• therapyinc

Acne, the basics…

Updated: Jan 17

A very quick overview of chronic inflammation of the hair follicle & intervention.


4 main factors of influence

  • Increased sebum production

  • Abnormal follicular hyperkeratinisation (build up of skin cells)

  • Colonisation of skin bacteria (‘P’ & ‘C’.acnes)

  • Inflammation


Managing acne is about controlling the bacteria buried in the hair follicle, as well as on the skin surface. Their presence, & consequential metabolic activity (what they eat & poo), produces additional fatty acids that attract & feed friends they invite to the party.


In balance they form part of our protective acid mantle & love sebum (of which our lipophilic pores are), but stripping away all oil compromises barrier function adding to inflammation.


Testosterone stimulates an increase of sebum level. For women & teens experiencing hormone fluctuations, it overwhelms the drop in progesterone oestrogen. Gals, look out for days 18-21 & introduce salicylic acid based products.


Regulation is more fluid with exfoliation, giving a clear pathway of oil & detritus to the surface, where bacteria is more easily taken care of. This is your essential line of defence, cleansing deals with the lipids, exfoliation, the protein. You have to find a way of exfoliating very regularly, if only with a flannel in your twice daily cleanse, preferably with something enzyme based (papain & bromelain are lightening, tightening & brightening !)


Maskne, a variation of acne mechanica (often experienced by sporty types on the forehead), is exacerbated by heat & moisture, but also potentially an unsuitable moisturiser. Continuing to trap that in a mucky mask creates a vicious cycle (one brief wear & wash). For this & milia (trapped sebum under superfluous skin cells) either switch to a lighter hyaluronic based lotion, it might be preferable to trial no moisturiser on confined areas if acne is serious. If you have a performing routine that under normal circumstances makes your skin feel conditioned (it might be time to reassess that) take action with the right treatment product. Caveat, acne could require antibiotics, & Accutane is the very last resort for grade 6 acne.


Hydroxy acids are helpful resurfacers, but act in different ways & depths. The smaller the molecule, the faster penetration & sensation felt on the skin. This is no indication of whether it’s ‘better’ for your particular skin concern or more effective. It may also feel a little sharper with more physical or neurological activity in the area. For example - impaired skin barrier if you’re dehydrated, change in pH with introduction of water, stress inducing cortisol or good ol’ female hormones.


Pryruvic gentle & antimicrobial

Mandelic inhibits tyrosinase (pigment)

Glycolic fades post inflammatory pigmentation

Salicylic decongests & anti-inflammatory


Retinol purges the skin & encourages cellular turnover

Benzoyl Peroxide coverts anaerobic bacteria hosting environment to an aerobic one

Charcoal anti-inflammatory & superior absorption

Beta glucan skin mending


There’s a lot you can be doing at home before you jump into an extraction session or a peel. Leave the former to the pros, very effective peels are available for home use, but please get advice on a program. Have a consistent, active skin care regime, designed to regulate the flow of oil & reduce inflammation first though. And while we’re at it, anything that comes into contact with your skin needs to benefit it (… not a fug of hairspray or deodorant) & as clean as your pants. When you put them on.


Housekeeping. Apologies if these are obvious…

  • Flip your pillow alternate nights, swap on the third.

  • Regularly antibac wipe your phone.

  • Clean hair, & that could mean a daily wash.

  • Watch out for shower gel & shampoo, detergents aren’t skin friendly.

  • And hair products that can wick or be sprayed onto your face.

  • Wash makeup brushes / applicators weekly & alternate a selection.

  • Anything with paraffin liquidium needs to go in the bin.

  • Tone to keep your skin hydrated, conditioned & pH balanced.


And finally, don’t squeeze or pick. Apart from exploding infection through the walls of the hair follicle (making it an up hill task for your immune system to deal with,) post inflammatory pigmentation & scaring may never go after the spots are forgotten.


Consultations available (virtually when we are closed), please email for details.


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