You were never unclean. Your pores did this.

Acne is one of the most common skin concerns there is — and one of the most misunderstood. Most of the advice people arrive with is wrong, or actively unhelpful. So before any treatment talk, here is the groundwork, drawn from Australian health guidance rather than a treatment menu.

Acne is not a hygiene problem

This is the myth that does the most damage. Acne is not caused by a lack of washing, and for most people food is not a common cause either.¹ Scrubbing harder, washing more often, or stripping your skin with harsh cleansers does not clear acne — it usually irritates the skin and makes things worse.

Acne is not only a teenage problem

Acne most commonly affects people aged 16 to 18.¹ Plenty of adults get it too. Adult acne is acne that carries on past the age of 18 to 20, or starts in adulthood.¹

Hormones play a part at any age. Androgen hormones enlarge the oil glands and increase the amount of oil they make,² and some people find their spots flare just before a period.² Breakouts can follow a pattern, and it is worth noticing whether yours do.

Other things that can play a part

Stress, family history, diet, certain medicines and being overweight can trigger acne.¹ Food is not a common cause, so treat this as a list of possible contributors.

Acne usually comes from several things working together. If your breakouts arrived suddenly, or you are concerned about other changes in your body, ask your GP.

What is happening in the pore

Acne starts inside the pore, not on the surface. A pore becomes blocked with a mix of dead skin cells and oil (sebum). Bacteria that live on everyone’s skin then multiply in that blocked pore, which triggers the redness and inflammation you see. Hormones — androgens in particular — can push oil glands to produce more oil, which is why breakouts often flare in the teenage years and around hormonal changes.^1,2

Not every spot is the same thing. There are four main types of spot: whiteheads, blackheads, pimples with pus, and painful nodules.¹ Cysts are also listed.² Shallower lesions (comedones, papules and pustules) are grouped apart from deeper nodules and pseudocysts.³

The difference matters because they behave differently. Individual lesions typically resolve in under two weeks, while deeper ones may persist for months.³ A deep, painful lump needs a different conversation than a whitehead does.

None of that is about being dirty. It is a combination of skin-cell turnover, oil, bacteria and hormones — most of which you cannot wash away.

Nothing here clears overnight, either. It often takes 2 to 3 months of treatment to see an improvement.¹ Anything that promises a clear face in days is promising more than the biology allows.

Why over-treating backfires

The instinct with a breakout is to hit it hard — layer on strong actives, exfoliate daily, dry it out. On acne-prone skin that often strips the barrier, prompts more oil, and leaves skin red and reactive. Two things quietly make acne worse over time: an aggressive, barrier-stripping routine, and picking. Picking at active spots is one of the clearest ways to turn a temporary breakout into a lasting scar.²

What a gentle routine looks like

The basics are simple: a gentle, soap-free, pH-balanced face wash twice a day, then moisturiser and sunscreen, removing makeup every night, and avoiding harsh soaps and picking.¹ In practice, that comes down to a few habits:

• Wash twice a day, not more. Wash the affected areas twice a day; too much cleansing can cause other skin problems.²
• Moisturise and use sunscreen after washing.¹ Use SPF50 or SPF50+, broad-spectrum, water-resistant sunscreen whenever the UV level is 3 or above.⁴
• Choose water-based, oil-free makeup, and take it off at night.^1,2
• Keep hair clean and off your face, because oil from the hair can make acne worse.²
• Leave the spots alone. Picking and squeezing can make pimples worse and lead to scarring.²

When products become the problem

If your skin is stinging or looking redder since you added something new, that is a sign to pull back rather than push through. It is also a good reason to have someone look at your skin in person.

Pharmacists can suggest over-the-counter options. See a doctor if acne does not improve with pharmacist-recommended treatments.¹

Marks, scars and what is the difference

These words are not interchangeable. Post-inflammatory marks, the redness or brown discolouration left after a spot, are temporary colour changes that “may improve with time, however this may take months or longer”.⁵

Scars are different. True scarring is permanent damage to collagen in the deeper layer of the skin: a loss of tissue rather than a surface colour change.⁵ Acne scars are usually permanent, although they may improve over time or with treatment.⁵

The kinds of scar

Most acne scars are atrophic, meaning they sit below the surrounding skin. There are three patterns: ice-pick scars, which are narrow and deep; boxcar scars, which are wider round or oval depressions; and rolling scars, which are wide with a sloping edge.⁵

Raised scars, called hypertrophic and keloid scars, involve excess collagen. They occur more often along the jawline and chest.⁵

What helps

Prevention has the strongest support. Timely, appropriate treatment during the active phase of acne can reduce how often scarring happens and how severe it is,⁵ and the best treatment for acne scarring is prevention.²

For scars that have already formed, Approaches include laser, chemical peels and skin needling.⁵ The right one depends on the scar type and your skin. Active, inflamed acne is a question for your GP first. You can read more in our guide to skin needling.

Everyday habits on the Gold Coast

Living on the Gold Coast means sun, heat and humidity, and it is easy to let the parts of a routine that feel like a chore slide when the weather is warm. A few habits carry most of the weight.

Start with sunscreen. Do not skip it because you are worried about breakouts: choose the one you will use consistently and apply correctly.⁴ If one does not suit your skin, try another rather than going without.

Hair and makeup matter more than most people expect. Oil from the hair can make acne worse, and water-based, oil-free makeup is better.² After a swim or a sweaty session, washing your face is reasonable, though the twice-a-day guidance still applies.²

When to see your GP

See your GP, who can treat acne directly or refer you to a dermatologist, if it is severe, painful, cystic, leaving scars, affecting your mental health, or not improving with pharmacist-recommended or over-the-counter treatments.^1,2 Untreated severe acne risks permanent scarring, and early treatment reduces that risk.^1,5

How Eila approaches acne-prone skin

We start with a skin assessment: a 30-minute First Consultation that looks at what is driving your acne, whether barrier damage from over-treating, hormonal patterns or product habits. From there we recommend a routine and a treatment, such as skin needling for acne scarring. Our Gold Coast climate adds its own wrinkles too — heat and humidity mean more sweat and heavier sunscreen, both of which can play into congestion.

What to bring to an appointment

A little preparation makes a skin assessment more useful. It helps to think about a few things before you come in:

• The products you use now, including cleansers, moisturisers, sunscreen and anything you use only occasionally.
• Anything you have tried in the past and how your skin responded.
• Any medicines you take, and any medical conditions, so we can see the whole picture.
• When your skin tends to flare, and whether there is a pattern.

Tell us the full story, including what went badly.