Seven common mistakes acne sufferers make, and how to avoid them
Out of every 100 patients I see in clinic, 20–25 are acne sufferers. Despite the common misconception that acne only affects teenagers, a large proportion of my patients are in fact adults. Many of them have suffered through previous failed attempts to clear their acne, and in many cases these interventions have made things worse.
Below are the seven most common mistakes acne sufferers make, and how to avoid them:
1. Complex skincare routines
Multi-step skincare regimes have previously been associated with Korean beauty, but in the past few years, they have taken the rest of the world by storm. It is now not uncommon to see 14-year old acne patients with 10-step skincare regimes.
Companies such as The Ordinary have pioneered the use of affordable, single ingredient products (SIPs) and made scientifically backed actives affordable to all. While this concept has revolutionised accessible skincare, the use of multiple SIPs layered on the skin may not suit everyone, especially the ones among us who are prone to acne and rosacea.
Quite often, layering too many actives can result in the opposite effect, namely painful breakouts. Introducing too many actives in one go may also increase the risk of skin reactions. Keeping it simple when prone to breakouts, rather than trying too hard with your skincare routine, can often lead to better results.
2. Time spent on skincare routine per day
“Two hours per day”. This was the reply of a young female acne patient when I asked how long her skincare regime took morning and night. While this may feel like a welcome escape and time for self-care to some, it can feel like an ordeal to others. Busy women and mums will often express feelings of guilt at being unable to spend this time on their family, or conversely blame their ongoing acne on lack of time spent on their skincare!
This amount of time does not necessarily equate to clearer skin, and unfortunately can sometimes lead to an unhealthy preoccupation on what your skin does or should look like, resulting in poor self-image and self-esteem. Believe it or not, you can achieve the same, if not better, results with a 5-minute routine tailored to your skin.
3. Money spent on expensive cosmetic treatments and products
So many of my patients end up in my office after spending a small fortune in an attempt to clear their acne. Typically, this consists of purchasing multiple high-end products, or a skincare system promising to clear acne for good. Add to that repeated courses of peels, microneedling or laser therapy, and some of my patients have calculated they have spent several thousand pounds on their quest to achieve clear skin.
Persistent acne however, especially in adults, is a medical condition with a strong inflammatory component, and is often best treated simply, effectively, and permanently with personalised medical care.
This is not to say that the above treatments don’t have their time and place. On the contrary, peels, laser and microneedling can be quite useful in improving hyperpigmentation and skin texture once medical treatment has been completed. However, you shouldn’t need to continue to spend this kind of money to keep your acne clear. Additionally, while you should feel free to spend your money to buy expensive skincare if that is what you wish, nowadays there are many great skincare options for the acne-prone to suit any budget.
4. Taking advice from well-meaning family, friends, and strangers
While your family and friends have your best interests at heart, they may not understand what’s best for your skin. What has worked for other people doesn’t necessarily work for everyone, and trying many different things can sometimes make matters worse. A lot of acne sufferers feel overwhelmed by unsolicited advice, often ending up feeling more self-conscious about their skin as it is brought into sharp focus by friends, family, and colleagues.
Well-meaning advice can also sometimes be a method of perpetuating common misconceptions about the causes of acne, such as not washing your face often enough, or eating too much of a particular food type. In fact, my acne patients are some of the most health-conscious, clean-eating people I come across, and the extra guilt they amass from these third-party suggestions is something they could do without! Focusing on individual acne triggers and giving their skin a helping hand with medical treatment comes as a relief to most.
5. Giving up on treatments too soon
When taking a history on previous treatments used, I often find that my patients have only used some treatments for 3–4 weeks, if not days, before giving up on them.
This could be because they were not given a clear explanation of how long they should expect to persist with treatment before they see any results.
Often, they begin to use topical gels and creams quite generously, every day, and promptly stop them on day 3 or 4, when classical symptoms of irritation begin.
Sometimes, they don’t see the point to a topical treatment when they are already taking oral medication for their skin.
Having a clear understanding of what to expect and how to use their medication is crucial to the success of any acne treatment course. A lot of people are surprised to hear it can take a minimum of 6–8 weeks for any treatment to begin to take effect, but are happy to persist with treatment if this is set out from the very beginning. Additionally, gradual introduction of topical preparations means skin irritation can be avoided, and the treatment continued until benefits are seen.
Knowing what each component of their prescribed treatment is for, and why it is important to counteract different aspects of their acne, is also incredibly useful, as patients are then less inclined to stop them midway through a course.
6. Relying on the internet for diagnosis and treatment
Nowadays there is so much free information online about different skin conditions and their treatment, which is a undoubtably a good thing. Many skinfluencers have done a lot to normalise what it means to be an adult sufferer of acne or rosacea, by sharing their own journey as well as treatments that have helped and products that haven’t. It therefore stands to reason that it should be really simple to self-diagnose and treat your breakouts, right?
Wrong! While knowledge can be empowering, it can also sometimes lead to confusion. I often see people who think they have acne when in fact they have rosacea, and it’s not uncommon for women to think they have developed rosacea in their late thirties or early forties when in fact they have persistent adult acne. Getting the diagnosis right is the first step in their treatment path. Understanding the true nature of their condition and its subtype, as well as whether there is a tendency to scarring, or skin sensitivity, is key to formulating a personalised treatment plan for each acne sufferer, with the ultimate result being clear skin for life.
7. Focusing only on perceived triggers rather than the solution
“Is it down to my diet?” “There must be something wrong with my hormones”
These are two very common concerns brought up in acne consultations.
While it is important to rule out a hormonal imbalance in a minority of women, for example if they report symptoms suggestive of polycystic ovarian syndrome, most women will have perfectly normal hormone levels and yet can still have problematic acne. Taking hormonal contraception can be an acceptable and effective way of managing acne for some, but may mask acne for years in others, when more targeted acne treatments could have been considered.
When it comes to dietary triggers, there is some suggestion that sugar or a high glycaemic index diet can predispose to breakouts, but there is not enough evidence to recommend a particular dietary regime at the moment. In fact, most of my patients come in for a consultation having tried very healthy and, in some cases, very restrictive, diets, but continue to have acne.
In truth, there is a combination of factors that results in the “perfect storm” that is acne. When examined closely, these are innate factors that are tricky to control with simply good intentions and without some medical intervention. I would always encourage a healthy diet and avoidance of triggers that patients have personally found can break them out, but a blanket ban on certain food types can be too punishing and unrealistic, not to mention unnecessary.
There is light at the end of the tunnel
Acne is such a common condition, and, with so much free and widely available information, these seven common pitfalls may seem rather obvious to some. Unfortunately, the sheer volume of information can also be overwhelming, and people end up not knowing who to rely on for help.
Don’t despair! Instead, take active steps to clear your acne, without putting it off any longer. Aim to get the correct diagnosis by an expert, follow a simple but completely bespoke treatment plan tailored to your skin, with no fads, and you’ll be on the path to clear skin for life. For more information, see my article on the 5 Steps to Clear Skin.
I am a consultant dermatologist and founder of Dr Pratsou Dermatology, a private medical practice focusing on all things skin. In my 10 years as a dermatologist, I have treated over 25,000 patients. I am passionate about promoting skin confidence without filters. Visit my website for more information on acne and specific treatment options.
