is TCA CROSS?

This would require application of TCA (trichloroacetic acid) directly on skin.  It is easy to think about this as a strong chemical that stimulates body to produce a layer of crust on top of the skin surface, and encourage the skin to smoothen this way.   The concentration used is usually high between 70 to 90%, will produce swelling for a few days, crust for a week or 2, and then red brown marks to up to 2 months.  This is very effective for the deeper narrower (Icepicks) scars.

What is needle subcision?

Some acne scars can be felt to be tethered (bound down) to the deeper skin layer and under gentle topical anaesthesia, either a needle or cannula can be inserted just under this scar to break down this attachment.  Many patients request this treatment but this is only suitable for patients with specific scars (generally if the skin pulls with the scar, it is tethered).  Bruising is common and some times blood clots are formed.

Where can I get acne scar treated in Melbourne?

We perform majority of our laser scar treatments in our Blackburn South rooms. We are within the vicinity of Knox, Wantirna, Mitcham, Ringwood, Burwood, Glen Waverley, Mount Waverley, Kew, Camberwell, Balwyn, Doncaster, Donvale, Templestowe, Box Hill, Mont Albert and Surrey Hills, and we serve a large referral base up to Croydon, Mooroolbark, Lilydale, Boronia and Yarra Valley / Yarra Ranges wineries.

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