Most patients walk into our consultation room with a tote bag of skincare. Three serums, two cleansers, a salicylic toner, a benzoyl peroxide spot treatment — and acne that won't sit still. Recurrence is rarely about which product. It's almost always about the pattern.
The four things we check first
Before we change anything in the routine, we ask:
- Does it flare with your cycle, or sit on your jaw and chin? Hormonal acne behaves differently and needs a different protocol.
- How much dairy is in your week? We don't blame food, but the link between dairy and inflammatory acne is well-documented and often the easy fix.
- How often do you change your pillowcase? When did you last clean your phone screen? Boring answers — but real triggers in our experience.
- Did you actually finish the last prescription? Most patients stop the moment skin clears. Stopping early is the #1 reason acne returns within weeks.
Acne is a 12-week protocol. Most patients judge it at week 3 and give up. By then the bacterial load is down, but the inflammatory cycle hasn't reset.
When the cream IS the problem
There are three scenarios where the prescription itself needs to change:
First — the active doesn't match the type of acne. Benzoyl peroxide is great for inflammatory papules but does very little for closed comedones (those small, deep bumps). A retinoid is the answer there. Hormonal acne usually needs an oral component, not just topicals.
Second — too many actives at once. We see patients layering retinoids, AHAs, BHAs, vitamin C, niacinamide and a peptide cream every night. The skin barrier is wrecked. Inflammation goes up. Acne worsens. Less is almost always more.
Third — stopping at clear, not at stable. Skin clears at week 8. It stabilises at week 16. The maintenance phase between those two is non-negotiable for most patients.
What we typically do at the clinic
For moderate inflammatory acne we usually combine: a single targeted topical (chosen based on the acne type), a structured cleansing routine, and one or two in-clinic procedures — chemical peels, comedone extraction, or a course of LED therapy depending on the case.
We schedule the first follow-up at 4 weeks, not 8. Patients lose faith between week 3 and 6, and that's when an in-person check-in matters most. By month three, most cases are visibly better. By month four, we know whether we're maintaining or escalating.
If you've been on rotation for more than a year — different creams, different brands, no plan — book a consultation. We'll start with diagnosing the type, not picking the next product.
Found this useful?
