My client from three years ago just came back with skin that looks better than ever, but she's doing the opposite of what I told her.

So, this client, let's call her Sarah, came to me in Chicago three years ago for persistent adult acne. I put her on a solid routine with a salicylic acid cleanser, a gentle retinol, and a good moisturizer. She stuck with it for a few months and her skin cleared up, then she moved away. Last week, she walks into my studio for a visit. Her skin is glowing, no active breakouts, just really healthy. I asked what she's using now, and she said she ditched the actives completely about a year ago. She only uses a cream cleanser, a basic hyaluronic acid serum, and a thick moisturizer, plus she gets a facial massage from a different place every month. I mean, I'm happy for her, but it goes against everything I was taught about treating acne-prone skin. It makes me wonder if sometimes we push actives too hard when maybe the skin just needs a break and some serious hydration. Has anyone else had a client succeed with a super simple, non-active approach after years of more aggressive treatment?

3 comments

3 Comments

terrycraig1mo ago

Used to swear by actives for every acne case. Her results make me question if we sometimes overcomplicate things. Maybe the skin barrier just needs to heal first.

webb.daniel1mo ago

Honestly terrycraig, you might be onto something big here. Tbh a lot of derms forget that acne is basically an inflammatory disease. If the barrier is wrecked, you're just pouring gas on a fire with strong actives. Ngl, I've seen people clear up way more once they cut everything and just focused on gentle hydration for a solid month. It's like the skin needs a chance to calm down before it can fight the real problem.

the_nathan1mo ago

The inflammatory part is spot on, but calling acne just an inflammatory disease misses the mark. It's a mix of things like too much oil, bacteria, and clogged pores all feeding into that inflammation. Focusing only on calming things down can leave the root causes totally unchecked. A balanced approach that fixes the barrier while still gently managing the other factors usually works better long term.