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Because understanding changes skincare.
Understanding Your Skin - Free Guide
Free guide
From Elissa O'Keefe - Nurse Practitioner · Adj. Associate Professor · Founder
What your skin
actually needs.
Not a generic routine. Not another list of trending ingredients. This is the guide I wish had existed when I started dealing with acne at ten years old - and everything I now know from thirty years of treating it clinically.
E
Elissa O'Keefe
Nurse Practitioner · Adj. Associate Professor, University of Canberra
Founder, Science Skincare · Acne sufferer since age 10
Founder, Science Skincare · Acne sufferer since age 10
Based on my published book Breakout and thirty-seven years of clinical practice. Everything in here is the truth - not what I think you want to hear.
Before we begin
I want to tell you something before you read a single word of advice in this guide.
I have been where you are. I had my first pimple at ten years old. By the time I was a teenager, I was refusing to let my mother photograph me at family events. A boy in my art class did a portrait of me and drew oil wells on my face. I stood at the school bus stop rubbing my face with the fabric of my shirt to stop myself from scratching until it bled.
I became a Nurse Practitioner. I spent thirty years treating skin in clinical settings. I became an Adjunct Associate Professor. And for a long time, even with all of that knowledge, I still couldn't fix my own skin.
Not because I wasn't trying hard enough. Because I was approaching it the wrong way - the way the entire industry approaches it. Treating the breakout. Not the barrier underneath it.
That realisation is the foundation of everything in this guide. It's also the foundation of Science Skincare. And it's why I sit down one on one with people whose skin I genuinely want to help - not to sell them something, but to give them an honest answer about what's actually going on.
Work through this guide honestly. The skin profile section will help you identify what type of acne you're dealing with and what it actually needs. The ingredient section will tell you what works and what doesn't. The timeline will tell you what to expect - including the parts that are uncomfortable but important to know.
And if you want to talk it through with me personally, the information is at the end.
Truth. Trust. Time. That's what this is built on.
With love,
Elissa
Elissa O'Keefe
Nurse Practitioner · Founder, Science Skincare
What's in this guide
First - understand what
you're actually dealing with.
Acne is not one thing. The approach that works for comedonal acne (blackheads and whiteheads) is completely different from the approach for hormonal cystic acne. Most people are treating the wrong type - or treating multiple types as if they're one. Let's sort that out.
"The most common mistake I see is people with inflammatory acne using aggressive drying products designed for blackheads. They're not the same condition and they don't respond to the same treatment."
- Elissa
Step 1 - What does your acne look like?
Look at your skin now and identify what you can see.
Step 2 - Where does it appear?
Location tells us a lot about cause.
Step 3 - What triggers or worsens it?
Select the one that resonates most.
"Take note of what you've answered here. Your answers point directly to what your skin actually needs - and they're the same questions I ask in every clinical consultation."
- Elissa
Your skin profile - what
it means and what it needs.
Based on what you've identified above, find the profile below that sounds most like your skin. Read all of it - including what to do and what to stop. Many people have overlapping profiles; that's normal.
Hormonal - jawline, chin, predictable
Cyclical pattern · Deep cysts · Common in adult women
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What's happening in your skin
- Androgens (male hormones) are driving your sebaceous glands to overproduce oil. This happens even when your hormone levels test as "normal" - which is why blood tests for acne hormones are often unhelpful.
- The jawline is where hormonal acne concentrates because the oil glands there are most sensitive to androgen activity.
- Up to 85% of women experience premenstrual acne flares. It's extremely common and extremely undertreated.
- A skin barrier-first approach. Most hormonal acne products strip oil aggressively - this worsens barrier integrity and creates more reactivity, not less.
- Vitamin A (retinaldehyde or retinyl palmitate) - drives cell turnover, reduces the follicular clumping that creates cysts, regulates oil production at the source.
- Niacinamide (Vitamin B3) - regulates sebum and reduces inflammation without disrupting the barrier.
- Consistency over ninety days minimum. For women, two to three full menstrual cycles are needed to assess whether any treatment is working.
- Consider a conversation with a GP or Nurse Practitioner about the oral contraceptive pill or spironolactone if topical care alone isn't sufficient after ninety days.
- Aggressive drying spot treatments on cystic lesions - they cannot be reached from the surface and you'll only damage surrounding skin.
- Over-cleansing - it stimulates more oil production, not less.
- Expecting results in two weeks. Hormonal acne is driven by a monthly cycle. Three months is the minimum fair assessment period.
"I had a patient with hormonal acne who had seen four different doctors and been told it would resolve after her twenties. She was 38 when she came to see me. That advice is wrong. Hormonal acne in adult women is common, treatable, and deserves proper care." - Elissa
Barrier-compromised - reactive, sensitive, persistent
Skin feels tight after cleansing · Reacts to most products · Ongoing without clear trigger
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What's happening in your skin
- Your skin's protective barrier has been compromised - by previous aggressive treatments, over-cleansing, over-exfoliating, or just by the nature of acne-prone skin itself.
- A damaged barrier means the skin can't regulate oil, inflammation, or bacterial colonisation properly. The acne and the sensitivity are both symptoms of the same underlying problem.
- This is the most common profile I see in people who have "tried everything" - because everything they tried was targeted at the breakout, not at the barrier that was causing them.
- Stop treating aggressively. The first step is to stop doing harm. Give your barrier permission to recover.
- A gentle cleanser with a pH close to 5.5. If your cleanser leaves your skin feeling tight, it is damaging your barrier. Change it.
- Vitamin B3 (niacinamide) - the most important single ingredient for barrier repair in acne-prone skin. Reduces redness, regulates oil, and strengthens the skin simultaneously.
- Vitamin B5 (panthenol) - reduces trans-epidermal water loss and soothes compromised skin.
- Introduce Vitamin A very slowly - start at a low concentration (0.1–0.25%) and increase gradually. Pairing with niacinamide makes the transition much gentler.
- Moisturise. This is not optional for acne-prone skin. Skipping moisturiser tells your skin it is dry and triggers more oil production.
- Alcohol-based toners, astringents, and anything with perfume/parfum high in the ingredient list.
- Scrubs and mechanical exfoliants - your barrier does not need physical abrasion, it needs recovery.
- Slugging (applying petroleum jelly as the final step) - this traps bacteria and worsens acne-prone skin despite being trendy.
- Cleansing more than twice daily.
"If your skin is tight, red, reactive, and nothing seems to work - please hear this: that's not your skin being difficult. That's your skin asking you to stop stripping it." - Elissa
Stress-triggered - unpredictable, emotionally linked
Flares during difficult periods · Inconsistent pattern · Hard to predict
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What's happening in your skin
- Stress triggers inflammatory responses in the skin that worsen acne. It also disrupts the gut microbiome and increases androgen activity - both of which contribute to breakouts.
- This is a real, physiological relationship - not a myth and not something you can simply "stress less" to fix. I am aware that telling someone with acne to manage their stress is not very helpful. I've been there.
- Anti-inflammatory actives as the foundation - Manuka honey, chamomile, aloe vera, and niacinamide all reduce the inflammatory response in the skin at the surface level.
- A consistent routine regardless of skin state. Stress-triggered acne is worsened by reactive skincare changes - switching products every time there's a flare prevents any treatment from building the data it needs to work.
- Probiotic foods - yoghurt, kefir, kimchi, kombucha - support gut health and in turn skin microbiome balance.
- Find your thing and do it. For me it's dancing around the house and the garden. For someone else it's sport, prayer, a pet. The physiological reality is that stress management is part of acne management.
- Alcohol - it worsens inflammation and disrupts the gut microbiome, both of which directly impact acne.
- Blaming yourself when your skin flares during a hard period. Your skin is responding to your body's stress chemistry. That is not a personal failure.
"Stress-triggered acne is the one my patients feel most ashamed of - as if they're causing their own skin problems by not being calm enough. You are not. Your skin is doing what skin does under physiological stress." - Elissa
Congestion-led - blackheads, texture, T-zone
Bumpy texture · Enlarged pores · Forehead and nose · Non-inflammatory
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What's happening in your skin
- Excess oil (sebum) and dead skin cells are accumulating inside the follicle and forming comedones - blackheads (open) and whiteheads (closed). The dark colour of blackheads is melanin oxidising, not dirt.
- This is the earliest stage of acne. It doesn't always progress, but it can - and the right approach early prevents it from becoming inflammatory.
- Salicylic acid (BHA) - the most important ingredient for comedonal acne. It is oil-soluble, which means it can dissolve sebum inside the pore itself. Nothing else does this as effectively.
- AHAs (mandelic, lactic acid) - remove the top layer of dead skin cells that contribute to congestion and help BHAs penetrate more effectively.
- Vitamin A - prevents the follicular clumping of skin cells (hyperkeratinisation) that is the root cause of comedone formation.
- Non-comedogenic moisturiser. Skipping moisturiser triggers more oil production - the opposite of what you want for congested skin.
- Pore strips - they only remove the top of the blackhead. As soon as the remaining contents of the pore re-oxidise, the blackhead reappears within days.
- Comedogenic oils in skincare - cocoa butter, isopropyl myristate, mineral oil, and some vegetable oils can worsen congestion. Non-comedogenic oils like jojoba and macadamia are fine.
- Manual extractions at home - they can force bacteria deeper into the tissue, cause secondary infection, and contribute to scarring.
"Comedonal acne is the type most dismissed - 'it's just blackheads' - but it's also the type that responds best to the right early treatment. Get onto it properly and many people don't develop inflammatory acne at all." - Elissa
Mixed - multiple types, complex, long-standing
Tried many things · Multiple presentations · Long history
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What's happening in your skin
- Most people dealing with long-term acne are dealing with multiple presentations simultaneously - some hormonal, some barrier-related, some congestion, some inflammatory. This is why "one size fits all" routines fail. They are designed for one type, not all of them.
- Additionally, years of treatments and products have often added barrier compromise on top of the original acne presentation, making the picture more complex over time.
- A system approach, not individual products. Products designed to work synergistically address multiple types simultaneously. Individual products targeting single issues can actually counteract each other.
- A ninety-day commitment to one approach before assessing it. Mixed acne takes longer to respond because there are more factors to address. Switching too early is the single most common reason good treatments don't get a fair chance.
- Professional assessment. At this level of complexity, a conversation with a Nurse Practitioner, GP, or dermatologist is not optional - it's the most efficient thing you can do.
"If you've been dealing with this for years and your skin falls into multiple categories - this is exactly who I designed the Breakout Collection for. And it's exactly the conversation I have in a skin consult." - Elissa
Ingredients - what actually
works and what doesn't.
This is where most people get lost. The skincare industry lists hundreds of ingredients with equally bold claims. Here is what the clinical evidence actually says - and what I use in Science Skincare because it works, not because it photographs well.
Vitamin A (Retinal / Retinaldehyde)
Essential
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The gold standard for acne - clinically the most effective non-prescription ingredient available. Vitamin A prevents the follicular clumping of skin cells that creates comedones, reduces C. acnes bacteria, regulates oil production, and drives cell turnover to fade post-inflammatory marks.
What most people get wrong: concentration. Most over-the-counter retinol products sit at concentrations too low to drive real cell renewal. The most bioavailable and least irritating forms are retinaldehyde and retinyl palmitate - which is why these are in Science Skincare rather than basic retinol.
On the purge: initial increase in breakouts in weeks 1–3 is normal and a sign that the product is working. Most people stop here. Most people who stop here miss the result that arrives at week four. Pairing with niacinamide significantly reduces the adjustment response.
Pregnancy: The forms used in Science Skincare (retinaldehyde and retinyl palmitate) are not detectable in the bloodstream when applied topically. If in any doubt, consult your midwife or doctor.
Niacinamide (Vitamin B3)
Essential
+
One of the most versatile ingredients in acne skincare. Niacinamide repairs the skin barrier, regulates sebum production, reduces redness and inflammation, minimises pore appearance, and helps fade post-inflammatory pigmentation.
Why it's particularly important for acne-prone skin: it does all of this without disrupting the barrier - which means it can be used alongside active ingredients like Vitamin A to buffer their adjustment response. It is the ingredient that makes other ingredients work better.
Look for it at 2–5% in a formulation. Below that, the concentration is unlikely to have meaningful clinical effect.
Salicylic Acid (BHA)
Essential for congestion
+
The only beta hydroxy acid used in skincare, and the most important exfoliant for acne-prone skin. Salicylic acid is oil-soluble - which means it can penetrate inside the pore and dissolve the sebum that forms blackheads and congestion. AHAs (mandelic, lactic acid) work at the surface; salicylic acid works inside the follicle.
This distinction matters enormously. Surface exfoliants address what you can see; salicylic acid addresses what's forming underneath. Any acne routine without it is missing the step that prevents congestion from forming in the first place.
Concentration 0.5%–2% for daily use. Higher concentrations used in professional peels.
AHAs - mandelic, lactic acid
Important
+
Alpha hydroxy acids exfoliate the skin's surface by loosening the connections between dead skin cells, promoting their removal, and stimulating the skin to produce its own natural moisturising factors. They also help fade superficial post-inflammatory hyperpigmentation (brown marks).
Use alongside BHA, not instead of it. They address different levels - AHA at the surface, BHA inside the pore.
Sun sensitivity: AHAs increase UV sensitivity. Sun protection is not optional when you're using them. Every morning, regardless of weather.
Vitamin C (Kakadu Plum)
Important for pigmentation
+
Vitamin C is a powerful antioxidant that protects the skin from oxidative stress (which worsens acne-related inflammation), prevents sebum oxidation, helps fade post-inflammatory hyperpigmentation, and boosts collagen production to support healing.
The most potent natural source of Vitamin C is Australia's Kakadu Plum - it contains the highest known natural Vitamin C concentration of any food on earth. This is one of the reasons Science Skincare uses Australian botanicals as part of the formulation, not as decoration.
Combined with physical sun protection, Vitamin C provides significantly better protection against UV-induced damage - which matters because sun exposure worsens brown scarring.
Manuka Honey
Clinically supported
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Manuka honey is one of the only topical agents with a robust evidence base for both antimicrobial and wound healing activity. Studies have shown it inhibits the growth of C. acnes bacteria (the organism responsible for acne) as well as Staphylococcus aureus.
The active components - methylglyoxal (MGO) and hydrogen peroxide - provide the antibacterial effect, while the honey itself supports the skin's natural healing response and reduces inflammation.
Why this matters in a system: most antibacterial acne treatments are aggressive and disrupt the skin microbiome. Manuka honey provides antibacterial activity while simultaneously supporting barrier health - the combination that makes it genuinely useful rather than just trending.
Benzoyl Peroxide
Useful but use carefully
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Benzoyl peroxide (BP) is a widely used, safe, and effective acne therapy. It kills C. acnes bacteria and is one of the few treatments where bacterial resistance has never been reported - making it useful alongside antibiotics to prevent resistance developing.
Useful as a spot treatment for pustular acne. Less useful as the foundation of a routine because of its drying, barrier-disrupting effect at higher concentrations.
Start low (2.5%) and work up. Bleaches hair, clothing, and bed linen. Avoid applying at the same time as tretinoin (prescription Vitamin A) as it reduces its efficacy.
Diet - the dairy and sugar question
Partial truth
+
The honest answer: diets high in sugar (including fast food, alcohol, and most packaged foods) and consuming more than one serving of dairy per day have both been linked to increased breakouts in clinical research.
That is the extent of the dietary evidence. Every other dietary claim - elimination diets, specific foods, supplements, detox protocols - is not backed by good quality research. Twenty-four years of elimination diets, as one reader of my book told me, is not an unusual experience. And it rarely works.
My advice: reduce sugar and dairy moderately. Add probiotic foods (yoghurt, kefir, kimchi) to support gut health. See a nutritionist if you want to go further - not a blog post or TikTok account. Don't put yourself on a restrictive diet without professional guidance; the nutritional consequences of dramatically limiting food groups can affect bone health and overall wellbeing.
Hydroquinone (skin lightening)
Do not use
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Hydroquinone has long been considered the "gold standard" for skin lightening and is widely used for post-inflammatory hyperpigmentation (brown acne marks).
I no longer recommend it. University of Texas researchers have found that hydroquinone exposure is linked to a significant increase in skin cancers, including melanoma. Additionally, in melanin-rich skin, it can cause exogenous ochronosis - a greyish discolouration that is extremely difficult to improve.
There are safer and effective alternatives: Vitamin C, azelaic acid, niacinamide, and peptides (particularly Tetrapeptide-30) all address post-inflammatory pigmentation without these risks.
Physical scrubs and pore strips
Stop using these
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Scrubs: The physical abrasion of facial scrubs disrupts the skin barrier and causes inflammation - worsening the very condition they're marketed to treat. The idea that scrubbing opens comedones is not supported by evidence. If you like the feeling of a scrub, monthly microdermabrasion by a professional is a more effective and less damaging version of the same concept.
Pore strips: These remove only the top of the blackhead. The moment the pore contents re-oxidise (within days), the blackhead reappears. They don't address the cause of congestion and can damage skin around the pores with repeated use.
Replace both with salicylic acid and AHAs. They do the job chemically, without the damage.
Things to stop doing -
right now.
Forty years of personal experience and thirty years of clinical practice have taught me that there are specific behaviours that keep people stuck. Most of them are things the industry has told you are good ideas.
Stop this immediately
Squeezing, picking, and scratching. I know. I did it too. But squeezing forces bacteria deeper into the tissue, disrupts healing that has already begun, removes the collagen base of the repair, and is the single biggest contributor to the scarring that so many people are dealing with. If you struggle to stop, cover it with a pimple patch as a physical barrier, and do something that occupies your hands for two minutes. That is often enough to break the impulse.
Stop this immediately
Changing products before giving them ninety days. Medical-grade skincare takes ninety days to assess properly. For women, that's two to three menstrual cycles. Skin cell turnover takes fourteen to sixty days depending on your age. Switching products at week three because you haven't seen results is like stopping a course of antibiotics halfway through. It's not that the treatment didn't work - it's that you didn't give it the chance to work.
Stop this immediately
Mixing multiple brands of active ingredients. Medical-grade skincare ranges are designed to work synergistically. Stacking individual products from different brands, each with their own concentrations and pH levels, can cause irritation and counteract each other's efficacy. It is significantly less effective than a well-formulated system used consistently.
Stop this immediately
Trusting celebrities and mega-influencers. I'll say this plainly: celebrities are paid significant amounts of money to promote products. How many of them have ever dealt with real acne? The before-and-afters are filtered. The testimonials are paid. The results are fabricated. The regulatory bodies in the UK, USA, and Australia are increasingly fining beauty companies and influencers for false advertising - and the fines are growing. Walk past the celebrity-endorsed products in large chain stores. They are almost never the answer.
Stop this now
Skipping moisturiser because your skin is oily. Oily, acne-prone skin still needs moisture. When the skin is dry, it compensates by producing more oil - worsening the exact problem you're trying to address. A non-comedogenic moisturiser (one that won't block pores) is a non-negotiable part of an acne routine, not an optional extra.
"Every single one of those things I have done myself. I'm not here to judge - I'm here to save you the decades I spent learning them the hard way."
- Elissa
What to expect -
week by week.
Nobody tells you this clearly enough, so I'm going to. Acne treatment takes time - real time, not the "overnight results" time that the industry sells you. Here is what an honest clinical timeline looks like when you start a medical-grade skincare system.
"Truth. Trust. Time. The time part is the one that tests people most. But it is also the part that separates the treatments that truly work from the ones that merely promise to."
- Elissa
Days 1–7 - starting
Your skin is adjusting. This is not the time to judge.
New actives - particularly Vitamin A and AHAs - begin the process of accelerating cell turnover. Your skin may feel slightly different. Some mild tingling or sensitivity is normal in the first week, particularly with Vitamin A. Do not stop. Do not reduce application frequency yet. Stay the course.
Weeks 1–3 - the adjustment period
Your skin may look worse before it looks better. This is called purging.
As Vitamin A drives accelerated cell turnover, existing congestion and blocked pores come to the surface faster than usual. This looks like increased breakouts. It is not the product making your skin worse. It is the product working. Purging lasts approximately two to three weeks, heals quickly, and is not associated with worsening scarring.
This is the week most people stop. If you stop during the purge, you will never know whether the treatment would have worked - and the evidence suggests it would have. Stay with it. If the response feels extreme (not mild - extreme), contact a professional. But mild sensitivity and a temporary increase in breakouts is expected and normal.
Weeks 3–5 - the shift
Something starts to change.
The barrier begins to strengthen. Skin that was reactive and sensitive starts to settle. Breakouts are still present but may be less inflamed, shallower, and resolving faster. Most people notice a change in texture before they notice a change in breakout frequency - the skin starts to feel more resilient.
"Around week three I stopped checking the mirror every five minutes. The skin just felt calmer. I hadn't felt that in a long time." - Science Skincare customer
Weeks 5–8 - visible improvement
Active breakouts are reducing. Post-inflammatory marks are fading.
With the barrier strengthening and cell turnover normalising, the conditions that create breakouts are changing. Active breakouts reduce in frequency and severity. Vitamin A-driven cell turnover brings fresh skin to the surface, fading post-inflammatory pigmentation. Skin texture becomes noticeably smoother.
"By week five I was getting ready in fifteen minutes instead of forty. I hadn't realised how much of that time was managing my skin." - Science Skincare customer
Week 8–12 - the clinical milestone
This is when you assess properly for the first time.
Ninety days is the clinical standard for assessing whether a medical-grade skincare system is working. For women, this covers two to three menstrual cycles - enough data to understand how your skin responds across its full hormonal range. If you are not seeing meaningful improvement at ninety days, that is useful information. It means the approach needs to change - not that your skin is hopeless. That is the conversation to have with a professional.
"The first morning I got ready and didn't check the mirror again after I left the bathroom. First time in years. That's what I think about most." - Grace, Science Skincare customer
Beyond 90 days - what if it's not enough?
If topical care alone isn't cutting it, the next step is prescription support.
After ninety days of consistent medical-grade skincare, if the result isn't satisfactory, do not keep toughing it out - seek help. A GP or Nurse Practitioner can discuss topical retinoids, antibiotics (topical or oral), the oral contraceptive pill for women, spironolactone, or isotretinoin for severe cases. These are not last resorts. They are appropriate, well-evidenced options that many people benefit from significantly.
Elissa's golden rules for
choosing your skincare.
Developed from forty years of wasting money on products that didn't work. These questions are what I ask myself before recommending or using anything.
01
Is it stocked by reputable skin clinics?
If skin clinicians trust it enough to stock and recommend it to their patients, that's a strong signal that experts have done the homework for you.
02
Are the active ingredients at the right concentration?
A product can list an active ingredient and contain so little of it that it has no clinical effect. Look for transparency around percentages. If they won't tell you, ask.
03
Is perfume or parfum high in the ingredient list?
Ingredients are listed in descending order of concentration. Parfum near the top means significant amounts of potential skin sensitiser. Walk away.
04
Does it make claims about overnight results?
Acne cannot resolve overnight. Ninety days is the minimum honest assessment period. Any brand claiming faster results is lying to you. This is the easiest way to filter out the noise.
05
Is it endorsed by a celebrity or mega-influencer?
This is the biggest red flag in the skincare industry. They are paid to promote it. They don't necessarily use it. The results they show are typically filtered or fabricated.
06
Is the packaging more impressive than the formula?
I have seen brands spend more on the box than on the ingredients inside it. Fancy packaging adds cost and says nothing about efficacy. What goes on your skin matters. What it comes in doesn't.
07
Are the before-and-after photos verified and real?
Stolen before-and-afters are common. Filtered ones are universal. Look for documented, named, real results with consistent lighting and photography conditions.
08
Is it quick and easy to use?
A twenty-product, ten-step routine is not superior to a well-formulated four-product system. If a routine is so complex you're likely to skip steps, you won't get the result. Simplicity is not a compromise.
When to see a professional -
and which one.
People wait far too long to seek professional help for acne. The sooner you get appropriate support, the less scarring, the less cost, and the less emotional toll. Here is a clear guide to who does what.
"There is no medal for toughing it out alone. I did it for years. All I got was more scars."
- Elissa
| Professional | Best suited for |
|---|---|
| Beauty / skin therapist | Non-inflammatory and mild acne. Extractions, superficial peels, LED therapy, skincare routine advice. |
| Registered nurse | Mild to moderate acne. Medical-grade peels, deeper skin needling, LED therapy. |
| GP / Nurse Practitioner | Mild to severe acne. Prescription medicines - topical retinoids, antibiotics, the pill, spironolactone, isotretinoin referral. Professional peels and procedures. The right first call for most people. |
| Dermatologist | Moderate to severe acne, complex scarring. Isotretinoin. The specialist when GP-level care isn't sufficient. |
| Psychologist / therapist | Any time acne is affecting mental health, self-esteem, relationships, school, or work. This is not a last resort - it is appropriate, effective care and should not wait. |
Seek help immediately if any of the following apply:
Medical emergency
Sudden onset of severe, painful, ulcerating acne with fever and joint pain - this is Acne Fulminans and is a medical emergency. Go to an emergency department immediately.
Seek help now
Any signs of severe allergic reaction after starting a new skincare product or prescription medicine - difficulty breathing, swelling of the throat or tongue, persistent dizziness. Call emergency services.
Please reach out
Any thoughts of self-harm or suicide. Acne has been linked to these outcomes in research and clinical practice. You are not alone and you deserve support. Call the emergency number for your region or go to your nearest emergency department. In Australia: Lifeline 13 11 14.
Your skin is not
all that's affected.
The psychological impact of acne has been clinically shown to be equivalent to living with chronic asthma, diabetes, back pain, or arthritis. I don't say that to be dramatic. I say it because the people living with it know it's true, and they deserve to hear it said plainly by a clinician.
What acne can do to a person - and what that means for your care.
Research documents the following as outcomes associated with acne. If any of these feel familiar, that is not weakness. That is a normal human response to a condition that the world largely dismisses while privately devastating the people living with it.
- Low self-esteem and self-worth - documented across all ages, not just teenagers
- Social isolation - avoiding events, gatherings, and interactions because of skin
- Relationship difficulties - including avoiding intimacy and sexual connection
- Academic and professional impact - confidence in meetings, interviews, presentations
- Anxiety and depression - clinical, diagnosable conditions, not just "feeling down"
If your acne is affecting your mental health - even mildly - seeing a therapist, counsellor, or psychologist is appropriate care, not an overreaction. Do it alongside your skin treatment, not instead of it, and not only after "trying everything else first."
Please know this
Suicidal thoughts and attempts - this is documented in the literature and I have seen it in my clinic. It is real. If this applies to you, please reach out. In Australia: Lifeline 13 11 14.
"I think it's only my strength of character that has helped me climb up from this in my life. I want to make sure more people have the information and support to do the same - faster than I did."
- Elissa, from her preface to Breakout
Ready for a real conversation?
I'd like to look at
I'd like to look at
your skin specifically.
This guide gives you the framework. But your skin is individual - the triggers, the history, the barrier, what's been tried. A 15-minute consult with me is the conversation this guide is the preparation for.
Book a skin consult with Elissa$150 · Applied as credit toward the Breakout Collection · Not what I think you should buy - what your skin actually needs.