Acne

Acne develops when pores become clogged with oil and dead skin cells and then become inflamed. Hormones play a major role, particularly androgens, which increase oil production. Genetics, stress, certain skincare products, medications, and inflammation all contribute. Acne is not caused by poor hygiene, and over-washing or harsh scrubs often make it worse.

Adult acne is extremely common and is often driven by hormonal sensitivity and inflammation, rather than hygiene. Many adults, especially women, experience acne into their 30s, 40s, and beyond. Jawline and chin breakouts are particularly suggestive of hormonal acne. In these cases, treatment often needs to address both clogged pores and hormonal influence.

Effective acne treatment usually combines therapies that target different pathways:

• Daily Acne Cream (clindamycin + benzoyl peroxide + niacinamide) to reduce acne-causing bacteria and calm inflammation.

• Nightly Acne Cream (tretinoin + niacinamide) to prevent clogged pores and improve skin texture over time.

• Daily Acne Wash (benzoyl peroxide) to support bacterial control as part of a routine.

Treatment plans are personalized based on acne type, severity, and skin tolerance.

Oral medications may be used for more inflammatory or persistent acne, or when topical treatments alone aren’t enough.

• Doxycycline may be used to reduce inflammation when clinically appropriate.

• Spironolactone is commonly used for female hormonal acne, particularly when breakouts are hormonally driven.

Your dermatologist determines whether oral therapy is appropriate based on your history and goals.

Most acne treatments take 6–8 weeks to show noticeable improvement, with continued improvement over several months. Retinoids like tretinoin work gradually to prevent new breakouts, while antibacterial treatments can calm inflamed lesions sooner. Stopping treatment too early is one of the most common reasons acne doesn’t improve.

Yes. Treatments that increase cell turnover, especially tretinoin in the Nightly Acne Cream, can cause a temporary increase in breakouts as clogged pores surface. This “purging” phase typically lasts 2–6 weeks and is different from irritation or an allergic reaction. Starting slowly and moisturizing can help reduce discomfort.

A simple routine works best:

• Gentle cleanser or Daily Acne Wash if tolerated

• Non-Comedogenic Moisturizer (if needed)

• Sunscreen during the day

• Targeted treatment (for example, Daily Acne Cream in the morning and Nightly Acne Cream at night, depending on your plan)

Over-exfoliating, scrubbing, or using too many active products often worsens acne.

Diet can influence acne for some people, particularly high-glycemic foods, dairy, whey protein, and chocolate, but diet alone is rarely the main cause. Acne is primarily hormonally and genetically driven. Dietary changes may help some patients but usually work best alongside medical treatment.

Acne often returns toward baseline if treatment is stopped, especially for hormonally driven acne. Many patients think of acne treatment as maintenance, similar to managing other chronic skin conditions.

Often, yes. Teledermatology works very well for acne because diagnosis and treatment decisions can usually be made based on history and photos. In-person evaluation may be recommended for severe acne, scarring, or acne that does not respond to standard treatment.

If acne is severe, rapidly worsening, painful, or causing scarring, in-person evaluation is recommended.