Nicole Hangsterfer, PA-C
Mar 31, 2021 · 8 min read
You’re doing everything right, and you still have acne. Frustrating, we know—but patience is key.
The time it takes acne to go away can vary from person to person. Even after you’ve found a treatment that works, you may need to keep using it for maintenance. In most cases, we must keep treating acne until the natural tendency to break out has passed. How long that is, however, varies. There isn’t an exact timeframe, and many people will experience an occasional pimple or blackhead from time to time, even when they’re no longer consistently breaking out.
But never give up on taking care of your skin! We like to think of skincare as a journey, not a destination. Of course, when your patience and effort aren’t yielding the clear skin you hoped for, it’s time to troubleshoot your skincare routine—so let’s get started.
Your acne may stick around (or keep coming back) because different factors can contribute to skin problems—stress, sleep, diet, hormonal fluctuations, etc.
It’s hard to tell when your acne will be gone. Because even if your acne clears up, you might still experience mild acne now and again—that’s because breakouts have many potential triggers. Here are some more common reasons your acne might be sticking around:
Hormonal fluctuations. If you’re going through puberty, menstruation, pregnancy, or menopause, your body is experiencing substantial hormonal changes. Sometimes the only way around something is through—hormonal fluctuations are one of those things.
Stress. Stress is not a direct cause of acne, but stress releases hormones that can lead to breakouts.¹ New research shows that stress may upset our gut microbiota, potentially contributing to breakouts.² A lack of sleep can also lead to a stress response, so be sure to get your nightly zzz’s!
Diet. For some people, it may help to decrease the amount of sugar they eat. Studies show that a low-glycemic diet can improve outcomes with acne treatment.³ A diet rich in omega-3 fatty acids, like salmon, may also have a positive effect on acne treatment.⁴
Genetics. In this case, the credit goes to Mom and Dad. One study looked at adults with acne and found that 50% of those patients had a first-degree relative with post-adolescent acne lesions.⁵ While there isn’t a specific “acne” gene (at least that we know of!), there may be genetic factors that predispose you to acne.
Medications. Several classes of medications can lead to or aggravate acne. This includes certain hormonal medications, like various birth control pills, but others that affect the immune system or stimulate insulin or insulin-like growth factor may also have an effect.⁶,⁷
Psst…there’s no need to wait to deal with acne scars.
Did you know that using certain skincare products too often or in excessive quantities may lead to or increase acne breakouts? In the case of acne, too much of a good thing may have harmful side effects (like irritation and breakouts).
Another common mistake newbies to acne treatment make is using too many products at once, like salicylic acid and alpha hydroxy acids—both remove dead skin cells—or benzoyl peroxides and salicylic acid. Benzoyl peroxide kills the bacteria that contribute to acne. These products can be safely used together, but it’s generally best to go slowly and incorporate one product at a time when first starting out. At Curology, we recommend that you temporarily stop using benzoyl peroxide when you begin your Curology Custom Formula to minimize the chance of irritation.
Stick to the stuff that works, and steer clear of products that contain comedogenic ingredients that may clog pores. And, above all else, be kind to the surface of your skin.
Believe it or not, some skin conditions look a lot like acne, but they’re not. For these conditions, you might need to see a medical provider for treatment.
Skin conditions that can mimic acne but are not acne include:
Rosacea, is a condition that can cause frequent facial redness, usually on your nose and cheeks. Acne-like breakouts may also appear.
Keratosis pilaris, is a condition that causes redness and sandpapery bumps and usually appears in children or young adults. Often someone in your family will also have keratosis pilaris.
Perioral dermatitis, is a condition that causes itchy or painful small red bumps to occur around the mouth, nose, or eyes. Patience is key when treating this condition!
If you feel like you’re never going to reach your skincare “after,” don’t despair! It’s easy to compare ourselves to others when we scroll through our Insta feeds and see flawless skin everywhere we look—but don’t give up hope.
Remember, skincare is a journey. Sure, there’s a “before” and an “after,” but there’s also a “now.” Your skin will stick with you for as long as you live, so patience and persistence can pay off!
It can be helpful to track your progress with selfies that you take just for you (no flattering angles required). All you need is a camera and some good lighting. Your Curology dashboard has a handy dandy photobooth you can use to keep track of your progress.
Before you give up and surrender to the incurable skin blues, these three tips may help:
Talk to a licensed dermatology provider. Your provider can assess your treatment and see if it needs to be tweaked. If you’re a Curology member, you can consult with your provider anytime.
Stick to a consistent skincare routine. Unfortunately, frequent changes to your routine won’t bring any quick fixes. Keep your routine simple and stick with it for at least two months!
Look for breakout triggers. First and foremost: Use moisturizers, cleansers, and creams free of ingredients that clog pores. After that, look to other factors that might contribute to breakouts—it might be as simple as swapping in a clean pillowcase or mask.
If you think your hormones or diet are playing a role, you may want to consult a medical provider to see if you can make any changes to help your skin and overall health.
Many Curology patients start seeing results within the first four to eight weeks of starting their new skincare routine. That means it can take up to two months to assess if acne medications like your Curology formula work for you. Don’t forget: Many people will still experience an occasional acne blemish from time to time, even when they’re no longer consistently breaking out.
It may be time to consider other options when your breakouts don’t respond to the usual forms of prescription treatment (e.g., topical medications and oral antibiotics). In this case, your provider may recommend isotretinoin, commonly known by its former brand name, Accutane. (We don’t prescribe isotretinoin here at Curology, so you’ll need to make an appointment with an in-person dermatologist to find out if this medication is right for you.)
The good news is that the treatments offered by Curology help most acne patients. In fact, more than nine out of 10 Curology members see clearer skin within 90 days.* We strive for consistent improvement over time and help with any “bumps” in the road that may come up (excuse the pimple pun)!
That said, Curology and other prescription topical treatments help most acne, but not all. In these cases, your Curology provider may recommend seeing an in-person dermatologist to consider other options. We want you to be happy with your care, which means being honest and transparent about all of your available treatment options.
Feel free to sound off in the comments if you have more questions or reach out to your Curology provider. If you’re not already a Curology member, you can get your first month of custom prescription skincare for free (just pay $4.95 to cover shipping and handling).*
Potentially! There may be specific genetic factors that can leave your skin more vulnerable to acne.
For some people, yes! High glycemic foods (like sugar and simple carbs) and dairy can lead to breakouts in some people.
This varies for males and females,⁸ but hormonal events like puberty, menstruation, pregnancy, and menopause can worsen acne.
If you experience breakouts frequently, you might have acne-prone skin.
If you have severe acne, acne that leaves depressed scarring, or recurring breakouts despite treatment, consider seeing a medical provider. Trained dermatology providers can help you where over-the-counter products and home remedies fall short.
Zari, S., et al. The Association Between Stress and Acne Among Female Medical Students in Jeddah, Saudi Arabia. Clinical, Cosmetic, and Investigational Dermatology. (2017, December 5).
Lee, Y.B., et al. Potential Role of the Microbiome in Acne: A Comprehensive Review.Journal of Clinical Medicine. (2019, July).
Mahmood, S.N., et al., Diet and Acne Update: Carbohydrates Emerge as the Main Culprit. Journal of Drugs in Dermatology. (2014, April).
Baldwin, H., et al. Effects of Diet on Acne and Its Response to Treatment.American Journal of Clinical Dermatology. (2021, January).
Goulden, V., et al. Post-adolescent Acne: A Review of Clinical Features. British Journal of Dermatology. (1997, January).
Momin, S.B., et al. A Status Report on Drug-associated Acne and Acneiform Eruptions. Journal of Drugs in Dermatology
Pontello, Jr., R., et al. Drug-induced Acne and Rose Pearl: Similarities. Anais Brasileiros de Dermatologia. (2013, November/December).
Skroza, N., et al. Adult Acne Versus Adolescent Acne. Journal of Clinical and Aesthetic Dermatology. (2018, January).
This article was originally published on March 31, 2022, and updated on July 11, 2022.
* In a clinical trial of 150 Curology patients. 95% saw improvement after 12 weeks. Self-reported.
* Subject to consultation. Subscription is required. Results may vary.
Nicole Hangsterfer, PA-C
Nicole Hangsterfer, PA-C