Acne & Acne Scarring

Breakouts, hormonal acne, clogged pores, acne marks & scarring

Acne is one of the most common skin conditions, and it doesn't just affect teenagers. Many adults experience persistent breakouts, congestion or hormonal acne well into their 30s, 40s and beyond.

Even after active acne has settled, it can leave behind pigmentation, redness or changes in skin texture.

At Peau Skin Health, I take an individual approach to treating acne and its effects. Understanding what's causing your breakouts, and whether you're dealing with active acne, post-acne marks or scarring, is essential when choosing the right treatment.

What is acne?

Acne is an inflammatory skin condition involving the hair follicles and sebaceous (oil-producing) glands.

It develops when several processes occur together:

Increased sebum production.
A build-up of skin cells within the follicle.
Changes in the activity of Cutibacterium acnes, a bacterium naturally present on the skin.
Inflammation within and around the follicle.

These processes can lead to blackheads, whiteheads, inflamed spots and, in more severe cases, deeper nodules or cysts.

Although acne is often associated with oily skin, you can have acne and still have dry, dehydrated or sensitive skin.

Different Types of Acne & Post-Acne Concerns

Comedonal Acne & Congestion

Comedonal acne is characterised by blackheads and whiteheads rather than predominantly inflamed spots.

Blackheads are open comedones, where material within the follicle becomes exposed to air and darkens through oxidation.

Whiteheads are closed comedones, where the follicle remains blocked beneath the skin's surface.

This type of acne may respond well to carefully selected skincare and superficial chemical peels.

Inflammatory Acne

Inflammatory acne causes red, swollen spots, including papules and pustules.

Inflammation plays a significant role in its development, so aggressive exfoliation or repeatedly stripping the skin can sometimes make irritation worse.

Mild inflammatory acne may benefit from appropriate skincare and selected professional treatments, while persistent or more severe acne often requires medical treatment.

Hormonal Acne

Hormonal acne is commonly associated with breakouts around the chin, jawline and lower face, although it can affect other areas.

Hormonal fluctuations can influence sebum production and contribute to recurring breakouts.

It may be associated with menstrual cycles, hormonal changes or conditions such as polycystic ovary syndrome (PCOS).

Professional skin treatments can support the appearance and condition of the skin, but they cannot correct the underlying hormonal cause.

Post-Inflammatory Hyperpigmentation

These are the brown or darker marks that can remain after a spot has healed.

They occur when inflammation stimulates excess melanin production.

Unlike true acne scarring, these marks are changes in pigmentation rather than permanent alterations in skin texture.

Post-Inflammatory Erythema

Post-inflammatory erythema (PIE) refers to persistent pink, red or sometimes purple marks left behind following acne.

These marks are associated with changes in superficial blood vessels rather than excess melanin.

This distinction matters because treatments targeting brown pigmentation won't necessarily improve red post-acne marks.

Acne Scarring

True acne scars develop when inflammation damages the skin's supporting structures, affecting collagen production and the healing process.

Common types include:

Rolling scars: Broad, shallow depressions that give the skin an uneven or undulating appearance.

Boxcar scars: Depressed scars with relatively defined edges.

Ice-pick scars: Narrow, deeper scars that extend into the skin.

Raised scars: Hypertrophic or keloid scars caused by excessive scar tissue formation.

Different scar types respond to different treatments. Some may benefit from collagen-stimulating procedures, while deeper or tethered scars may require specialist medical treatments.

What Causes Acne?

Acne is influenced by several factors, and it's rarely as simple as having dirty skin or using the wrong cleanser.

Hormones

Androgens stimulate sebaceous gland activity, which can increase oil production and contribute to blocked follicles.

Genetics

A family history of acne can increase the likelihood of developing it.

Follicular Blockages

Changes in the way skin cells shed within the follicle can contribute to the formation of blackheads and whiteheads.

Inflammation

Inflammatory processes are involved throughout acne development, not just when a spot becomes visibly red or swollen.

Skincare & Cosmetic Products

Some products may contribute to congestion in susceptible individuals, while excessive cleansing and exfoliation can damage the skin barrier and increase irritation.

Certain Medications & Medical Conditions

Some medications and hormonal conditions can contribute to acne or acne-like eruptions.

Diet may also influence acne in some individuals, although the relationship varies and is more complex than simply blaming particular foods.

How Can Acne & Acne Scarring Be Treated?

The most appropriate approach depends on whether you're treating active breakouts, congestion, residual marks or established scarring.

For Active Acne

Treatment generally focuses on reducing follicular blockages, regulating excess oil production and controlling inflammation.

Evidence-based skincare ingredients such as retinoids, benzoyl peroxide, azelaic acid and salicylic acid can be helpful, depending on the type and severity of acne.

Superficial chemical peels may provide additional benefits for selected cases of mild acne and congestion.

However, moderate to severe inflammatory acne, nodules or acne that is causing scarring should be medically assessed rather than relying on cosmetic treatments alone.

For Post-Acne Marks

Brown post-inflammatory pigmentation may improve with targeted skincare, sun protection and carefully selected superficial peels.

Red post-acne marks often fade gradually, although persistent vascular redness may respond better to appropriate vascular laser or light-based treatments.

For Acne Scarring

Once active acne is adequately controlled, collagen-stimulating treatments such as microneedling may help improve the appearance of certain depressed acne scars.

Scarring generally requires a course of treatments, and improvement depends on scar type, depth and individual healing response.

The aim is realistic improvement in skin texture, rather than promising to completely remove scars.

Acne & Acne Scarring Treatments at Peau Skin Health

Chemical Peels

For congestion, blackheads, mild acne and post-inflammatory pigmentation.

Professional chemical peels use carefully selected acids to encourage controlled exfoliation and help reduce the build-up of skin cells within the follicles.

Depending on the formulation, they may help improve comedonal acne, mild inflammatory breakouts, uneven skin tone and darker post-acne marks.

At Peau Skin Health, I use professional Medik8 and advanced Korean peel formulations, tailoring the treatment to your skin type, concerns and tolerance.

Chemical peels are not necessarily suitable for highly inflamed or compromised skin, and stronger exfoliation doesn't automatically produce better results.

Dermapen 4 Microneedling

For acne scarring, uneven texture and enlarged pores.

Microneedling creates controlled micro-injuries in the skin, stimulating a wound-healing response and supporting collagen remodelling.

It's a well-studied treatment for improving the appearance of certain types of atrophic acne scarring, particularly rolling and some boxcar scars.

Microneedling may also improve overall skin texture and the appearance of enlarged pores.

However, it isn't a treatment for active inflammatory acne, and treatment should generally be postponed in areas with active inflammatory lesions.

Deeper ice-pick scars and tethered scars may require other specialist approaches.

Advanced Korean Skin Treatments

For congestion, hydration and supporting the skin barrier.

Not every acne-prone skin needs more exfoliation.

Over-cleansing, excessive use of active ingredients and poorly tolerated skincare routines can contribute to irritation and barrier disruption.

My advanced Korean skin treatments can be tailored to focus on gentle cleansing, congestion, hydration and barrier support.

These treatments may be particularly useful for skin that feels dehydrated, irritated or overwhelmed by acne skincare.

While they can support overall skin condition, they aren't a replacement for evidence-based acne medication when this is needed.

Why Acne Treatment Needs an Individual Approach

Two people can experience breakouts for completely different reasons.

One person may have predominantly comedonal acne and benefit from carefully selected exfoliating ingredients, while another may have persistent hormonal inflammatory acne requiring prescription treatment.

Equally, someone concerned about acne scarring may no longer have active acne at all.

Treating the wrong concern, or introducing too many treatments at once, can sometimes make skin worse rather than better.

At Peau Skin Health, I focus on understanding your skin, your existing skincare routine and your treatment goals before recommending an approach.

Sometimes this means professional treatments. Other times, the best starting point is simplifying your skincare or seeking medical treatment for active acne before addressing the marks and scarring it leaves behind.

Not Sure What's Right for Your Skin?

You don't need to know whether you're dealing with hormonal acne, congestion, post-acne pigmentation or scarring before getting in touch.

If you're struggling with breakouts or the marks they've left behind, I'm happy to discuss your concerns and help you understand which treatments may be suitable.