By Dr. Rajat Kandhari — MD Dermatology (Gold Medalist), MSc Non-Surgical Facial Aesthetics (Distinction, UK), Medical Director, Dr. Kandhari’s Skin Clinic, Greater Kailash-1, South Delhi
Acne is one of the most undertreated skin conditions in South Delhi — not because people are not trying to treat it, but because most of what gets sold as acne treatment is not actually treating it. Facials do not treat acne. Most over-the-counter spot creams do not treat acne. Stripping the skin with harsh cleansers does not treat acne. What those things do is address surface symptoms temporarily while the underlying drivers — excess sebaceous gland activity, hormonal triggers, bacterial colonisation, and follicular blockage — continue unchecked beneath the surface.
I see this pattern constantly at my clinic in Greater Kailash Part-1. Patients arrive having spent months — sometimes years — cycling through pharmacy creams, salon facials, and online-recommended regimens, while the acne keeps returning. By the time they reach a dermatologist for proper acne treatment in South Delhi, many have also developed scarring that could have been prevented with earlier intervention. The good news is that with the right clinical approach, almost all acne responds. The key is understanding exactly which type of acne you have — and matching the treatment accordingly.
The Four Types of Acne — and Why the Distinction Changes
Everything
Not all acne is the same, and not all acne responds to the same treatments. This is the single most important clinical point that separates effective acne treatment from guesswork. The four main categories are:
1. Comedonal Acne
Comedonal acne presents as blackheads and whiteheads — blocked follicles without active infection. It is caused by the accumulation of sebum, dead skin cells, and debris inside the pore. This type responds well to retinoids and chemical exfoliants — particularly salicylic acid, which is oil-soluble and penetrates the pore lining effectively. Comedonal acne is often undertreated because it seems mild — patients wait until it becomes inflamed before seeking help, by which point it is harder to manage.
2. Inflammatory Acne
Inflammatory acne presents as red papules and pustules — the classic ‘pimples’ with visible infection and swelling. It involves Cutibacterium acnes (formerly Propionibacterium acnes) bacteria colonising blocked follicles and triggering an immune response. Treatment requires antimicrobial intervention — topical or oral — alongside agents to reduce inflammation and follicular blockage. A short course of antibiotics combined with a retinoid and benzoyl peroxide is a standard first-line approach for moderate inflammatory acne treatment
3. Hormonal Acne
Hormonal acne is one of the most commonly missed diagnoses in adult women presenting to clinics across South Delhi. It typically presents along the jawline and chin, worsens cyclically in the week before menstruation, and often does not respond adequately to standard topical or antibiotic treatment — because those approaches address bacteria and blocked pores, not the hormonal driver.
The underlying mechanism involves androgens stimulating sebaceous gland activity, producing excess oil that feeds the acne cycle. In women with polycystic ovarian syndrome (PCOS), the hormonal imbalance is often more pronounced. Effective treatment of hormonal acne treatment requires addressing the hormonal trigger — through anti-androgen agents, hormonal contraceptives where appropriate, or oral isotretinoin for severe cases — not simply repeating antibiotic courses that provide temporary relief followed by relapse.
4. Cystic Acne
Cystic acne is the most severe form — deep, painful, nodular lesions that carry the highest risk of permanent scarring. Topical products alone are almost never sufficient for cystic acne treatment. Oral isotretinoin (Accutane) is typically required — a Vitamin A derivative that reduces sebaceous gland size and output dramatically. It requires dermatologist supervision, baseline blood tests, and careful monitoring throughout the course. For Fitzpatrick type IV–VI Indian skin, isotretinoin protocols require specific attention to sun protection and post-acne pigmentation management during and after treatment.
What Dermatologist-Led Acne Treatment Actually Looks Like
At the first consultation for acne treatment in South Delhi at our clinic, I take a detailed history before examining the skin: when did the acne start, is it cyclical, what has been tried and for how long, what medications are currently being taken (several common drugs trigger or worsen acne), diet and lifestyle patterns, and stress levels. I examine the skin carefully — looking at the type, distribution, severity, and depth of lesions, the skin cell cycle health, and any early scarring that needs to be factored into the treatment plan.
Treatment is then designed as a programme — not a single product or single session. A typical programme for moderate inflammatory acne in an adult South Delhi patient might involve: a prescription topical combining a retinoid with an antimicrobial agent, a short oral antibiotic course to bring active inflammation under control quickly, a rationalised skincare routine (most patients are over-cleansing or using multiple products that are counterproductive), and a course of in-clinic procedures every three to four weeks to accelerate clearance and prevent scarring.
In-Clinic Procedures for Active Acne
1. Chemical Peels for Acne
Medical-grade chemical peels for acne use concentrations of salicylic acid, glycolic acid, mandelic acid, or combination formulations that are not achievable with at-home products. They exfoliate the skin surface and — critically — the inside of the pore lining simultaneously, clearing both surface blockages and the follicular congestion that drives breakouts. A well-designed peel programme also reduces post-acne pigmentation and improves overall skin tone between sessions. Most patients complete a course of four to six peels spaced three to four weeks apart. Full details on our treatment approach are available on the Chemical Peel Treatment page.
2. Carbon Laser Toning
Carbon laser toning — sometimes called the Hollywood peel — applies a liquid carbon solution across the skin before a Q-switched NdYAG laser passes over the surface. The laser vaporises the carbon, removing dead skin cells, excess sebum, and surface bacteria in a single pass while delivering controlled thermal energy into the pores to shrink sebaceous glands and reduce oil production. It is particularly effective for patients with oily, congested skin and persistent comedonal or mild inflammatory acne who have not responded adequately to topical management alone. No downtime. Full details on our Carbon Laser Toning page.
3. Acne Clarity Protocol
For patients with persistent, moderate-to-severe, or complex acne, we use a structured multi-treatment programme that integrates medical management with procedural treatments at defined intervals — the Acne Clarity Protocol. This ensures the skin is being treated simultaneously at the medical level (topical + oral) and the procedural level (peels or laser), producing significantly faster and more sustained clearance than either approach used alone. Read more about this programme on our Acne Clarity Protocol page.
Acne Scarring: Why Early Intervention Changes the Outcome
Every time a deep or inflammatory acne lesion heals, it leaves behind altered skin architecture — either a depressed scar (atrophic), a raised scar (hypertrophic or keloid), or a flat pigmented mark. The atrophic scars — ice pick scars, boxcar scars, and rolling scars — are the most common consequence of moderate-to-severe acne and represent permanent structural damage to the dermal matrix.
The earlier these are treated, the better the outcome. Scars treated within the first six to twelve months of formation — before the collagen reorganisation fully matures and hardens — respond significantly better to CO2 fractional laser, MNRF, and TCA CROSS than scars that have been present for years. If you are currently managing active acne and are already noticing early marks or depressions forming, this is the time to discuss a phased treatment plan that addresses both. See our full Acne Scar Treatments page for the complete range of scar procedures available.
Realistic Timelines: What to Expect and When
Acne treatment takes time — and this is the single piece of information most patients either are not given or do not believe. The skin cell cycle is approximately 28 days, which means that any treatment — topical or procedural — needs at least six to eight weeks before a meaningful clinical assessment can be made. A retinoid that appears to be doing nothing at two weeks may be producing exactly the cellular changes it is supposed to produce, which will become visible at weeks six to eight. Stopping it at week two is the most common patient error in acne management.
For moderate inflammatory acne, a well-managed treatment programme typically produces significant improvement at the 8–12 week mark, with near-clearance at 16–20 weeks. Cystic acne managed with isotretinoin typically clears over a five to six month course, with results that last for years or permanently in many patients. Hormonal acne may require longer management while the hormonal driver is being addressed. I provide a clear, week-by-week expectation at every consultation — so that patients do not abandon treatments that are working simply because the skin looks worse before it looks better.
Patients from across South Delhi — from Greater Kailash to GK-1 and across to Hauz Khas, Defence Colony, and Lajpat Nagar — attend the clinic for structured, evidence-based acne care. The common thread in those who achieve the best outcomes is consistency with the prescribed plan and realistic expectations about what the first few weeks will look like. The skin often gets slightly worse during the initial retinoid adjustment phase — this is normal, expected, and a sign the treatment is working, not failing.
Frequently Asked Questions
Common questions about acne treatment in South Delhi — from identifying acne type to what in-clinic procedures involve.
Q1. What is the best acne treatment for Indian skin?
The best approach depends on the type and severity of acne. For mild-to-moderate acne on Fitzpatrick type IV–VI Indian skin, a combination of a retinoid, salicylic acid cleanser, and a course of chemical peels produces strong results with low risk of post-inflammatory hyperpigmentation. For hormonal acne, addressing the hormonal driver is essential. For cystic acne, oral isotretinoin under dermatologist supervision is usually required. A dermatologist assessment establishes which category applies and designs the appropriate programme.
Q2. How many sessions of chemical peels are needed for acne?
Typically four to six sessions of chemical peels spaced three to four weeks apart, alongside consistent topical management. The peel depth and formulation are adjusted based on skin response and acne type at each session
Q3. Is carbon laser safe for acne-prone Indian skin?
Yes. Carbon laser toning is specifically well-suited to Indian skin because it is non-ablative — it does not break the skin surface — making it low-risk for post-inflammatory hyperpigmentation in darker skin tones. It reduces sebum production, clears pore congestion, and is effective for oily and acne-prone skin across Fitzpatrick type IV–VI
Q4. Why does my acne keep coming back after antibiotics?
Antibiotics address the bacterial component of acne but not the underlying drivers — excess sebaceous gland activity, hormonal influence, or follicular blockage. When the antibiotic course ends, these drivers resume, and the acne returns. Effective long-term management requires a plan that addresses all contributing factors — not repeated antibiotic courses, which also carry the risk of antibiotic resistance with prolonged use.
Q5. At what age does acne usually stop?
Acne is common in adolescence but frequently persists into adulthood. Hormonal acne in women can persist into the 30s and 40s. Cystic acne does not resolve on its own without treatment. There is no reliable age at which acne ‘stops’ — if it is not being treated effectively, the correct response is a dermatologist assessment, not waiting.
Q6. Can I treat acne and acne scars at the same time?
In most cases, active acne needs to be stabilised before scar treatment procedures (laser, MNRF, TCA CROSS) are begun — because treating scars in actively inflamed skin risks worsening inflammation and scarring further. However, medical management of both can be planned simultaneously in a phased approach. Early scarring can often be addressed with peels and lower-intensity procedures while active acne is still being managed. Full scar treatment details are on our Acne Scar Treatments page.
Q7. How long does it take to see results from acne treatment?
Meaningful improvement is typically visible at six to eight weeks. The skin cell cycle is approximately 28 days — any treatment needs at least one full cycle before its effects become apparent. Patients on isotretinoin see significant clearing at eight to twelve weeks. Most combination treatment programmes produce near-clearance at sixteen to twenty weeks. Consistency with the prescribed plan throughout this period is the most important variable in the outcome.
Q8. Where is Dr. Rajat Kandhari’s clinic located in South Delhi?
The clinic is at S-79, Greater Kailash Part-1, New Delhi 110048. Easily accessible from GK-1, GK-2, Hauz Khas, Defence Colony, Green Park, Lajpat Nagar, Malviya Nagar, and Saket — all within a 10 to 15 minute drive. Open Monday to Saturday. Book by calling or WhatsApp on +91 9315479193.