For skin that has tried everything and is still breaking out.
For skin that has tried everything and is still breaking out.
Most people arrive at our clinic having already tried a lot. Different cleansers, stronger actives, something from the pharmacy, a period of stripping the skin back to nothing. Some have been told to wait it out. Some were told that at fifteen and are now thirty two, still waiting.
Acne is a condition of the hair follicle and the oil gland attached to it. It is influenced by hormones, inflammation, barrier function, the skin's own microbiome, genetics, stress, and in some cases what is happening in the gut. It responds well to treatment when the treatment is matched to the type of acne, the stage it is at, and the person in front of us. It responds poorly to guesswork.
Our approach is built on skin longevity rather than short-term clearing. A strong barrier, a calm inflammatory picture, and skin that holds up over years. Not a face that has been stripped into temporary submission.
That is the work we do here. Assess properly, then treat with intent.
Four things go wrong at once inside an acne-prone follicle.
The oil gland becomes more active. Sebaceous glands respond to androgens, the hormones present in all of us in differing amounts. When those hormones fluctuate, or when the gland becomes more sensitive to them, oil production increases.
The lining of the follicle stops shedding properly. Skin cells that should lift away and clear instead stick together and build up. This is the beginning of congestion, and it is the reason blackheads and closed comedones form long before anything becomes visibly inflamed.
Bacteria proliferate. Cutibacterium acnes lives on everyone's skin. In an oil-rich, blocked, oxygen-poor follicle it multiplies and shifts the local environment.
Inflammation follows. The immune system responds to all of the above. That response is what turns a quiet blockage into a red, sore, raised lesion, and it is also what causes the marks and scarring that outlast the breakout itself.
This is worth knowing for one practical reason. The pimple you can see today began forming in that follicle somewhere between two and eight weeks ago. Treatment is not working on what is on the surface. It is working on what has not surfaced yet.
That is why we assess progress at eight to twelve weeks, not at two.
The word covers several different conditions that happen to share a name.
Puberty brings a surge in androgens and the oil glands respond in kind. Teenage acne usually starts in the T-zone, tends toward comedones and pustules, and often sits alongside genuinely oily skin.
The mistake we see most often at this age is over-treatment. Foaming cleansers used twice a day, scrubs, spot treatments layered on top of each other, and skin that has been stripped so thoroughly the barrier has given up. A compromised barrier does not calm acne. It inflames it, and it makes every subsequent treatment harder to tolerate.
Teenage skin usually needs less than people expect. A gentle cleanser, one well-chosen active, sun protection, and consistency. In clinic, we work conservatively and build slowly.
If you are a parent reading this, you are welcome to attend the consultation. We will explain what we are seeing in language your teenager can follow, and we will not sell you a ten-step routine that a sixteen year old will abandon in a fortnight.
This is where acne stops being predictable. Some people carry teenage acne straight through. Others have clear skin all through school and break out for the first time at twenty three.
Common drivers in this decade include coming off hormonal contraception, changing contraception, a period of genuine stress or poor sleep, a new occupation with new products or new hours, and skincare routines built from online recommendations rather than assessment.
Late-onset acne in your twenties is real and it is common. It is not a sign that you did something wrong.
Adult acne is a distinct pattern and it deserves to be treated as one. It affects women far more often than men. It tends to sit along the jawline, chin, and lower cheeks. It is more inflammatory and less comedonal, the lesions sit deeper, they hurt, they take longer to resolve, and they are more likely to leave a mark.
It often follows a cycle, flaring in the week or two before a period. Underlying hormonal conditions such as polycystic ovary syndrome can be involved. So can chronic stress, thyroid function, and gut inflammation.
The critical difference is that adult skin cannot be treated like teenage skin. Barrier function, hydration, and collagen are all changing at the same time. Treat adult acne with a teenage protocol and you clear the breakouts while dehydrating and ageing the skin.
We do not do that here. The plan has to address acne and skin quality together, because in this age group they are the same conversation.
If your breakouts sit along the jawline, chin, and lower cheeks, and they return to the same handful of places every month, there is a physiological reason for it.
The lower face carries the highest density of androgen receptors on the face. That means this area responds more strongly to hormonal fluctuation than your forehead or nose does. It is also why jawline acne tends to be deeper, more painful, and slower to clear than the congestion you may have had as a teenager.
Here is the part most people are never told. You can have completely normal blood test results and still have hormonally driven jawline acne. The sensitivity often sits at the follicle itself rather than in your circulating hormone levels. Normal bloods do not mean you imagined it.
Polycystic ovary syndrome, or PCOS, is worth ruling out if jawline acne sits alongside irregular cycles, unexplained weight change, or increased facial hair. That is a conversation for your GP, and we will encourage you to have it.
Friction plays a role too. Phones, chin resting, helmet straps, and hands. So does product residue along the jaw and neck, which is the most commonly under-cleansed part of the face.
If you menstruate, your skin is not the same skin all month. Treating it as though it were is one of the reasons acne plans get abandoned early.
The first few days. Oestrogen and progesterone are both at their lowest. Skin often feels drier, duller, and more reactive, and the barrier is at its least resilient point of the month. Pain sensitivity is also higher, which is worth knowing before you book anything uncomfortable.
The follicular phase, roughly the week after your period ends. Oestrogen climbs. For most people this is the best skin of the month. Better hydration, a stronger barrier, more efficient healing, and oil production under better control.
Around ovulation. Oestrogen peaks and then falls away, with a small rise in testosterone at the same time. Some people get a reliable mid-cycle breakout and never connect it to the cause.
The luteal phase, the second half. Progesterone rises and becomes dominant while oestrogen sits relatively lower. Sebum production increases, the follicular opening can swell slightly, and the skin becomes more reactive and more prone to inflammation. This is where the premenstrual flare lives, usually in the last seven to ten days.
Two things follow from this, and both matter for how you judge your own progress.
The first is that a breakout arriving the week before your period did not necessarily start there. Because a lesion takes weeks to form beneath the surface, what surfaces premenstrually often began developing in the previous cycle. The hormonal shift is frequently what pushes it through rather than what caused it.
The second is about measurement, and it is the reason we do not hand out week-by-week progress charts. Comparing your skin in week two to your skin in week four tells you very little, because you are comparing two different hormonal environments. Comparing the same point in two consecutive cycles tells you a great deal.
A flare in your premenstrual week is not evidence that a plan has failed. It is evidence that you have a cycle. Skin does not improve in a straight line and we would rather you knew that at the start than concluded something had gone wrong at week five.
We will usually ask you to note roughly where in your cycle your breakouts appear. It is one of the most useful things you can bring to a consultation and almost nobody arrives with it.
Where we can, we schedule peels and needling in the follicular phase. Better tolerance, less discomfort, better healing, and less risk of provoking pigmentation in skin that is already inflamed.
A few situations change the picture entirely. Hormonal contraception flattens the natural cycle, so the pattern may disappear or shift, and coming off it frequently produces a rebound that takes months to settle. In perimenopause, cycles become irregular and the pattern grows harder to predict before it stops altogether. And if your premenstrual flare is severe, or arrives alongside irregular cycles, that is worth raising with your GP.
Acne in pregnancy goes in one of two directions and there is no reliable way to predict which.
Some people find their skin clears entirely. Others break out for the first time in their lives at thirty four. The most common pattern we see is a flare through the first trimester, when progesterone climbs sharply and sebaceous activity climbs with it, sometimes settling later and sometimes not.
It tends to present as inflammatory rather than comedonal, concentrated along the jawline and chin, which is the same androgen-sensitive territory described above.
The timing is difficult in a way that is worth naming. This is frequently the point at which someone most wants to feel well in their own skin, and it is also the point at which almost everything we would normally reach for is unavailable.
What comes off the table. Retinoids, entirely. This is not a cautious position, it is an absolute one, and it applies to topical as well as oral. Strong peels, skin needling and IPL are not performed. Higher-concentration salicylic acid over large areas is avoided.
A separate and important point. If you are currently taking oral prescription treatment for acne and there is any possibility of pregnancy, that is a conversation to have with your prescribing doctor before conceiving rather than after. Strict pregnancy prevention requirements exist around some of these medications for good reason.
What remains, and it is more than people expect. Azelaic acid has a long and well-established safety record in pregnancy and is genuinely useful for inflammatory acne, which makes it the workhorse of most plans we build at this stage. Niacinamide is well tolerated. Benzoyl peroxide has decades of safe use behind it. In clinic, LED and enzyme treatments are both suitable, and gentle lactic work can be appropriate depending on the skin.
We coordinate with your GP, obstetrician or midwife rather than working around them. If anything we propose is something they would rather you did not do, we do not do it.
Delivery brings a sharp hormonal drop, and skin responds unevenly. Some people clear within weeks. A great many flare somewhere between three and six months postpartum, often just as they thought they had got away with it.
Several things are happening at once. Hormones are still resettling. Sleep is broken and cortisol is high, and both feed inflammatory skin. If you are breastfeeding, some options remain limited, though fewer than in pregnancy.
Here is the tension we want to be honest about. The urge to deal with this quickly is strongest at exactly the point your skin tolerates the least, and pushing hard on a postpartum barrier tends to produce more inflammation, not less.
So we split it. Controlling the acne itself should not wait, because every month of active inflammatory acne is scarring you cannot recover later. Corrective work on the scarring and marking that acne left behind can and generally should wait until you have finished breastfeeding and things have stabilised.
That distinction matters. Waiting on the scar work is patience. Waiting on the acne is not.
As oestrogen declines, the balance between oestrogen and androgens shifts, and skin that has been clear for twenty years can begin breaking out again. This often arrives alongside dryness, thinning, and increased sensitivity, which narrows the range of what the skin will tolerate.
This is where restraint matters most. Gentle, layered, well-sequenced treatment. Not aggressive stripping.
Acne is not limited to the face, and the areas people cover up are the ones that go untreated the longest.
The skin on the back and chest has larger, more active oil glands and a thicker outer layer, which means congestion sits deeper and lesions take longer to clear. Sweat, friction from clothing and gym gear, and sitting in activewear after training all contribute.
It is treatable. Body peels, LED, and appropriate home care work here in the same way they do on the face, with adjusted strength for thicker skin.
Tell us at consultation if this is part of your picture, because most people do not think to mention it.
Getting this right at the assessment stage changes everything that follows.
Comedonal acne. Blackheads, whiteheads, and the rough, bumpy congestion under the surface that you feel more than you see. Little redness. Responds well to exfoliation, retinoids, and consistent professional treatment.
Inflammatory acne. Red papules and pustules. Sore, raised, and prone to leaving marks. Needs calming as much as clearing.
Nodulocystic acne. Deep, painful, firm lesions that sit under the skin for weeks. This category needs medical management, and we cover it properly below.
This deserves its own section, because it is the type most likely to leave permanent damage and the type most often left too long.
Cystic acne forms when inflammation ruptures the follicle wall deep in the skin rather than at the surface. The contents spill into the surrounding dermis, the immune response spreads outward, and what you end up with is a firm, deep, painful lesion that can sit there for weeks. Nodules are similar but more solid. Neither has a head, neither should be squeezed, and neither responds to the things that clear a surface pimple.
Two things make this category different.
It scars, and the scarring is structural. Because the damage happens in the dermis, collagen is destroyed rather than simply inflamed. That is true scarring, not a mark, and it does not fade with time or with skincare. Every month of untreated cystic acne is scarring you cannot get back later.
It usually needs medical treatment. International guidelines are clear on this. The 2024 American Academy of Dermatology guidelines strongly recommend systemic prescription treatment for acne that is severe, that is scarring, or that is causing significant psychosocial burden. That is a prescriber's decision, made by a GP or dermatologist, and it is not something a skin clinic can provide.
So if we assess you and this is what we see, we will tell you plainly and we will help you get to the right person. We are not going to sell you a course of peels for a condition that needs medicine.
What we can do is work alongside that treatment. Barrier support while the skin is dry and fragile, LED to calm inflammation, lymphatic drainage, and a plan for the scarring once the acne itself is controlled. Skin that has been through cystic acne almost always needs collagen work afterwards, and that is squarely our territory.
The one thing we would ask is that you do not wait. Cystic acne treated at month three has a very different outcome to cystic acne treated at year three.
Not every breakout is acne, and treating the wrong condition for months is how people lose a year.
Fungal acne, properly called Malassezia folliculitis. Small, uniform, often itchy bumps, usually clustered on the forehead, hairline, chest, or back. It is driven by a yeast that lives on everyone's skin, not by acne bacteria, which is why it does not respond to standard acne treatment and can be made worse by it. It flares with heat, sweat, humidity, occlusive clothing, and sometimes after a course of antibiotics. If your bumps are uniform and itchy and nothing has worked, this is one of the first things we look at.
Papulopustular rosacea. This one matters enough to spell out properly, because treating it as acne will make it considerably worse.
Rosacea can produce red bumps and pustules across the cheeks, nose, chin, and forehead that look, at a glance, exactly like inflammatory acne. Plenty of people are treated for acne for years before anyone questions it.
The differences are there if you know what to look for. Rosacea sits on a background of persistent central facial redness that intensifies periodically, which international consensus regards as diagnostic in its own right. It usually comes with a history of flushing. It tends to burn or sting rather than feel sore. And critically, it does not produce comedones. If you have red bumps but no blackheads or whiteheads anywhere, that is a significant clue. Triggers tend to be environmental rather than hormonal: heat, sun, alcohol, spicy food, temperature change, exercise, and stress.
Here is why the distinction is not academic. Rosacea skin has an impaired barrier and a heightened inflammatory and vascular response built in. The standard acne toolkit, meaning strong exfoliating acids, physical scrubs, drying agents, benzoyl peroxide, and high-strength retinoids introduced quickly, provokes exactly those pathways. The result is more redness, more burning, more papules, and a face that gradually becomes reactive to everything.
People in this position often tell us their skin has become impossible. It has not. It has been treated for the wrong condition, with good products, for a long time.
Our approach is close to the opposite. Barrier repair first. Gentle, anti-inflammatory actives rather than aggressive ones, with azelaic acid frequently useful here. LED to calm. IPL to address the vascular component, which is the part that topical treatment cannot reach. Careful trigger identification. And referral to your GP where prescription treatment is warranted, because for moderate to severe rosacea it often is.
Some people have both conditions at once, which needs a plan that respects both. That is a proper assessment conversation, not something to work out from a page.
Perioral dermatitis. Its own pattern, clustered around the mouth, nose, or eyes, often sparing a thin border right at the lip line. It has its own set of triggers, and it frequently worsens with the very products people reach for to treat it.
If you have been treating acne for months with nothing to show for it, the diagnosis is the first thing worth questioning.
Two people can clear their acne completely and be left with entirely different skin. Knowing which mark you are looking at determines how it is treated.
Post-inflammatory erythema. Flat pink or red marks where a lesion used to be. These are vascular, meaning dilated capillaries near the surface, not pigment. Very common in fair skin. This is where light-based treatment earns its place.
Post-inflammatory hyperpigmentation. Flat brown, grey, or deeper marks. This is pigment, produced by melanocytes responding to inflammation. More common and more persistent in olive and deeper skin tones. Treated with pigment-targeted actives, considered peel selection, and disciplined sun protection.
Atrophic scarring. True textural loss, where collagen was destroyed and not replaced. Rolling, boxcar, and icepick scars. This is a collagen problem and it requires collagen-stimulating treatment. It does not fade on its own.
Worth knowing at this stage: these three types do not respond to the same treatment. Rolling scars are tethered from below and need releasing before anything else will work on them. Boxcar scars respond to collagen stimulation. Ice pick scars are too narrow and deep for either and need a focal approach. A plan that treats all three the same way will only ever partly work.
Marks are not scars. Most of what people call scarring is redness or pigment, and it improves. We will tell you which you have.
Winter here means ducted heating, hot showers, and a barrier under pressure. It is why so many people break out in July while their skin simultaneously feels dry and tight, and why treating that flare as though it were oily teenage skin makes it considerably worse.
Summer brings heat, sweat, sunscreen worn all day, and a different set of problems entirely.
Your plan should shift with the season. Ours does.
Acne scarring is the clearest example of why our clinic is structured the way it is.
Most scarring plans fail for a structural reason rather than a clinical one. The patient is treated by a Dermal Clinician who cannot access the medical side, or by a prescriber who does not perform the resurfacing. Each does their part well. Nobody sequences the whole thing, and the patient ends up carrying the coordination themselves.
We do not work that way. Caitlin is a Registered Nurse with ten years in cosmetic medicine. Belinda and our Dermal Clinicians hold a Bachelor of Dermal Science with over a decade of hands-on skin work between them. Both sides sit in the same building, work from the same assessment, and build one plan rather than two.
For acne scarring specifically, that matters at three points.
At assessment. Scar type determines treatment, and getting it wrong wastes years. Rolling scars are tethered from below and need releasing. Boxcar scars need collagen stimulation. Ice pick scars need a focal approach. Post-inflammatory erythema is vascular and needs light. Post-inflammatory pigmentation is pigment and needs something else again. Most faces carry three or four of these at once, and a single plan has to address each with the right tool. That assessment happens once, with a Wood's lamp and dermatoscope, and informs everything after it.
At sequencing. Order changes outcome. Active acne is controlled before any scar work begins, because needling or resurfacing inflamed skin produces more scarring and more pigment. Tethering is released before resurfacing, so the surface work is not fighting a band underneath. Vascular marking is addressed separately from pigment. None of that sequencing survives being split across two clinics with different diaries.
At the medical boundary. Where your acne needs prescription management, we say so and refer, and we keep treating the skin alongside that care rather than pausing for a year. Where scarring needs something beyond dermal scope, the nursing side is already in the room.
The result is that your plan is built once and progressed continuously, rather than assembled from separate opinions that were never designed to fit together.
We are a Dermal Clinician led clinic. Belinda, our Senior Dermal Clinician, brings around ten years of industry experience, and our team works to a shared philosophy: assess first, treat conservatively, sequence with intent, and never do more to the skin than it can handle.
Acne treatment here is built on two halves that have to work together. What happens at home, and what happens in clinic. Neither one works properly without the other.
Home care is where most of the change happens. In-clinic treatment accelerates it and refines it, but it cannot compensate for a routine that is working against you.
We want to be clear about something before we go any further. What follows is not a list for you to shop from.
Acne skincare is not a pick and mix. The same active that clears one person's congestion will inflame the next person's barrier, and the difference between those two outcomes is not something you can work out from a video, a quiz, or a page like this one. Every week we see skin that has been made considerably worse by a routine assembled from perfectly good products, used in the wrong combination, at the wrong strength, on the wrong skin.
The most reliable way to treat acne properly is to come in and be assessed. It is also, for most people, the least expensive route in the end.
In clinic we look at your skin in person and in real time, which is something no online tool can do.
We use a Wood's lamp, a specialised UV light that reveals congestion, oil distribution, bacterial activity, and pigment sitting beneath the surface where the naked eye cannot see it. We use a dermatoscope to examine individual lesions and follicles under magnification. Together, these show us what is genuinely happening inside your skin rather than what it looks like from the outside.
Then we apply experience to what we are seeing. Our Dermal Clinicians hold a Bachelor of Dermal Science and bring over a decade of hands-on work with skin, a great deal of it with acne specifically. That combination, a proper diagnostic view of your skin plus someone who has treated thousands of variations of it, is what a search bar cannot replicate.
It usually saves you money too. Most people who walk through our door have already spent several hundred dollars on products that were never going to suit their skin. One consultation and a correctly built routine costs considerably less than a year of guessing.
We retail from professional ranges, primarily Dermaceutic and iS Clinical. Both are formulated for clinical use, held at concentrations that require professional guidance, and backed by real research rather than marketing.
We prescribe from these ranges rather than handing you a list, and we build the routine in stages rather than giving you six products on day one. Cleanse, treat, protect. Introduce one thing at a time, let the skin adjust, then build on it.
What you end up with depends entirely on what we find. It might be a gentle acid, a barrier-supporting active such as niacinamide, azelaic acid where acne and rosacea overlap, or a retinoid introduced slowly. That decision is made with your skin in front of us, not in advance.
Fewer products, chosen properly and used consistently, will beat a complicated routine every time. That is not us being minimal for the sake of it. It is what the skin responds to.
Retinoids remain the most evidence-supported topical treatment for acne, and they come with an adjustment period. Several weeks where the skin can look worse before it looks better, as existing congestion is pushed to the surface. This is the exact point where most people quit. We prepare you for it and we stay in contact through it. There is a full breakdown of how to tell an adjustment from a genuine reaction further down this page.
Sunscreen is not the optional final step. UV worsens post-inflammatory pigmentation and it undoes the results of nearly every treatment we perform. In an acne routine it is one of the most important products you own.
Over-exfoliating, layering multiple strong actives, scrubs, and picking. Picking converts a mark that would have faded into a scar that will not.
Every treatment below is selected during consultation, not from a menu. The sequence matters as much as the treatment itself.
Light therapy at specific wavelengths, delivered in a comfortable, non-invasive session with no downtime.
Blue light targets the bacterial component of acne. Red and near-infrared light work at a deeper level to reduce inflammation and support the skin's healing and repair processes. For inflamed, angry, reactive skin, LED is often where we begin, because it calms without provoking.
LED works cumulatively. A single session feels pleasant. A course delivers results. It also pairs beautifully as a finishing step after peels and needling, where it supports recovery.
Suitable during pregnancy and breastfeeding, when many other options are off the table.
Our signature peel program, structured across tiers so we can start where your skin is and progress as it strengthens.
Enzyme treatments use fruit-derived enzymes to gently digest the bonds holding dead cells to the surface. No acid, minimal reactivity, no downtime. Ideal for sensitive, inflamed, or first-time skin, and for pregnancy.
Level 1 peels introduce gentle acids, usually lactic or mandelic. Light resurfacing, a small amount of flaking for some people, and a noticeable improvement in clarity and congestion.
Level 2 peels step up in strength and depth. Salicylic-based formulations for oily and congested skin, or blends targeting pigmentation and post-acne marking. Expect a few days of visible peeling.
Level 3 peels are our medium-depth tier, built around TCA, or trichloroacetic acid. This is a considerably more serious treatment and it reaches into the upper dermis rather than resurfacing the surface.
For acne this is where we go when the issue is what the acne left behind. Stubborn post-inflammatory pigmentation, uneven texture, enlarged pores, and shallow atrophic scarring all respond to depth in a way that no superficial peel achieves. It also works well in sequence with skin needling, where the two treatments address the same scarring from different directions.
You should know what it involves. Genuine downtime of roughly five to seven days with visible peeling, a period where the skin looks worse before it looks better, and strict sun avoidance afterwards. It is not a treatment you book the week of an event.
It is also not a starting point. Level 3 requires the skin to be conditioned first, usually with several weeks of appropriate home care and often a course through the lower tiers. We will not perform it over active inflammatory acne, and we take particular care with olive and deeper skin tones, where the risk of post-inflammatory pigmentation is higher and pre-treatment matters enormously.
Suitability is assessed individually. Some people are ideal candidates. Some are better served by needling, and we will say so.
For acne, peels do several things at once. They clear the follicular blockage, reduce surface oil, calm bacterial load, help fade post-inflammatory pigmentation, and improve how well your home care penetrates.
We generally recommend a course rather than a single treatment, spaced two to four weeks apart, and we progress the strength only when your skin has shown us it is ready. Starting at level 2 on inflamed skin is how people end up with more damage than they arrived with.
Skin needling does two things at once, and the second is the one most people underestimate.
The first is mechanical. Controlled micro-channels trigger a genuine wound-healing cascade, and new collagen and elastin are laid down over the following weeks and months. That is what physically remodels an atrophic scar, and nothing topical achieves it.
The second is delivery. Those same channels temporarily bypass the stratum corneum, which is the barrier that stops most actives from reaching the depth where they would do useful work. An ingredient applied to intact skin and the same ingredient delivered through open channels are not the same treatment.
This is why our booster work exists, and it is the difference between our two tiers.
Tier One pairs the needling with an LED or peel chosen for your skin on the day, using a hyaluronic acid glide for comfort throughout, plus post-care to take home. A complete treatment in its own right.
Tier Two adds a medical booster infusion formulated to your presenting concern.
We want to be careful here, because this is an area where marketing has run considerably ahead of the research. Below is what we use, what the published data actually shows, and how strong that evidence genuinely is.
One note before we start. The figures below come from clinical trials in specific populations under controlled conditions. They tell you that an ingredient does something real. They are not a prediction of your result, and we would be misleading you if we presented them that way.
Polynucleotides and PDRN. Polydeoxyribonucleotide, derived from salmon or trout DNA. We use it both as a standalone infusion, including Rejuran, and within Byryzn Opuluxe V.
The mechanism is well described. PDRN acts on adenosine A2A receptors, which reduces inflammatory signalling and promotes angiogenesis through upregulation of VEGF, while also supplying nucleotides that fibroblasts use directly through the salvage pathway. In acne scarring specifically, that combination of reduced inflammation and supported collagen remodelling is precisely the biology you want.
The angiogenic effect is measurable. In experimental wound models, PDRN produced a significant increase in VEGF expression against control, at p less than 0.001. Several clinical studies, predominantly from Korea, report better outcomes from PDRN combined with microneedling than from microneedling alone.
What we will also tell you is that a 2026 narrative review of PDRN in aesthetic recovery was explicit about the limitations of this field: a shortage of randomised controlled trials in human aesthetic cohorts, small sample sizes, variability between formulations, and little long-term follow-up. The mechanistic case is strong and the clinical evidence is still developing. We think it is a reasonable and biologically sound addition. We are not going to tell you it is proven.
Byryzn Opuluxe V. A Korean-formulated booster brought into Australia by Hugel, combining eight actives in one infusion: PLLA, trout DNA PDRN, hyaluronic acid, glutathione, sphingomonas ferment extract, adenosine, an amino acid complex and a vitamin complex.
We use it where the presentation is post-acne skin that needs several things at once. Barrier support, hydration, texture, tone and early laxity together, rather than one concern in isolation.
PLLA, poly-L-lactic acid. A biostimulator. Rather than filling or hydrating, it provokes a low-grade fibroblast response that builds collagen gradually over months. Useful where post-acne skin has lost structural quality rather than simply developed discrete scars.
Tranexamic acid. This is the one with the strongest evidence base of the group, though most of it sits in melasma rather than acne. It acts on plasmin-driven inflammatory and pigment signalling, which makes it directly relevant to the brown marks acne leaves behind, particularly in olive and deeper skin tones where post-inflammatory pigmentation is more persistent.
Niacinamide. The best-evidenced active on this list, and unusually well tolerated. It reduces inflammation, helps regulate sebum, supports barrier recovery, and interrupts the transfer of pigment from melanocytes into surrounding skin cells.
It has been tested head to head against a prescription topical. In a randomised, double-blind trial of eighty patients with moderate inflammatory acne, published in the International Journal of Dermatology in 2013, topical four percent niacinamide was compared against one percent clindamycin over eight weeks. Acne grade fell from an average of 5.93 to 2.08 in the niacinamide group and from 5.70 to 2.03 in the clindamycin group. Both improvements were statistically significant, and the difference between the two groups was not.
The study also found skin type mattered: niacinamide performed better in oily skin, clindamycin in non-oily. That is the kind of detail that only becomes useful when someone is assessing your skin rather than handing you a product.
Ascorbic acid. Antioxidant protection and tyrosinase inhibition, plus a genuine role as a cofactor in collagen synthesis. Delivered through channels rather than across an intact barrier, which is where the formulation limitations of topical vitamin C stop applying.
Glutathione. An antioxidant with a role in shifting melanin synthesis toward the lighter pigment pathway. Worth being honest that the evidence for glutathione in skin is weaker than the enthusiasm around it, and we use it as a supporting active rather than a primary one.
Hyaluronic acid, peptides, growth factors, amino acids and skin vitamins. Hydration, collagen signalling support, and the raw materials for repair. These are the foundation of most infusions rather than the headline.
Each of these is selected and combined intentionally, never at random, and always based on what your skin actually needs on the day.
We do not needle over active inflammatory acne. Doing so risks spreading bacteria and worsening inflammation, and inflammation is what produces both the scarring and the pigment we are trying to prevent. Active acne is controlled first.
And we do not overstate this treatment. Skin needling with boosters is a strong, biologically sensible intervention for post-acne skin. It is not a substitute for controlling the acne itself, and where your scarring is deep, tethered, or ice pick in character, other approaches will do more.
Expect redness for one to three days, and a course of three to six treatments spaced four to six weeks apart for meaningful textural change.
Some scars do not respond to resurfacing, and the reason is worth understanding because it changes what you should be spending money on.
A rolling scar is not a hole in the surface. The surface is largely intact. What has happened is that fibrous bands have formed beneath it, anchoring the base of the scar to the deeper tissue and pulling it downward. That is why rolling scars have soft, sloping edges and why they look worse in raking light than they do straight on.
If the problem is a tether underneath, no amount of work on top will fix it. You can needle that skin, peel it, and resurface it, and the band will still be pulling. This is the single most common reason someone tells us they have had six needling sessions and seen very little change in their scarring.
Subcision addresses the tether directly. Under local anaesthetic, a fine instrument is introduced beneath the scar and moved in a controlled fanning motion to release the fibrous bands holding it down. The base lifts. The space created then fills with new collagen as it heals, which lifts it further over the following weeks.
What it treats well. Rolling scars, and tethered boxcar scars where there is a clear anchoring component.
What it does not treat. Ice pick scars, which are too narrow and too deep for this approach and need a different technique entirely. Raised hypertrophic or keloid scarring, which is a separate problem requiring medical management.
What to expect. Bruising, and we want to be upfront that it can be substantial. Plan for seven to fourteen days, and do not book this the fortnight before an event. Swelling for a few days is normal. Most people need two to three sessions spaced four to eight weeks apart.
Risks include bruising and haematoma, temporary firmness or nodularity at treated sites, infection, and in a small number of people an incomplete response. All of this is discussed in full before you proceed.
How it fits with everything else. Subcision is very often the first step rather than a standalone treatment. Release the tethering, then use needling and resurfacing to refine the surface once the base has lifted. Sequenced that way, the needling you do afterwards works considerably harder than the same needling would have done first.
As with everything on this page, we do not perform it over active inflammatory acne. The acne is controlled first.
We use the Lumenis M22 with XPL, one of the first of these systems in Australia, and it earns its place in acne treatment in two distinct ways.
For active acne, specific wavelengths target the porphyrins produced by acne bacteria and reduce the inflammatory vascular response feeding a breakout. It calms without any of the disruption of a stronger treatment.
For post-acne redness, this is the treatment that changes things. Those flat pink and red marks that linger for months are dilated capillaries, and no cream, no acid, and no amount of patience clears them efficiently. IPL targets the haemoglobin within them directly.
For people whose skin has cleared but who still look like they are breaking out, this is often the missing piece.
It also treats diffuse background redness, flushing, and the vascular presentation of rosacea, which frequently sits alongside or is mistaken for acne.
A patch test and full consultation are required. IPL is not suitable for every skin type or every level of sun exposure, and we will assess this carefully with you before proceeding.
Fractional CO2 resurfacing is joining our device line-up shortly, in the form of the DEKA Tetra Pro with CoolPeel.
For acne this matters mainly at the scarring end. CO2 works at depths and with a precision that neither peels nor needling reach, and the CoolPeel protocol delivers that energy in very short pulses so the surface is resurfaced without heat building up in the surrounding tissue. Historically the trade-off with CO2 was results against downtime. This narrows that considerably.
Where it will earn its place is textural scarring, enlarged pores, and the general surface change that long-standing acne leaves behind.
It will not change how we treat active acne, and it does not shortcut the sequencing described on this page. Acne is controlled first, always.
If it is relevant to your concern we will raise it at consultation. We would rather you waited a few weeks for the right treatment than paid for the wrong one now.
Acne is a skin condition, but the drivers are not always sitting in the skin. When someone has done everything right topically and is still breaking out cyclically, or when acne arrives alongside digestive symptoms, fatigue, or hormonal change, we look further.
Alida is our naturopath, and she works with patients on the internal factors that commonly contribute to inflammatory skin conditions. Her focus areas include gut function and dysbiosis, hormonal balance, stress and the physiological load it places on the body, and inflammation more broadly.
Her approach is investigative rather than prescriptive. Rather than treating acne as a standalone complaint, she looks at digestion, cycle patterns, stress load, sleep, and nutrition, and works to identify what may be contributing in your individual case.
This is complementary care, designed to work alongside your dermal treatment plan rather than replace it, and alongside any medical care you are receiving. Recommendations are individualised following a full consultation.
We are careful not to promise that internal work will resolve acne on its own, because that depends entirely on what is driving yours.
The gut and skin axis is an area of active and developing research. There is reasonable evidence linking blood sugar regulation and androgen activity to sebum production, and emerging work on the role of the gut microbiome in inflammatory skin conditions. Other parts of the picture are less settled. We will tell you which is which rather than presenting the whole field as proven.
Also with Alida, who is a lymphatic specialist.
The lymphatic system is how the body clears inflammatory by-products and excess fluid. When it is sluggish, that clearance slows. Lymphatic drainage is a light, rhythmic, deeply calming manual technique that supports this process.
For acne-prone skin, patients often find it helps with facial puffiness and congestion, and describe the skin as looking clearer and less inflamed afterwards. It also feels wonderful, which matters more than it sounds when stress is part of your picture.
Alida also offers remedial face release and TMJ release, which are particularly useful for people who hold significant tension through the jaw, an area where adult hormonal acne tends to concentrate.
Our private wellness room houses an infrared sauna, cold plunge, and private shower. It is a solo-use space, fully private, with no shared change rooms and no audience.
For patients managing stress as a contributing factor, this becomes part of the routine rather than an indulgence. If you have active inflamed acne, we will discuss timing and suitability, as heat and sweat need to be managed thoughtfully alongside certain treatments.
Your plan will be your own, but the shape is usually consistent.
Weeks 1 to 4. Full assessment. Home care corrected and simplified. Barrier repaired if it has been compromised. Gentle in-clinic treatment, often LED and enzyme, to calm without provoking. Active introduction begins.
Weeks 4 to 12. Progression. Peels stepping up through the tiers as tolerance builds. Retinoid strength increased. This is the adjustment window, and we stay in close contact through it. Naturopathic or lymphatic support introduced where relevant.
Weeks 12 and beyond. Reassessment against where you started. Once active acne is controlled, we shift focus to what it left behind. IPL for redness and vascular marking. Skin needling for texture and scarring. Pigment work where needed.
Ongoing. Acne is a condition that is managed, not permanently cured. Most people move to a maintenance rhythm, which is far lighter than the corrective phase.
A note on how we measure. If you menstruate, we assess your progress at the same point across consecutive cycles rather than week by week, because your skin is in a different hormonal environment at week two than it is at week four. This is also why we do not issue progress timelines. Skin does not improve in a straight line, flares happen, and a chart that implies otherwise sets people up to feel they have failed when they have not.
We will not quote you a number before we have seen your skin, because a plan for mild congestion and a plan for inflammatory acne with scarring are not the same investment.
What we will do is give you a clear, itemised plan at consultation, including what the corrective phase is likely to cost, roughly how long it will run, and what maintenance looks like afterwards. No surprises, and no pressure to commit on the day.
If budget is a constraint, tell us. We would rather build you a smaller plan that you can actually complete than an ideal one you abandon at week six. A partly completed acne plan is money spent for very little return.
Please note that cosmetic and dermal treatments do not attract a Medicare rebate. Some private health extras policies cover naturopathy consultations, so it is worth checking your own policy.
A fair question, and the honest answer is that it depends on what you have.
Dermatologists are medical specialists. They diagnose, prescribe, and manage severe and complex disease. If your acne is deeply cystic, scarring quickly, or has not responded to appropriate treatment, that is where you belong. You will usually need a GP referral to access a Medicare rebate.
Dermal clinicians work with the skin itself. Assessment, home care, resurfacing, collagen stimulation, light-based treatment, and the long-term management that sits between medical appointments. We do not prescribe.
For a great many people the answer is both. A dermatologist manages the medical side while we manage the skin, and the two work considerably better together than either does alone.
We are comfortable saying when you need more than us.
We are Dermal Clinicians, not prescribers, and part of good practice is knowing where our scope ends.
If your acne is severe, deeply cystic, scarring rapidly, or not responding to appropriate topical and in-clinic treatment, you need medical review with a GP or dermatologist. Prescription options exist that we cannot provide, and for the right person they are the right answer. We will say so, we will help you get there, and we will support your skin alongside that treatment.
If you have recently completed or are currently taking oral prescription treatment for acne, please tell us at consultation. Certain in-clinic treatments require a waiting period afterwards, and we will plan around it.
This is the most persistent one, and it is largely outdated.
The blanket rule that all procedures must wait six to twelve months after systemic prescription treatment traces back to three small case series published in the mid-1980s. A 2017 systematic review published in JAMA Dermatology examined thirty-two publications covering 1,485 procedures and found insufficient evidence to support delaying superficial chemical peels, manual dermabrasion, cutaneous surgery, laser hair removal, or fractional ablative and non-ablative laser procedures for people currently taking or recently finished on that treatment.
The same review did recommend against mechanical dermabrasion and fully ablative laser resurfacing during systemic therapy. Those remain off the table, and we respect that.
What this means in practice is that LED, barrier support, gentle hydrating treatment, and lymphatic drainage are not only permitted, they are often genuinely useful during a course, because the skin is dry, tight, and fragile and needs support. We take a more conservative position on skin needling, where the evidence is thinner, and we will usually wait.
The part that is true is this. Your barrier is compromised while you are on treatment. It is not the moment for strong acids, aggressive exfoliation, or a full active routine. But "gentle" is not the same as "nothing", and being told to use a basic moisturiser for a year and hope is not a plan.
Every decision here is made in coordination with your prescribing doctor. We will ask who is managing your treatment, and we will not proceed with anything they are not comfortable with.
It is not. Acne begins inside the follicle, below the surface, weeks before anything is visible. No amount of washing reaches it.
Over-washing does the opposite of what people hope. It strips the barrier, which increases inflammation, which worsens acne. If you are cleansing three times a day and scrubbing, you are almost certainly making it harder to treat.
Some people do. Many do not, and telling an adult with acne to wait it out has cost a lot of people years of unnecessary scarring. Adult acne is common, it is particularly common in women, and it is treatable at any age.
Dehydrated skin is not the same as oil-free skin, and stripping the surface does not switch off a sebaceous gland sitting deep in the dermis. What it does is damage the barrier and drive inflammation, which is the mechanism that produces the red, sore lesions in the first place.
A great many people who describe themselves as oily are actually oily and dehydrated at the same time.
A poorly chosen sunscreen can congest some skins. Sunscreen as a category does not.
UV worsens post-inflammatory pigmentation and undoes the results of nearly every treatment we perform, which makes sunscreen one of the most important products in an acne routine. The answer is to change the formulation, not to skip the step.
Stinging is irritation. Irritation is inflammation. Inflammation is the thing we are trying to reduce.
Effective actives can tingle mildly on application. Burning, persistent stinging, and tightness are signals to stop and ask, not badges of progress.
Usually what has actually happened is one of four things. The diagnosis was incomplete, and something other than acne was being treated. The plan was inconsistent. Treatment was too aggressive too early and the barrier gave out. Or it was abandoned during the adjustment phase, at around week four, right before it would have turned.
Start with a proper assessment. We will tell you honestly what we think is achievable.
Often, but not always.
The jawline and chin carry the highest concentration of androgen receptors on the face, which makes that area more responsive to hormonal fluctuation. If your breakouts are cyclical, deep, and clustered along the lower face, hormones are very likely part of the picture.
Friction, product residue, and under-cleansing along the jaw and neck also contribute, and in some people they are the whole story. That is what assessment is for.
Purging is congestion that was already forming being brought to the surface faster. It appears in the areas you normally break out, it usually begins two to six weeks after starting something new, and it typically settles within four to eight weeks with consistent use. It is generally not painful or itchy.
A reaction is different. It appears in places you do not normally break out, it comes with stinging, itching, burning, or widespread redness, and it does not settle.
If that is what you are seeing, stop and contact us. Knowing the difference is exactly what we are here for. You should not have to work it out alone from a video.
Because your skin is responding to a predictable hormonal pattern. In the second half of the cycle progesterone rises, sebum production increases, and skin becomes more reactive and more prone to inflammation. The flare usually lands in the last seven to ten days.
Worth knowing: what surfaces premenstrually often began forming weeks earlier. The hormonal shift is frequently what pushes it through rather than what caused it in the first place.
We assess progress across cycles rather than across weeks, because comparing week two to week four is comparing two different hormonal environments.
Give it eight to twelve weeks before judging a plan. Because of how long a lesion takes to form beneath the surface, earlier assessment is not measuring what you think it is.
Some people notice improvement in the first month. Others go through an adjustment period first.
The pattern is the giveaway. Fungal acne tends to be small, uniform, often itchy bumps clustered on the forehead, hairline, chest, or back, and it typically worsens with heat and sweat. It does not respond to standard acne treatment.
We will assess this properly rather than guessing, because the treatment approach is different.
Yes, with modifications, and there is more available than most people assume.
Generally suitable: LED, enzyme treatments, azelaic acid, niacinamide, benzoyl peroxide, barrier support and lymphatic drainage. Not performed: retinoids in any form, skin needling, IPL, and stronger peels.
Tell us at booking. We will build a plan around what is safe now and hold the corrective work until afterwards. There is a fuller explanation further up this page.
Yes, with careful protocol selection.
Deeper skin tones carry a higher risk of post-inflammatory pigmentation, which means treatment choice, strength, and progression need to be considered rather than standardised. Some devices and settings require additional caution.
This is exactly what consultation and patch testing are for.
You are never obligated, but we will be direct with you. In-clinic treatment without appropriate home care delivers a fraction of the result, and the professional ranges we stock are not available over the counter for a reason.
If budget is a consideration, tell us. We would rather prescribe three products you will actually use than eight you will not.
If you already own products, bring them in. We would far rather work out what is worth keeping than have you start again from nothing.
It can contribute for some people, and it is not the whole story for anyone.
The clearest evidence sits around high-glycaemic eating and, for some individuals, dairy. Both influence the hormonal signalling that drives oil production. What we will not do is tell you that a single food caused your acne, or hand you a restrictive plan on the basis of a trend. If diet appears to be a factor for you, that is a conversation to have properly with Alida.
Yes. We will talk through formulation and removal, because the way makeup comes off at night matters more than the makeup itself.
We hear this often. Usually it means the diagnosis was incomplete, the plan was inconsistent, treatment was too aggressive too early, or it was abandoned during the adjustment phase.
Start with a proper assessment and we will tell you honestly what we think is achievable.
Every acne plan at Plump begins with a full consultation. We assess your skin properly, discuss your history, medications, and lifestyle, explain what we believe is driving your breakouts, and build a plan with realistic expectations and clear timelines.
There is no cost and no obligation.
Book online, or call or text us on 0478 844 048
Plump Aesthetic Clinic
525 Chapel Street, South Yarra
www.plumpaestheticclinic.com.au
We see patients from South Yarra, Prahran, Windsor, Toorak, Armadale, Richmond, Malvern, St Kilda, and across inner Melbourne.
Reviewed by the clinical team at Plump Aesthetic Clinic
Caitlin King, Registered Nurse, Founder and Clinical Director. Ten years in cosmetic and skin medicine.
Belinda, Senior Dermal Clinician. Approximately ten years of industry experience.
Last reviewed: July 2026
We treat skin, not trends. Where we make a claim about what a treatment does, we want it to be traceable to something better than marketing.
The recommendations on this page are informed by current international guidelines and systematic reviews, alongside the clinical experience of our team. Where evidence is genuinely mixed, we say so rather than overstating it, and where your situation calls for medical rather than dermal care, we will tell you that too.
Key sources informing this page:
Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2024;90(5):1006.e1-1006.e30.
Spring LK, Krakowski AC, Alam M, et al. Isotretinoin and timing of procedural interventions: a systematic review with consensus recommendations. JAMA Dermatology. 2017;153(8):802-809.
Tan J, Almeida LMC, Bewley A, et al. Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel. British Journal of Dermatology. 2017;176(2):431-438.
Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. British Journal of Dermatology. 2020;182(5):1269-1276.
Schaller M, Almeida LMC, Bewley A, et al. Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. British Journal of Dermatology. 2017;176(2):465-471.
Barbaric J, Abbott R, Posadzki P, et al. Light therapies for acne. Cochrane Database of Systematic Reviews. 2016.
Polydeoxyribonucleotide (PDRN) in post-procedure recovery in aesthetic medicine: a narrative review. 2026.
Rattananukrom T, Tejapira K, Pomsoong C, Ratanapokasatit Y, Vachiramon V. Efficacy of microneedle fractional radiofrequency combined with topical insulin for the treatment of facial atrophic acne scars: a split-face, double-blinded, randomized, placebo-controlled trial. Journal of Cosmetic Dermatology. 2025.
McDonald KA, Shelley AJ, Pierscianowski T, Alavi A. A 2017 update: challenging the cosmetic procedural delay following oral isotretinoin therapy. Journal of Cosmetic and Laser Therapy. 2019;21(1):58-60.
Important information: All treatments described on this page require an individual consultation with a qualified practitioner to determine suitability. Results vary between individuals and depend on skin type, acne severity, underlying contributing factors, home care compliance, and the treatment plan followed. No result is guaranteed. All treatments carry risks and potential side effects, which will be explained to you in full before you proceed. This information is general in nature and is not a substitute for individual medical advice. If your acne is severe, painful, or scarring, please seek review from your GP or a dermatologist.
