Understanding acne

Acne happens when dead skin cells and oil build up and become trapped in the hair follicle (pore). It can show up in a few different ways:

• Blackheads: an open, blocked pore. The dark colour comes from oxidised melanin, not dirt.
• Whiteheads: a closed, blocked pore that shows as a small white bump.
• Papules: small, tender red bumps under the skin, sometimes called blind pimples.
• Pustules: a papule with a visible pus-filled head.
• Nodules: large, firm, painful lumps deeper in the skin.
• Cysts: large, painful, pus-filled lumps beneath the surface.

Skin cells naturally renew over roughly 28 days, moving up from the deeper layers to the surface to be shed. In acne-prone skin this process can speed up, so more dead cells build up and stay in the pore.

Oil (sebum) is important for healthy skin, but too much oil, or oil of a thicker quality, mixes with these cells to form a sticky plug. If the pore stays open, it oxidises into a blackhead. If skin grows over it, it becomes a whitehead.

As oil keeps building, the pore can become inflamed. C. acnes bacteria, which lives on all skin, thrives on oil and can lead to pustules, or to deeper inflammation that forms nodules and cysts.

It's worth knowing that acne doesn't always look oily. Some acne-prone skin is actually very dehydrated, with a build-up of dry cells on the surface.

• Genetics: your genes can influence acne and how severe it is, but family members can have very different skin experiences.
• Stress: stress hormones like cortisol can increase inflammation and affect how your skin responds.
• Hormones: hormonal changes can increase oil production and cell turnover. Acne is common well beyond the teenage years, particularly in women in their 20s to 40s.
• Environment: changes in season, humidity and air quality, as well as some skincare or makeup ingredients, can contribute to congestion.
• Gut health and diet: high-sugar diets have been linked with increased oil production, and gut health can be reflected in the skin. Balance is the goal, not restriction.

Every plan is tailored after a skin consultation, but these are the treatments we most often use for acne and congestion:

• BioRePeel: a peel with minimal visible peeling that can help with congestion, oiliness and skin texture, suitable all year round.
• Ultraceuticals peels: layered peels tailored to your skin on the day. AHA peels help loosen the bonds between dead cells so they lift away more easily. Expect some mild redness, dryness or flaking for a few days, and plan to avoid sun exposure the week after.
• Mesoestetic peels: targeted peels, including formulas designed for blemish-prone skin.
• DMK enzyme therapy: a customised program that works to strengthen the skin and help bring deeper congestion to the surface so it can be managed. For acne, we recommend a course of treatments.
• LED light therapy: a gentle, no-downtime treatment that can help calm inflammation and support healing, either on its own or alongside other treatments.
• Intraceuticals Oxygen Facial: a gentle, hydrating treatment that infuses a serum into the skin using pressurised oxygen. It's cooling and calming, and the Clarity serum is designed for breakout-prone skin.

Once active breakouts are under control, we can look at the marks and texture they may leave behind:

• Skin needling: not suitable for active acne, but may help improve the appearance of acne scarring and texture by stimulating the skin's natural collagen production. We usually recommend at least 4 treatments, 4 to 6 weeks apart.
• Laser Genesis: a gentle laser that may help improve the appearance of redness, texture and post-breakout marks, with no downtime.