Volume Two: Understanding Skin Concerns

Chapter One

Acne Explained: Why Acne Happens at Every Age

“Acne isn’t simply a skin problem—it’s a condition influenced by hormones, inflammation, bacteria, oil production and your skin barrier.”

Acne is one of the most common skin conditions in the world.
Yet it’s also one of the most misunderstood.
Many people believe acne happens because their skin is dirty.
Others think chocolate, poor hygiene or not washing enough is the cause.
In reality, acne develops because of several biological processes happening within the skin—not because your skin isn’t clean.
Understanding why acne develops is the first step towards managing it successfully.

What Is Acne?

Acne is a chronic inflammatory skin condition affecting the hair follicle and sebaceous (oil) gland.

It develops when pores become blocked with a combination of:

• Excess oil (sebum)

• Dead skin cells

• Bacteria

• Inflammation
• This blockage can develop into different types of acne lesions.

Different Types of Acne

Not every breakout is the same.
Common types include:

• Blackheads (Open Comedones)
• Blocked pores that remain open, allowing the contents to oxidise and appear black.
• Whiteheads (Closed Comedones)
• Blocked pores trapped beneath the skin.
• Papules
• Small red inflamed bumps without pus.
• Pustules
• Inflamed pimples containing visible pus.
• Nodules
• Large, painful inflamed lesions deep beneath the skin.
• Cysts
• Deep inflammatory lesions that often lead to scarring if untreated.

Why Does Acne Develop?

Acne usually develops because several factors occur together.

1. Increased Oil Production

Hormones stimulate the sebaceous glands to produce more oil.
This is why acne commonly appears during puberty but can also occur during adulthood.

2. Dead Skin Cells Build Up

Normally skin cells shed naturally.
When they don’t shed efficiently, they accumulate inside pores and combine with oil.
This forms congestion.

3. Bacterial Overgrowth

A naturally occurring bacteria called Cutibacterium acnes (formerly Propionibacterium acnes) lives on everyone’s skin.
When pores become blocked, this bacteria multiplies inside the follicle, contributing to inflammation.

4. Inflammation

Inflammation plays a significant role in acne.
Even before a pimple becomes visible, inflammatory processes have often already begun beneath the skin.

Acne Isn’t Just A Teenage Problem

Although acne commonly begins during puberty, many adults continue experiencing acne well into their 20s, 30s, 40s and beyond.

Adult acne is increasingly common, particularly in women.

Contributing factors include:

• Hormonal fluctuations

• Stress
• Pregnancy

• Perimenopause

• Certain medications

• Genetics

• Cosmetic products

• Barrier damage

Why Does Hormonal Acne Look Different?

Hormonal acne often develops around:

• Chin
• Jawline
• Neck

It frequently worsens before menstruation and may fluctuate with pregnancy or menopause.

Hormonal acne often requires a different treatment approach than teenage acne.

Does Diet Cause Acne?

Diet alone rarely causes acne.

However, some evidence suggests certain foods may contribute to breakouts in susceptible individuals.

These may include:

• High glycaemic diets

• Excess refined sugars

• Some dairy products (particularly skim milk)

Diet is usually one contributing factor—not the entire cause.

Common Acne Myths

Acne is caused by dirty skin.
False.
Over-cleansing often makes acne worse by damaging the skin barrier.

Sun exposure clears acne.
Temporary drying may occur, but UV damage often worsens pigmentation and inflammation over time.

Toothpaste helps pimples.
No.
Toothpaste can burn and irritate the skin.

You should pop pimples.Squeezing acne increases inflammation, infection risk and the chance of permanent scarring.

Treating Acne Successfully

Successful acne treatment depends on identifying the underlying cause.
Treatment may include:

• Appropriate cleansing
 
• Barrier repair

• Salicylic Acid (BHA)

• Retinoids (Vitamin A)

• Azelaic Acid

• Benzoyl Peroxide (where appropriate)

• Professional chemical peels

• LED Light Therapy

• Professional skin treatments

• Medical management when required
  

There is rarely one single product that “cures” acne.

Consistency is far more important than intensity.

Professional Guidance Matters

Many people spend years trying product after product without understanding why their acne persists.

At The Skin Code, we focus on identifying the biological drivers behind your acne before recommending treatment.

This creates healthier skin—not simply temporary improvement.

Frequently Asked Questions

Does oily skin always mean acne?
No.

Many people produce excess oil without developing acne.
Acne develops when oil combines with congestion, bacteria and inflammation.

Can adults suddenly develop acne?
Yes.
Hormonal changes, stress, medications and lifestyle changes can all trigger adult acne.

How long does acne treatment take?

Most treatments require at least 8–12 weeks before significant improvement is seen.
More severe acne may take several months to manage effectively.

Will acne scars disappear?

Some superficial marks fade naturally.
Deeper scars often require professional treatments such as microneedling, laser or collagen-stimulating therapies once active acne is controlled.

Continue Your Skin Journey

Understanding acne is the first step—but not all breakouts are caused by acne alone.
Many skin concerns that look similar have completely different causes and require different treatment approaches.

Next Chapter: Pigmentation — Melasma, Sun Damage & Post-Inflammatory Pigmentation

Discover why pigmentation develops, why some dark marks fade while others persist, and how to treat pigmentation safely without triggering further skin damage.

Or, if you’re experiencing persistent breakouts, Book a Skin Consultation at The Skin Code and let our experienced clinicians develop a personalised treatment plan based on your skin, lifestyle and long-term goals.