Ask an Esthetician: Understanding Breakout-Prone Skin

Acne is one of the most common and most complex concerns we hear about. The truth is that our bodies are trying to tell us something when breakouts appear on the skin. Rather than taking the conventional approach of attacking and stripping the skin, we support it with topical micronutrients that help it function optimally.

Below, our Lead Esthetician, Eleanor, answers some of the most frequently asked questions about acne and caring for breakout-prone skin.

What is Adult Acne?

Rather than focusing solely on the diagnosis of "acne," we often find it more useful to think about pimples, pustules, and congestion as manifestations of skin imbalance and inflammation. While acne has traditionally been associated with the bacterium Cutibacterium acnes, formerly Propionibacterium acnes, current research has revealed a far more complex picture involving the skin microbiome, immune function, barrier health, sebum composition, and inflammation.

Importantly, C. acnes is not merely a harmful bacterium to be eliminated. In healthy skin, it is a natural and essential member of the microbiome, contributing to microbial balance, skin acidity, and immune regulation. Research increasingly suggests that breakouts are not necessarily the result of the presence of C. acnes, but rather changes in microbial diversity, shifts in bacterial strains, excess sebum production, impaired barrier function, and chronic inflammation.

When experiencing breakouts, three major factors are often involved: sebum production, microbial imbalance, and inflammation. Addressing each of these components strategically is generally more effective than focusing on any one factor alone.

The skin does not function independently of the rest of the body. Stress, poor sleep, hormonal fluctuations, dietary factors, and other internal stressors can influence barrier function and alter the skin's ecosystem. When the barrier becomes compromised, changes may occur in the acid mantle, pH, sebum quality, microbial diversity, and inflammatory signaling, all of which can contribute to recurrent breakouts.

The skin microbiome plays an important role in regulating immune responses and helping maintain balance within the skin ecosystem. Rather than viewing bacteria as inherently "good" or "bad," we find it more useful to think in terms of diversity, resilience, and equilibrium. Healthy skin supports a broad community of microorganisms that work together to discourage the overgrowth of potentially problematic species and help regulate inflammation.

How Does Marie Veronique Approach Treating Breakouts?

Our philosophy differs from traditional approaches that focus primarily on skin sterilization or the elimination of bacteria. While antimicrobial interventions may be appropriate at times, we believe long-term skin health is best supported by strengthening the skin barrier, restoring balance, and creating conditions in which the microbiome can regulate itself.

Topically, our goal is to provide the skin with the nutrients and support it needs to maintain a healthy acid mantle, natural moisturizing factor, lipid barrier, and microbiome. Internally, we emphasize practices that support overall physiological balance, including nutrient-dense nutrition, restorative movement, adequate sleep, stress management, and healthy circulation. Together, these foundations support the systems that most directly influence skin health, including immune function, hormonal signaling, detoxification pathways, and tissue repair.

How do you identify an internal imbalance?

Breakouts are rarely caused by a single factor; they are usually the result of multiple contributing factors. Often, various internal components are involved. Hormones frequently play a significant role in skin function, from sebum production to immune response; this is especially common during puberty, adolescence, pregnancy, perimenopause, and menopause.

If breakouts occur during adulthood, consideration of current lifestyle details should be considered. Factors to evaluate include lifestyle changes, dietary or supplemental shifts, recent illnesses, or new topical treatments.

Working with an esthetician is a great step to get the skin back into balance. As internal influencing factors are often trickier and more time-consuming to address, starting with the skin through a strong home care regimen is often the most effective way to reduce symptoms. Skin barrier function, inflammation, sebum production, and microbial balance can all be effectively addressed via topicals. If, after several months of continuous balancing care and support, you are still experiencing breakouts, we often suggest integrating a medical practitioner who can support the primary internal systems that are often associated with breakouts, i.e., gut function, hormonal balance, reproductive, thyroid, cortisol, etc.

What about hormonal or cyclical breakouts? How do I treat it?

The Treatment Remedy collection supports barrier integrity and microbial balance at any stage of breakout development. This synergistic routine helps stabilize the skin, regulate oil production, reduce congestion and inflammation, and promote skin barrier and microbial health.

Daily Treatment Remedy Regimen

Morning:

1. Rinse with water. Avoid cleansers in the AM to preserve your skin's natural protective oils and microbiome integrity.

2. Balance: Apply Rescue Tonic with a cotton pad to reset your pH, hydrate, and support your skin's natural defenses.

3. Treat: Apply 1-2 pumps of Control Serum. Works with nature to control hormonal-related breakouts by addressing the primary causes of acne. May be used all over or on specific areas where breakouts occur.

4. Nourish: Follow with a few drops of Clarifying Oil to nourish and regulate oil production.

5. Finish with your preferred SPF.

Evening:

1. Cleanse: Use Refining Cleanser.

2. Balance: Apply Rescue Tonic.

3. Treat: Apply Control Serum.

4. Nourish: Apply Clarifying Oil.

Targeted Intervention

• Spot Intensive: For cyclical or periodic breakouts, apply this roller-ball treatment directly to the area at the first sign of a flare-up. It is designed to reduce inflammation without over-drying the surrounding skin.

• Retinol: This versatile ingredient addresses both acne and signs of aging by promoting cell turnover, reducing congestion, supporting barrier health, and calming inflammation. Apply in the PM, alternating nights with the Control Serum. Start by using it 1-3 times per week, increasing the frequency as your skin adjusts.

  • Gentle Retinol Night Serum: Recommended for those new to retinol, individuals under 35, or those addressing post-inflammatory hyperpigmentation.

  • Multi-Retinol Night Emulsion: Recommended for those over 35, experienced retinol users, or those with drier, more mature skin.

Pro Tip for Success

Consistency is key. Since breakouts involve intricate systemic factors, we recommend sticking to this regimen for at least three months. What to expect: You may go through a period of adjustment during the first two to four weeks as your skin eliminates trapped debris. This is a normal part of the process - please stay committed to allow your skin to stabilize and heal completely. We encourage you to reach out to our team. Get a Personalized Skin Health Regimen from an Esthetician.